This revised application for a Mentored Research Scientist Development Award (K01) is designed to support the career of Laura Senier, MPH, PhD, an assistant professor at the University of Wisconsin-Madison. Dr. Senier's goals are (1) to obtain additional training in population genetics, public policy analysis, and ethical frameworks governing emerging genetic technologies;(2) to build a research program that explores technical, political, and ethical barriers in translating genetic discoveries to public health poliies and programs;and (3) to become an independent investigator in the politics of research translation. Dr. Senier will accomplish these goals through a combination of formal coursework, mentored collaboration, and empirical research on state public health policy. The research plan examines the modernization of public health genetics programs in state health agencies.
The specific aims are to (Aim 1a) describe the conceptual models, organizational structures, and financing solutions that state health agencies are using to modernize public health genetics programs;
(Aim 1 b) explore the opinions and attitudes of stakeholders about the scope and suitability of state public health genetics programs;
(Aim 2 a) through a comparative case study, identify the critical elements that impede or promote integration of genetics into public health;
and (Aim 2 b) explain how public health genetics programs vary under different structural arrangements, and show how the opinions of stakeholders influence public health genetics programming. In response to questions from study section reviewers, this revised application clarifies the sampling strategy and explains the analytic method of the qualitative comparative case study more thoroughly. The research will be based on original data collected via field observation, in-depth interviews, and archival analysis of state public health genetics activities n four states (Michigan, Connecticut, New York, and Utah). Dr. Senier has recruited an interdisciplinary mentor committee to guide her in these training and research activities. Dr. Pila Ossorio (Associate Professor of Law and Bioethics), Dr. Daniel Kleinman (Professor and Chair of Community &Environmental Sociology), Dr. Tom Oliver (Professor of Population Health Sciences), and Dr. D. Paul Moberg, (Director, Population Health Institute) will guide Dr. Senier in these endeavors. At the suggestion of study section reviewers, Dr. Nancy Cox (University of Chicago) and Dr. Peter Conrad (Brandeis University) are joining the mentorship committee to provide additional methodological guidance. Together, this committee of mentors has expertise in the emerging legal and ethical challenges in biotechnology;organizational and political barriers in science policy and health policy;and innovative research methods in comparative case study design and program evaluation research. They are eminently qualified and fully committed to assisting Dr. Senier in her multidisciplinary training, research, and career path.

Public Health Relevance

In the past decade, some state health agencies have begun modernizing their public health genetics programs to address both new scientific discoveries and emerging ethical issues in genetics (e.g., escalating demand for clinical services, workforce development, discovery of genetic markers for chronic disease). The proposed research will identify common elements that enhance capacity in public health genomics across states, and will clarify which elements may be unique or would work only in a particular state. This research will identify guidelines that will help states modernize public health genetics programs in ways that are ethical, equitable, and cost-effective. The NHGRI 2011 Strategic Plan argues that genomic medicine will only achieve its full potential to improve health when its innovations are available to all. States are important but understudied nodes in the nation's research translation network, and in a time of grave state budgetary constraints, it is critically important that we prepare state agencies to maximize partnerships and program resources in this ambitious goal.

National Institute of Health (NIH)
National Human Genome Research Institute (NHGRI)
Research Scientist Development Award - Research & Training (K01)
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Special Emphasis Panel (SEIR)
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Lockhart, Nicole C
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University of Wisconsin Madison
Schools of Medicine
United States
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Senier, Laura; Tan, Catherine; Smollin, Leandra et al. (2018) Understanding the potential of state-based public health genomics programs to mitigate disparities in access to clinical genetic services. Genet Med :
Doyle, Debra Lochner; Clyne, Mindy; Rodriguez, Juan L et al. (2018) Proposed outcomes measures for state public health genomic programs. Genet Med 20:995-1003
Senier, Laura; Smollin, Leandra; Lee, Rachael et al. (2018) Navigating the evidentiary turn in public health: Sensemaking strategies to integrate genomics into state-level chronic disease prevention programs. Soc Sci Med 211:207-215
Senier, Laura; Lee, Rachael; Nicoll, Lauren (2017) The strategic defense of physician autonomy: State public health agencies as countervailing powers. Soc Sci Med 186:113-121
Senier, Laura; Brown, Phil; Shostak, Sara et al. (2017) The Socio-Exposome: Advancing Exposure Science and Environmental Justice in a Post-Genomic Era. Environ Sociol 3:107-121
Senier, Laura; Kearney, Matthew; Orne, Jason (2015) Using Public-Private Partnerships to Mitigate Disparities in Access to Genetic Services: Lessons from Wisconsin. Adv Med Sociol 16:269-305
Senier, Laura; Shields, Michael; Lee, Rachael et al. (2015) Community-Based Family Health History Education: The Role of State Health Agencies in Engaging Medically Underserved Populations in Understanding Genomics and Risk of Chronic Disease. Healthcare (Basel) 3:995-1017