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

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

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-7 net votes
6 up votes
13 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

Implementation Research Workforce Addressing Health Inequities

What are the best strategies to develop a highly competent diverse Implementation Science research workforce to address health inequities?

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 :

• Enhance fundamental knowledge about new and trans-disciplinary D&I field.

• Improve understanding on ways to scale-up and deliver proven interventions to address health inequities.

• New knowledge generation regarding important adaptations of interventions implemented in the local context.

• Improve health outcomes, particularly in underserved populations in both the U.S. and abroad.

• Successful D&I research training programs will help ensure a competent diverse D&I research workforce.

• Identification of the most effective career timing and combination (balance) of discipline-specific and trans-disciplinary courses essential to develop a cadre of trans-disciplinary implementation science researchers.

Feasibility and challenges of addressing this CQ or CC :

Feasibility:

• Dedicated NHLBI Center to promote, develop, implement, and disseminate research findings to address heart, lung, blood, sleep-related conditions and diseases.

• Identified new approaches to creating partnerships with trans-disciplinary research teams that expand beyond academia and increased understanding of the unique nature of mentorship needed for this discipline.

• Experience from several other ICs can be leveraged to improve or ability to be successful and decrease our launch time.

• Field is gaining momentum because of the realization of the unsustainable economic burden of health inequities (expected to increase in the future) in the U.S.

 

Challenges:

 

 

• Dedicated training mechanisms are needed to develop and meet our current/future T4 research workforce needs to address health inequities.

 

• Resources needed that provide unique training approaches (e.g., a trans-disciplinary scientific training environment, knowledge and experience with health disparity populations, unique training faculty (mentor) composition and opportunities to train mentees as future D&I mentors, innovative research tools and research experiences, and broad and diverse partnerships.

 

• Unique linkages with practice settings across disciplines needed.

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

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11 net votes
20 up votes
9 down votes
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Goal 4: Develop Workforce and Resources

Need to train and nurture more "translators"!

One of the major challenges in translating from bench-to-bedside and back is communication: the ability of basic and clinical scientists to understand each other's scientific language to be able to appreciate the importance of the other’s research questions and findings.

Submitted by (@nhlbiforumadministrator1)

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

Details on the impact of addressing this CQ or CC :

Having an increased number of researchers able to connect dots across the continuum of translational research should increase overall success of translation of ideas into health.

Feasibility and challenges of addressing this CQ or CC :

This requires "rearranging" of already existing elements. Within 5-10 years of running specifically designed re/cross -training programs, the effects might be widely visible.

Basic scientists usually do not keep up with the latest outcomes of important clinical studies, and thus might miss important starting points for new basic research (e.g., negative trials that suggest the need for new hypotheses). The great majority of clinical scientists do not attend basic scientific sessions because are turned off by the specialized (dense/obscure) scientific terms used. Those who are interested in being translators have a hard time integrating and surviving in the "opposite camp" (i.e., at many medical schools, basic scientists are expected to bring in all their salary in a clinical department, and clinicians get little protected time for basic research)

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

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22 net votes
39 up votes
17 down votes
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Goal 4: Develop Workforce and Resources

NOVEL APPROACHES TO TRAINING IN SLEEP AND CIRCADIAN RESEARCH

Sleep and circadian disorders are relatively new areas of medicine. Most universities currently lack a critical mass of investigators to develop institutional T32 grants. Thus, there are, unfortunately, few such programs nationally. The Sleep Research Society has recognized this and is taking active steps to facilitate development of other T32 institutional training grants. This will not, however, help the majority ...more »

Submitted by (@jnoel0)

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 current status of research training in sleep and circadian disorders suggest that new approaches are needed. The field has developed one multi-center training grant to bring training to different institutions. This is focused on genetic/genomic approaches. It is run by the University of Pennsylvania which has a well developed program in this area. The fellows in training are, however, at other institutions, i.e., Johns Hopkins, University of Michigan and Stanford. Web-based approaches are used for work-in-progress seminars, grant development workshops and group mentorship, and didactic lectures. This strategy could be used more broadly to develop research training in other areas of sleep and circadian research. Stimulating this would have a major impact on research training in this new field of medicine.

 

Another relevant strategy would be to encourage adding slots in a competitive way for sleep/circadian research to other existing institutional T32 grants.

 

There are multiple mechanisms in place to communicate opportunities to the sleep/circadian academic community, i.e., Sleep-L, administered by the National Center for Sleep Disorders Research; Sleep Research Society biweekly blog; the Sleep Research Network. Specific encouragement of this approach would broaden the base for research training and would be of high impact.

Feasibility and challenges of addressing this CQ or CC :

The field of sleep and circadian research has had a long commitment to facilitating research training. The Sleep Research Society has hosted Trainee Day at our annual meeting for 20 years. The Sleep Research Society is funding early-stage investigators through its Foundation. The American Academy of Sleep Medicine runs, in collaboration with the NHLBI, an event at NIH for early-stage investigators in clinical research. The American Academy of Sleep Medicine Foundation has a “Bridge to K Award” program that provides funds to early-stage investigators who just missed funding on their first application for a K award. The Sleep Research Society has provided travel funds for early-stage investigators to attend recent workshops held by different NIH Institutes including National Heart, Lung and Blood Institute. Thus, there is no doubt of the commitment of the field and its professional organizations.

 

The impact of these new initiatives would be to broaden the base for research training beyond a few institutions. The number of institutions with a critical mass of investigators to mount successful T32 institutional training grants is not sufficient to provide the necessary future biomedical research workforce in this area. Novel approaches, based on modern communication IT technology, are needed.

Name of idea submitter and other team members who worked on this idea : Sleep Research Society

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142 net votes
209 up votes
67 down votes
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Goal 4: Develop Workforce and Resources

Career Development in "Group Based" Science

As the current chair of the Research and Training Division, I would like to convey that the AAAAI membership would like the NHLBI to consider the following in the development of its strategic plan:

 

NHLBI should be challenged on how best to provide career development grants to junior faculty involved in “group based” clinical and bench science.

Submitted by (@wheeze)

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

Name of idea submitter and other team members who worked on this idea : Mitchell Grayson on behalf of the American Academy of Allergy, Asthma, and Immunology

Voting

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

Training the new generation: not all about “big data” & "omics"

How do we attract more students/trainees into fields that are not popularized by “catchy” names?

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 :

Training the next generation of scientists

Feasibility and challenges of addressing this CQ or CC :

While the need to train the next generation of scientists in emerging fields (e.g. “omics” and “big data”), we should not overlook the need for nurturing “old fashioned” scientists (e.g. physiologists, integrative biologists) which are on the decline.

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

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23 net votes
35 up votes
12 down votes
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Goal 4: Develop Workforce and Resources

Bridge “translational gap”

Provide resources and training to improve the ability of scientists to bridge the “translational gap”. Continue and expand the VITA program.

Submitted by (@societyforvascularsurgery)

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

Name of idea submitter and other team members who worked on this idea : Society for Vascular Surgery

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5 net votes
7 up votes
2 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

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

Expanding the training efforts (e.g. greater number of funded summer programs, extend training beyond 2 summers, provision for 5-year grants so an additional cohort can be included) would be highly beneficial.

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 :

Expand training efforts by increasing number of programs. The PRIDE is now turning away outstanding applicants due to the limited number of training slots across the different program. Since each program is currently training as many scholars as is feasible given their current infrastructure and resources, a solution may include increasing the number of independent programs in the PRIDE or number of trainees a given program can support. This will lead to increasing the number of independent researchers in the health-related fields who come from diverse backgrounds. Flexibility to increase the training period: Some junior faculty need more assistance than others. Some trainees from less research-intensive institutions may have had fewer opportunities to participate in research and thus have less experience and fewer (sometimes no) publications. They would greatly benefit from an initial period dedicated to increasing core research skills and publications prior to proposing and seeking independent grant funds. In the long run, they will be more likely to succeed given the extended training since the PRIDE offers opportunities to collaborate with nationally known researchers and provides access to data resources and the possibility of increasing their publication record. Also, a small percentage of the slots may be reserved for repeat participation in structured manner that provides escalating levels of support.

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

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

Modernizing Research Training

As the current chair of the Research and Training Division, I would like to convey that the AAAAI membership would like the NHLBI to consider the following in the development of its strategic plan:

 

Since the focus of research has changed over the past decade, training programs need to be encouraged to use newer models of research in their training and mentoring of potential research faculty.

Submitted by (@wheeze)

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

Name of idea submitter and other team members who worked on this idea : Mitchell Grayson on behalf of the American Academy of Allergy, Asthma, and Immunology

Voting

10 net votes
23 up votes
13 down votes
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