Promoting a Broad, Sustainable NIDDK-Supported Workforce through Mentoring Early Career Investigators: Focus on Health Outcomes

Children'S Hosp Of Philadelphia, Philadelphia PA

Investigators

Linked publications & trials

Abstract

Modified Project Summary/Abstract The broad, long-term objectives of this proposal are two-fold: 1) to provide high-quality mentoring to contribute to the career development of trainees from varying backgrounds and 2) to advance the quality, rigor and breadth of health outcomes research in transplantation and pediatric nephrology. For decades, it has been recognized that some children are less likely to receive kidney transplantation compared with others, especially from a living donor. Most published studies examining transplant access and outcomes have been limited in how they have measured social determinants of health (SDOH) and the majority of studies are descriptive with few providing actionable findings to overcome barriers to access. Further, proposed interventions are often targeted at the individual patient rather than the healthcare systems that contribute to access barriers. Another challenge to improving transplant access for all children lies in the limits of national data. Currently, national surveillance registries capture patients when they begin renal replacement therapy (United States Renal Data System) and when they are waitlisted or transplanted (Scientific Registry of Transplant Recipients), but not what happens during the time in between when patients must undergo transplant referral and evaluation to be deemed transplant eligible. Given this context, the transplant community has asserted a call to action to achieve access and outcomes in transplantation by improving rigor, quality and transparency in transplant-related health outcomes research. Dr. Amaral’s research proposal seeks to move from describing differences in access to improving transplant access and outcomes through research that leverages diverse study designs and varied data sources to identify potentially modifiable healthcare system barriers to transplant access. Two current projects will support this award. The REACH-TRANSPLANT study (R01 DK120886) examines differences that arise during recipient and living donor (LD) evaluation, LD selection, and LD follow-up related to healthcare system practices. The study has three aims and applies both primary and secondary data collection, large electronic health records, research cohort data and survey data. The second project, The House Calls Project, focuses on identifying and addressing adverse social determinants of health (SDOH) that interfere with pediatric kidney transplant evaluation completion. This study will use interview and survey data. These studies provide robust training opportunities in health outcomes research for Dr. Amaral as a mentor and for mentees across many levels and background, making this proposal ideally aligned with the overarching goals of the K26 award mechanism.