This K24 application is from a mid-career patient-oriented researcher with a research program focused on understanding the information needs of vulnerable patient populations and developing informatics-based self- management tools to promote health and prevent disease. This K24 application will build on my current portfolio of successful HIV research and enable me to focus on long-term objectives to broaden the scope of my research in the next phase of my career and to provide the protected time to mentor the next generation of nurse scientists in patient-oriented research (POR). Career Objectives: 1) Become a national and international leader in combining bio-behavioral and informatics approaches for the management of chronic illness, largely focusing on HIV-related illnesses, as a model for other underserved chronic illness populations; 2) Gain expertise in molecular genetics in symptom science to advance my program of research on informatics strategies to improve bio-behavioral health outcomes; 3) Transform my laboratory into a local, regional, national, and international center of excellence for precision nursing, bio-behavioral health interventions, and self-management of chronic illness; and 4) Implement an outstanding training program in POR in self- management and informatics for the next generation of nurse scientists. Mentoring Plan: Using an individualized training approach, which includes a needs assessment of core research competencies and an ongoing intensive evaluation process, each mentee will monitor their progress through an Individual Development Plan (IDP). They will also participate in several training modules tailored to their individual needs, e.g., Didactics; Focused Skills Training; Applied, Hands-on Training & Team Management; Research Dissemination; and Grant Writing and Study Development. The Research Strategy of this proposal focuses on incorporating biomarkers into my existing studies to augment the pace and scope of two HIV self- management trials and two HIV prevention trials. My mentees and I will work to achieve the following specific aims.
Aim 1 : Determine the extent that inflammatory cytokines, which may serve as biomarkers, are related to symptom burden in persons living with HIV.
Aim 2 : Explore changes in cortisol concentrations in hair as a hormonal response to changes in chronic stress over time in youth who are at high-risk for HIV.
Aim 3 : Conduct a pilot study to assess the feasibility of the ?mLab App Plus? which incorporates the use of the duplex HIV/syphilis point-of-care test. This research trajectory holds promise for enhancing behavioral health research by clarifying the influence of biomarkers as predictors of efficacy in our extant trials. Moreover, since HIV/AIDS research has recently been shown to yield dividends across medical fields, the proposed work with persons living with and at risk for HIV can easily be extended to other chronic illnesses, thus informing a wide array of learning opportunities for mentees. Through these aims, I will provide my mentees with practical experience in proposing, designing, and conducting POR in areas of self-management research that match their career goals.
This midcareer investigator award will provide protected time for Dr. Schnall to achieve the following three goals: 1) further develop her research program as an independent researcher by examining the influence of biomarkers as predictors of efficacy in her ongoing Randomized Clinical Trials; 2) use her research program as a platform to mentor and guide the careers of new nurse scientists and other Patient-Oriented Research investigators, thereby furthering the development of her leadership and mentoring skills; and (3) expand her mentoring activities to enhance and broaden interdisciplinary collaborations nationally and internationally.
