Journal of Clinical and Translational Science最新文献

The Duke Research Equity and Diversity Initiative (READI) was established in 2021 to engage Durham and surrounding communities in clinical research and build capacity to promote equitable access to research participation. Within READI, a voucher program was launched with the goals of increasing diverse participation in clinical research, improving community-partnered research, and enhancing community engagement. The vouchers leveraged a stand-alone, community-centered, outpatient research clinic, the Duke Research at Pickett (R@P) facility, which was originally opened to support COVID-19 trials. A formative evaluation of the voucher program was conducted with 3 voucher-awarded teams, READI personnel, and R@P staff. Data included 18 semi-structured interviews (n = 14) over two timepoints (Spring 2023, 2024). A rapid response analysis approach was used. Data indicate that READI voucher-awarded services were useful for voucher teams, with value for supporting community-engaged efforts, making research participation accessible, creating a community-centered and streamlined service facility, and personnel development benefits. Communication and flexibility of support services facilitated program implementation. Challenges occurred in service utilization logistics and incorporating community engagement into research support services. Ultimately, we find that a research support program with embedded community engagement support is feasible; this type of support can be integral in normalizing community-engaged research.

Introduction: Travel distance is a key barrier for patients to participate in clinical trials or receive cancer care. The National Cancer Institute (NCI) is a major funder of cancer research infrastructure through grant programs like the NCI Cancer Center (NCICC) and NCI Community Oncology Research Program (NCORP); however, the majority of US sites that care for people with cancer do not directly receive this funding.

Methods: Through geospatial analysis we examined patient distance to NCI-funded sites and evaluated demographic subgroups to identify potential disparities in access to research opportunities. We assessed whether new NCI support to previously unfunded sites could address identified barriers in access.

Results: NCI-funded sites tend to be in urban centers and are less accessible to low-income or rural patients. Nearly 17% of the US population over 35 years old would have to drive over 100 miles to obtain care at an NCI-funded site; only 1.6% would be beyond that distance when non-funded sites are added. For those below poverty level, the proportions are 20.2% and 1.9%, respectively. Several US regions, including the South and Appalachia, have particularly limited access to NCI-funded sites despite high cancer incidence, and much of the West and Great Plains are distant from any cancer facilities.

Conclusions: NCI could address travel distance as a major barrier to research participation by expanding the geographical footprint of its infrastructure funding using existing institutions in areas with identified gaps. Geospatial analysis at the census tract level is recommended and geospatial visualization can help identify strategic areas for interventions.

Background: Black or African Americans (AA) with Parkinson's disease (PD) are underrepresented in both care and research and experience significant health disparities. The existing literature provides limited guidance on how to enhance the engagement of AA individuals in PD care and research, particularly from the perspectives of AA patients, care partners, and healthcare providers. This project aimed to (1) describe the use of Community Engagement (CE) Studios as a community-engaged research approach to inform culturally appropriate and inclusive research and (2) examine factors influencing AA engagement in PD-related activities.

Methods: We conducted three CE Studios: one with AA with PD and care partners (N = 6), one with healthcare providers of AA with PD (N = 8), and one with AA with PD, care partners, and healthcare providers (N = 4).

Results: The CE Studios informed the design (e.g., cultural appropriateness) and conduct (e.g., accessibility) of the planned PD project, as well as identifying stakeholders to engage with, improving alignment between research and the AA community. We highlighted the importance of multifaceted factors, including environmental (e.g., segregation), biological (e.g., symptoms), sociocultural (e.g., not being invited), and behavioral (e.g., empowerment) domains, which influence AA engagement.

Conclusions: The CE Studios method is a feasible and useful approach for understanding the perspectives of AA in PD. It is possible to conduct an in-depth exploration of community perspectives by synthesizing comprehensive analyses and leveraging additional frameworks. These efforts include identifying barriers to engagement, recognizing locally relevant individuals, and refining PD-related care to enhance cultural appropriateness.

Background/objective: Point-of-care technologies (POCTs) have grown increasingly prevalent in clinical and at-home settings, offering various rapid diagnostic capabilities. This study presents findings from a nationwide survey conducted between November 2023 and January 2024, capturing clinician perceptions of POCTs.

Methods: The survey was distributed via email to healthcare professionals through academic and industry listservs and through LinkedIn posts. A total of 159 responses were analyzed.

Results: Core priorities, including accuracy, ease of use, and availability, remain consistently valued over the years. However, several perceived benefits, including continuous patient monitoring, diagnostic certainty, and patient management exhibited significant declines in agreement compared to previous years. Despite this, clinician perceptions of POCTs' abilities to enhance patient-provider communication remained stable. Evolving concerns may reflect heightened expectations and greater scrutiny as these technologies become commonplace. Agreement that POCTs may undermine clinical expertise increases, while concerns related to reimbursement and usability decline. Pilot questions related to artificial intelligence (AI) and machine learning (ML) indicated moderate openness to adopting AI-enhanced POCTs, particularly with tools offering novel clinical insights.

Conclusions: While POCTs continue to be an asset in clinical settings, the findings of this study suggest a shift in provider attitudes toward a more neutral standpoint. Limitations include a low response rate, self-selection, and missing demographic data from a subset of participants. Future surveys will further integrate AI/ML-related questions while prioritizing broader demographic and geographic reach.

Introduction: Community-acquired bacterial pneumonia (CABP) contributes significantly to mortality and healthcare costs worldwide. The use of guideline-concordant antibiotic therapy for CABP is associated with improved outcomes.

Methods: This was a retrospective cohort study of inpatients with CABP due to MRSA or P. aeruginosa in the All of Us database. The proportion of patients on guideline-concordant antibiotics or guideline-discordant antibiotics was compared within groups based upon patient age, sex, self-reported race, ethnicity, marital status, alcohol use, and tobacco use. Guideline concordance was determined using the 2019 IDSA/ATS CABP guidelines. Associations were further analyzed using multivariate logistic regression.

Results: A total of 336 patients with CABP due to MRSA (152) or P. aeruginosa (184) were included. Guideline-concordant antibiotic therapy was prescribed to 70% of CABP-MRSA patients and for 57% of CABP-P. aeruginosa patients. Independently predictive factors of guideline-concordant antibiotic prescribing for CABP-P. aeruginosa patients were Non-Hispanic Black (NHB) vs. Non-Hispanic White (NHW) race (odds ratio = 0.30, 95% confidence interval = 0.12 - 0.75).

Conclusion: In the All of Us database, the majority of CABP-MRSA and CABP-P. aeruginosa patients were prescribed guideline-concordant antibiotic therapy. Race was independently predictive of guideline-concordant antibiotic therapy for patients with CABP-P. aeruginosa, but not CABP-MRSA. NHB patients were less likely to receive guideline-concordant antibiotic therapy than NHW patients when treated for CABP-P. aeruginosa.

While community engagement (CE) has been increasing in the mental and behavioral health fields, evaluation of CE remains a challenge. Currently, there are no published evaluation tools that assess frequency of engagement, and many CE measures are not based on established engagement theories. Based on the International Association for Public Participation's CE continuum, the CE team of the Mental and Behavioral Health Institute (MBHI) at a large pediatric hospital developed a system of measurement to describe frequency of engagement across eight initiatives. This tool, the Frequency of Active Community Engagement (FACE) measure, was administered to the leaders of each of the participating MBHI teams. FACE summarized CE frequencies for three target populations (youth, caregivers, and community members) for each team. Follow-up team meetings provided additional descriptive information for the development of CE goals. In this special communication, we describe this data collection approach, CE results, as well as future directions and potential uses for FACE as an evaluation tool.

Introduction: Portfolio-level publication tracking collects research output from related programs. Tracking publications is imperative to evaluate the scholarly impact of a program, synthesize program findings, and document impact to funders. A valid tracking protocol increases data quality for accurate impact assessment, but there is little literature on publication tracking methods appropriate for assessing impact across multiple programs.

Methods: We tracked, managed, and evaluated publications from the National Institutes of Health-funded Rapid Acceleration of Diagnostics - Underserved Populations, which included over 137 projects and a Coordination and Data Collection Center. During the four-year project, we deployed a quarterly self-report survey to project leads and conducted twice-monthly searches for grant-related publications. Search strategies comprised a simple search of project grant numbers and an enhanced search. We evaluated the sensitivity and positive predictive value of search strategies compared to the surveys.

Results: Compared to the survey, the simple search was 21.5% to 27.4% sensitive with a positive predictive value between 81.1% and 95.8%. The enhanced search was 62.6% to 68.0% sensitive with a positive predictive value between 76.2% and 96.9%. Response rates declined over time from a maximum of 61.3% to a minimum of 32.8%.

Conclusions: The enhanced search increased specificity in identifying publications, but the survey was necessary to refine strategies and identify missed products. However, the enhanced search may have relieved participant burden in entering citations. These findings may be valuable for coordinating centers, academic departments, working groups, and other academic entities that must quantify the impact of their publications.

The fifteenth annual Science of Team Science Conference, "Insights on the Science of Team Science: 15 Years and Counting," was held virtually from July 30 to August 1, 2024. Two hundred participants from diverse backgrounds and sectors celebrated the evolution of team science and looked to the future. This paper presents a summary of the conference proceedings, highlighting keynotes, workshops, presentations, and posters that explored innovations in the science of team science. Notable topics included the integration of artificial intelligence (AI) in teams and methods for evaluating team effectiveness. The conference fostered networking opportunities through an interactive virtual platform, enhancing community building among attendees.