Goal 2: Reduce Human Disease

Transforming Clinical Practice through Patient-Centered Medical Nutrition and Lifestyle Education

The fact that diet contributes significantly to prevention and treatment of disease is now a foregone conclusion. National and international guidelines offer evidence based recommendations advocating nutrients, foods and eating patterns that are most closely associated with reduced risk. Patients assume that physicians are knowledgeable regarding the role of diet in health and that they are trained to counsel patients ...more »

Submitted by (@lvanhorn)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

AHA/ACC guidelines subsequent to the NHLBI ATPIII all provide diet-related recommendations for improving public health that, if followed, could offer tremendous benefits in reduced disability, death and health care costs. However, imperative to the implementation of these life-saving recommendations, is an informed and educated provider base that is skilled in: assessment of patients’ diets and eating behaviors, evaluation of possible risk factor contributors and initiation of diet counseling or referral to a qualified nutritionist.

 

Nowhere is the opportunity greater to assess, evaluate and offer guidance towards improvement of key diet behaviors than in primary care. Patients perceive physicians as credible, respected sources of nutrition counseling. Physician endorsement of diet and lifestyle change favorably influences patient adherence. Research to evaluate patient-centered medical education and training programs is needed to evaluate and compare patient perception, health impact and health outcomes of these translational nutrition efforts. Ultimately, the goal is to further calculate and quantify the economic and personal benefits that accompany these strategies in order to implement transformed medical education aimed at preventive strategies.

Feasibility and challenges of addressing this CQ or CC :

This is a major challenge due to current medical training focused on diagnosis and treatment rather than prevention. Research is needed to demonstrate cost/benefit of transformative education and training that shifts the focus from treatment to prevention. Successful outcomes can provide preliminary evidence needed to promote a paradigm shift across -medical schools and allied health professions with the ultimate goal of - improving medical practice and quality of life. Evidence is needed that documents patient-centered impact resulting from this training and actual practice. Proposed is a comprehensive, team science approach to testing the results of nutrition and lifestyle medicine in primary care and the biomedical, behavioral and economic impact derived from it.

This represents an ambitious task requiring an academic medical center environment that not only has the educational aspect in place but also the capacity to provide the translational effort at the bedside and in outpatient settings to allow measurement of results. It requires leadership in multiple arenas and coordination between education and clinical application that are crucial to successful implementation. It further requires leadership and expertise in big data, economics, biostatistics and the accompanying technology required to

assess, analyze and report all of the aspects and components inherent in a project of this magnitude.

Name of idea submitter and other team members who worked on this idea : Linda Van Horn, PhD, RD

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3 net votes
7 up votes
4 down votes
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Goal 4: Develop Workforce and Resources

Translational training programs

The strategic vision to enhance translation and to enhance the workforce both require training that spans the scope of basic science, pre-clinical development, clinical trials. We lack coherent mechanisms for training the next generation of translational researchers, some of whom may be MDs, and some PhDs. A program should provide cross-training of Clinical Fellows and Postdocs to reflect the needed interactions between ...more »

Submitted by (@wjones7)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

The impact will trainees with more comprehensive exposure and involvement in translation of science from the bench to bedside. MDs will spend more time in labs or involved in pre-clinical work, PhDs will become CITI certified and assist with enrollment of clinical trials and trial design. Journal clubs will span the sciences, the clinical practice and the translational realm including regulatory and industry considerations. Trainees can use this background whether they go on in medicine, science, translation, or industry to fit and contribute to an increasingly translational medical bioscience field.

Feasibility and challenges of addressing this CQ or CC :

Feasibility must include a academic medicine environment active in translational biomedical science such that the mentors can include scientists, physicians and physician/scientists, some of whom are translators. Some of the scientists should be from industry and perhaps projects and funding can involve industry/Pharm as well these will benefit from an educated workforce. Challenges involve individuals at the sites putting the right teams together, but many Universities are doing this with incubators and translational units at present. This will further the clinical involvement to include Fellows in Fellowship programs in Cardiology, Medicine and Surgery.

Name of idea submitter and other team members who worked on this idea : Keith Jones

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27 net votes
38 up votes
11 down votes
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Goal 4: Develop Workforce and Resources

What Training Outcomes are Significant?

What trainee outcomes will best fulfill the mission of NHLBI, and what programs best promote these outcomes?

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

A significant number of trainees do not become independent researchers but enter other career paths whose impact on the mission of NHLBI is unclear. A better understanding of the importance of these outcomes and the role of NHLBI-supported training in relation to our mission will inform the implementation and design of training strategies in the future.

Feasibility and challenges of addressing this CQ or CC :

OER is rapidly implementing automated approaches to replace the manual tracking of trainees and their subsequent career paths. This effort should facilitate our ability to look specifically at NHLBI-supported programs.

 

 

Challenge: Obtaining and integrating outcome data that is not included in NIH databases or eRA Commons

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

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-6 net votes
10 up votes
16 down votes
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Goal 4: Develop Workforce and Resources

Training Programs Go Green

Training programs may consider a more green approach by producing easy to access on-line materials and resources to be shared with other training programs and trainees, with a common website repository where such information is archived.

Submitted by (@treva0)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

Analogous applications include the repositories for genome-wide data and results, and the PMCID repositories where publications using NIH support are stored. Archived information may include, e.g., training manuals and lectures (both PowerPoint presentation as well as audio-visual materials). Such a system would need a front end that describes the purpose and goals of the program for which the materials are developed, reference to the authors, copyright information (who has open access versus secured access), etc.

Name of idea submitter and other team members who worked on this idea : Treva Rice for the PRIDE (Programs to increase diversity among individuals engaged in health-related research): Joe GN “Skip” Garcia, Francisco Moreno Girardin Jean-Louis, Gbenga Ogedegbe, DC Rao, Victor Davila-Roman, Mohamed Boutjdir, Betty Pace, Juan Gonzales, Bettina M Beech, Keith Norris, Marino Bruce, Alicia Fernandez, Kirsten Bibbins-Domingo, and Margaret Handley.

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0 net votes
6 up votes
6 down votes
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Goal 4: Develop Workforce and Resources

Medical student research training in LMIC settings

What are the strategies for heart, lung, blood, sleep workforce to gain first-hand international experience in clinical research/implementation research training in low- and middle-income country (LMIC) settings?

Submitted by (@nhlbiforumadministrator1)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

• Among the students who earn medical degrees in the United States, very few of them have been sufficiently trained to address the health needs of the most vulnerable populations.

• An international exposure in an LMIC setting would have enormous impact on clinical practice and research

• Any medical student interested in broadening their training may have opportunities for clinical and non-clinical hands-on experience and in turn this would increase number of physicians and researchers in global health.

Feasibility and challenges of addressing this CQ or CC :

Feasibility: • The NHLBI has a wealth of experience in training and career development programs in general and has supported and worked with global centers of excellence in this area.

• This experience can be used to leverage international experience in clinical practice and research outcomes in LMIC settings.

 

Challenges: • NHLBI would have to develop additional training mechanism(s) to foster clinical practice and research in an LMIC area.

 

• Resources for this unique training may be a challenge.

 

• Helping patients from vulnerable populations would involve confronting cultural differences and language barriers.

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

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-30 net votes
5 up votes
35 down votes
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Goal 4: Develop Workforce and Resources

Expanding short term Junior Faculty Training Programs such as the Summer Training Programs for Junior Faculty (PRIDE): Focus

Expanding the base of the program foci (e.g. including NCI in addition to the current HLBS).

Submitted by (@treva0)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

Expanding the PRIDE program foci beyond NHLBI’s heart, lung, blood, and sleep foci, may involve a common-fund effort, for example by having multiple institutes involved in the program. It is well accepted that good research today is a collaborative effort that often reaches across institutes. For example, the research interests of several PRIDE/SIPID trainees were at the intersection of cardiology and areas such as cancer, diabetes and aging.

Name of idea submitter and other team members who worked on this idea : Treva Rice for the PRIDE (Programs to increase diversity among individuals engaged in health-related research): Joe GN “Skip” Garcia, Francisco Moreno Girardin Jean-Louis, Gbenga Ogedegbe, DC Rao, Victor Davila-Roman, Mohamed Boutjdir, Betty Pace, Juan Gonzales, Bettina M Beech, Keith Norris, Marino Bruce, Alicia Fernandez, Kirsten Bibbins-Domingo, and Margaret Handley.

Voting

10 net votes
14 up votes
4 down votes
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Goal 4: Develop Workforce and Resources

How will we train younger generation of scientists with skils in understanding the glycans?

Recent results suggests that glycans play critical roles in human physiology and pathology. Understanding glycan protein interactions may lead to next generation of drugs. But limited research is being funded on understanding structure - function relationships on glycans. Likewise, we are training very few researchers in the glycosciences. More programs are needed to impart glycoscience knowledge at the undergraduate, ...more »

Submitted by (@urdesai)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Name of idea submitter and other team members who worked on this idea : Desai

Voting

-21 net votes
6 up votes
27 down votes
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Goal 4: Develop Workforce and Resources

Preparing a Diverse Biomedical Technology Development Workforce

How do we best develop a scientific workforce that is fluent in product development and commercialization issues? How can NHLBI best expand the training opportunities for early career scientists to prepare them for entry into the dynamic biomedical workforce landscape? There is a need for scientifically-trained experts from diverse backgrounds who also understand business needs relevant to biomedical technology development, ...more »

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

A well-trained biomedical technology development workforce would enhance the quantity and quality of research translated from the lab to the market focused on heart, lung, blood, sleep indications. A better understanding of the product development pathway would improve efficiency and resource usage, and accelerate the time for products to reach the market. Structured training would better prepare academic scientists for industry collaboration and provide an industry-ready scientific workforce. Ensuring these training opportunities are inclusive of scientists from different backgrounds would increase the diversity of the biomedical technology development workforce.

Feasibility and challenges of addressing this CQ or CC :

Industry is a large employer of research trainees, and trainees are becoming increasingly vocal about their interest in opportunities to be trained in areas beyond the academic lab that would prepare them for roles in industry. NHLBI can leverage recently launched educational opportunities, including the BEST (Broadening Experiences in Scientific Training), NCAI (NIH Centers for Accelerated Innovations), REACH (Research Evaluation And Commercialization Hubs), and CTSA (Clinical and Translational Science Awards) programs.

Transitioning scientific discoveries to inventions and products to benefit public health requires knowledge and education beyond what is traditionally learned during medical, graduate, and post-doctoral training.

 

Challenges to addressing this CQ include:

 

• Need for educators and mentors with relevant industry experience and expertise.

 

• This would be a culture shift in academic institutions, though the new NIH programs described above has already started to influence this shift.

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

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0 net votes
19 up votes
19 down votes
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Goal 4: Develop Workforce and Resources

Training Mentors and Protégés to create a T4 translation pipeline

How can training of investigators (both mentors and trainees) be supported to create a T4 translation research pipeline?

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

A robust global T4 translation research community would be developed that would help translate proven-effective interventions for use in populations for a positive health impact

Feasibility and challenges of addressing this CQ or CC :

The NHLBI Global Health and Health Inequities Think Tanks identified T4 translation research as an important area that needs development in the very near future.

 

However, conducting high quality T4 research requires a research community focused in this area. Currently, very few researchers are working in this area. The T4 research community needs to be identified so capacity can be established for conducting T4 research. Incentives would need to be developed to maintain a robust global T4 research community.

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

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-7 net votes
6 up votes
13 down votes
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Goal 4: Develop Workforce and Resources

Developing/adapting training programs to address future areas of critical need

What are the best methods to identify future training areas and develop/adapt training and mentorship programs to address future critical needs?

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

• Increased return on investment

• Cross-fertilization/cross pollinate with other ICs

Feasibility and challenges of addressing this CQ or CC :

High feasibility but may require pilot projects, marketing and dissemination

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

Voting

8 net votes
16 up votes
8 down votes
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Goal 4: Develop Workforce and Resources

Enhancing T4 Implementation Research Expertise

We need to increase our base of T4 implementation research expertise among researchers, reviewers, and investigators.

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

Increase our base of expertise in a relatively new field. Increase the number of funded grants and projects that include T4 implementation research.

Feasibility and challenges of addressing this CQ or CC :

Additional training for T4 implementation research can be added to the training infrastructure currently in place at the NHLBI/NIH.

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

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-6 net votes
4 up votes
10 down votes
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Goal 4: Develop Workforce and Resources

What should mentors report?

There is a need to establish markers that are predictive of future trainee success.

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

Instructions to Mentors for K Awards and Sponsors for F awards for reporting on the progress of their trainees in RPPR non-competitive renewal applications are very general. Developing more specific criteria and rankings should better predict future stars. Having more explicit training criteria throughout the life of a program could improve the overall quality of the mentoring and the training within the program.

Feasibility and challenges of addressing this CQ or CC :

Five to ten years is sufficient time to track a representative sample of programs to develop criteria to be tested.

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

Voting

-7 net votes
6 up votes
13 down votes
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