The goals of the proposed projects are to support my continued development and impact as a mentor, to establish a research training program for patient oriented research (POR) in the Section of Rheumatology at my institution, and to expand my current POR program. Regarding the former, I am strongly committed to devoting a significant percent of my career to mentoring. Among the trainees I am currently working with, I am the primary mentor for 2 junior faculty (1 who is a K awardee), 2 rheumatology fellows interested in pursing a career in POR, and 3 residents planning a career in rheumatology. While my primary interest is in the field of decision making, my training and previous practical experience in epidemiology allow me to be an effective mentor for trainees interested in other aspects of POR related to rheumatic disease. Given my commitment to mentoring, Yale's rich resources dedicated to POR, and strong institutional support to create this program, the K24 Award provides an invaluable opportunity to expand my mentoring efforts and to establish a specialized structured POR curriculum. The program will ensure that fellows interested in becoming independent investigators will be supported by an interdisciplinary team of mentors and will acquire training in clinical research methods and biostatistics. In addition, I will establish a biweekly Research in Progress meeting during which trainees and faculty will be expected to present materials at all stages of development and offer constructive critiques during each session. The training program will include formal mentoring sessions which will adhere to a process for moving research forward. The POR training program will also include formal evaluation of trainees and mentors. In addition to mentoring young investigators, one of my important long-term goals is to advance my own research agenda so that I can continue to conduct scientifically rigorous and meaningful POR. I have established a defined area of expertise and a strong network of collaborators with complementary proficiencies that will support and enhance my research program. Current examples include collaborations with Dr. Curtis (UAB) with whom I have recently submitted a grant to develop individualized outcome estimates in rheumatoid arthritis, Drs. Reyna (Cornell) and Peters (Ohio State) who are basic science experts in decision making and are current collaborators on a project to develop a decision aid in rheumatoid arthritis, Dr. Almazor (MD Anderson) with whom I am working on 2 projects examining the value of conjoint analysis in patients with knee OA, and Dr. Street (Baylor College of Medicine) an internationally renowned expert on communication, who is a collaborator on a new research project: Measuring Patients'Risk Perceptions in Real Time. New planned studies will continue to focus on understanding the reasons underlying poor quality decision making in clinical practice and I will expand my current projects to include randomized controlled trials to test the efficacy/effectiveness of the tools developed.

Public Health Relevance

The goals of the proposed project are to support my continued development and impact as a mentor, to establish a research training program for patient oriented research in rheumatology at my institution, and to expand my current research program. I have found that mentoring persons from various backgrounds who share a passion to design high quality studies in order to improve the methods by which we deliver health care to be the most rewarding aspect of my job. The K24 Award would ensure that I have the protected time to be able to expand my current mentoring activities while continuing to advance my own patient oriented research program to improve medical decision making in patients with rheumatic disease.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Midcareer Investigator Award in Patient-Oriented Research (K24)
Project #
5K24AR060231-04
Application #
8698168
Study Section
Arthritis and Musculoskeletal and Skin Diseases Special Grants Review Committee (AMS)
Program Officer
Witter, James
Project Start
2011-07-01
Project End
2016-06-30
Budget Start
2014-07-01
Budget End
2015-06-30
Support Year
4
Fiscal Year
2014
Total Cost
Indirect Cost
Name
Yale University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
City
New Haven
State
CT
Country
United States
Zip Code
06510
Zak, Agnes; Corrigan, Cassandra; Yu, Zhi et al. (2018) Barriers to treatment adjustment within a treat to target strategy in rheumatoid arthritis: a secondary analysis of the TRACTION trial. Rheumatology (Oxford) 57:1933-1937
Dubov, Alex; Ogunbajo, Adedotun; Altice, Frederick L et al. (2018) Optimizing access to PrEP based on MSM preferences: results of a discrete choice experiment. AIDS Care :1-9
Hsiao, Betty; Binder-Finnema, Pauline; Benjamin Nowell, W et al. (2018) Preference phenotypes can be used to support shared decision-making at point-of-care for patients with rheumatoid arthritis: A proof of concept study. Arthritis Care Res (Hoboken) :
Dubov, Alex; Galbo Jr, Phillip; Altice, Frederick L et al. (2018) Stigma and Shame Experiences by MSM Who Take PrEP for HIV Prevention: A Qualitative Study. Am J Mens Health 12:1843-1854
Fraenkel, Liana; Nowell, W Benjamin; Stake, Christine E et al. (2018) The Impact of Information Presentation Format on Preferencefor Total Knee Replacement Surgery. Arthritis Care Res (Hoboken) :
Cozmuta, Raluca; Wilhelms, Evan; Cornell, Diana et al. (2018) Influence of Explanatory Images on Risk Perceptions and Treatment Preference. Arthritis Care Res (Hoboken) 70:1707-1711
Shrestha, Roman; Karki, Pramila; Altice, Frederick L et al. (2018) Measuring Acceptability and Preferences for Implementation of Pre-Exposure Prophylaxis (PrEP) Using Conjoint Analysis: An Application to Primary HIV Prevention Among High Risk Drug Users. AIDS Behav 22:1228-1238
Binder-Finnema, Pauline; Dzurilla, Kathryn; Hsiao, Betty et al. (2018) A Qualitative Exploration of Triangulated Shared Decision Making in Rheumatoid Arthritis. Arthritis Care Res (Hoboken) :
Seng, Elizabeth K; Grinberg, Amy S; Fraenkel, Liana (2018) Willingness to trade-off: An intermediate factor in patient decision-making regarding escalating care. Health Psychol Open 5:2055102918767718
Hsiao, Betty; Bhalla, Sonal; Mattocks, Kristin et al. (2018) Understanding the Factors That Influence Risk Tolerance Among Minority Women: A Qualitative Study. Arthritis Care Res (Hoboken) 70:1637-1645

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