WELCOME TO THE 111th MEETING OF
THE NATIONAL ADVISORY COUNCIL
FOR NURSING RESEARCH AND SPECIAL
WELCOME TO OUR COUNCIL MEMBERS
AND OUR NINR SCIENCE COMMUNITY.
THIS MEETING IS BEING VIDEOCAST
LIVE AND ARCHIVED ON THE NIH
VIDEOCAST WEBSITE.
THANK YOU ALL FOR JOINING US
TODAY.
SO WE HAVE A NEW EXOO
EX-OFFICIO MEMBER AND SENIOR
ADVISER TO THE DEAN AND
ASSISTANT PROFESSOR IN THE
DANIEL K GRADUATE SCHOOL OF
NURSING AND THE UNIFORM SERVICES
UNIVERSITY OF THE HEALTH
SCIENCES.
LIEUTENANT COLONEL GARDNER ALSO
SERVES AS THE CONSULTANT.
HE RECEIVED A DIRECT COMMISSION
INTO THE AIR FORCE MEDICAL
SERVICE AS A FAMILY NURSE
PRACTITIONER IN AUGUST 2008.
AFTER A COLD WAR ERA IN
ENLISTMENT AS A MEDICAL SERVICES
SPECIALIST FOLLOWED BY A
CIVILIAN CAREER IN TEXAS LOCAL
PUBLIC HEALTH.
AFTER RETURNING TO ACTIVE DUTY
HE SUPPORTED CONTINGENCY
OPERATIONS IN AFGHANISTAN.
WELCOME TO THE COUNCIL
LIEUTENANT COLONEL GARDENER.
NOW I'LL TURN THE MEETING OVER
TO ELIZABETH TARLOV THE
EXECUTIVE SECRETARY WHO WILL
PROCEED WITH MEETING LOGISTICS.
DR. TARLOV.
>>THANK YOU, DR. ZENK.
GOOD MORNING AND WELCOME.
I WILL NOW DO A ROLL CALL OF
COUNCIL MEMBERS TO ENSURE WE
HAVE A QUORUM FOR TODAY'S
MEETING AND PLEASE TURN ON YOUR
CAMERA AND SAY PRESENT OR HERE.
>>PRESENT.
>>THANK YOU.
COUNCIL MEMBERS IN THE ROOM,
PLEASE RAISE YOUR HAND AND SAY
PRESENT OR HERE WHEN I CALL YOUR
NAME.
DR. MUNRO.
>>PRESENT.
>>DR. STONE.
>>PRESENT.
>>DR. FITZPATRICK.
>>PRESENT.
>>DR. AYALA.
>>PRESENT.
>>PROFESSOR DAWES.
>>PRESENT.
>>DR. ATKINS.
AND AS EX-OFFICIO DR. SULLIVAN
AND LIEUTENANT COLONEL GARDNER.
>>PRESENT.
>>THANK YOU.
DR. ZENK WE HAVE QUORUM FOR THIS
MEETING.
DOCTORS PROVENCIO-VASQUEZ AND
DR. MALLORY JOHNSON WERE UNABLE
TO BE WITH US TODAY.
NOW, ON TO SOME LOGISTICS.
DATES FOR FUTURE COUNCIL MEETING
ARE LISTED ON THE NISH COUNCIL
WEB PAGE AND OPEN MATERIAL IN
THE ELECTRONIC COUNCIL BOOK.
ADD THE DATES TO YOUR CALENDAR.
THE NEXT MEETING IS JANUARY 25,
2024.
THIS WILL BE A VIRTUAL MEETING.
I WANT TO REMIND COUNCIL MEMBERS
OF A THEN EX-OFFICIO YOU ARE
SPECIAL GOVERNMENT EMPLOYEES.
AS SUCH -- I BEG YOUR PARDON AS
SUCH YOU MAY NOT ENGAGE IN
LOBBYING ACTIVITIES WHILE
RECEIVING PAY FROM THE FEDERAL
GOVERNMENT.
FURTHER INFORMATION ON CONFLICT
OF INTEREST AND CONFIDENTIALITY
REQUIREMENTS ARE IN THE COUNCIL
BOOK TO PLEASE REVIEW THOSE IF
YOU HAVEN'T DONE SO ALREADY.
I'LL GIVE MORE SPECIFIC
INSTRUCTIONS ABOUT CONFLICT OF
INTEREST AND CONFIDENTIALITY AT
THE BEGINNING OF THE CLOSED
SESSION LATER THIS AFTERNOON.
NOW, I'LL TURN IT BACK TO
DR. ZENK FOR THE NINR DIRECTOR'S
REPORT.
>>THANK YOU, ELIZABETH.
I'M PLEASED TO SHOW WHAT'S BEEN
GOING ON AT NINR SINCE OUR LAST
COUNCIL MEETING.
WE'LL START WITH AN UPDATE ON
OUR STRATEGIC IMPERATIVE.
IN JANUARY WE ANNOUNCED FIREARM
INJURY PREVENTION AS OUR FIRST
STRATEGY IMPERATIVE UNDER THE
2022, 2026 NINR STRATEGIC PLAN.
FOUR NINR STRATEGIC IMPERATIVE
IS AN ONGOING INVESTMENT IN A
SPECIFIC AREA OF RESEARCH THAT
IS ALIGNED WITH NINR'S MISSION
AND CAN BE VIEWED THROUGH MOST
IF NOT ALL THE STRATEGIC LENSES
OF OUR MILLION AND HAS THE
POTENTIAL TO MAKE A DIFFERENCE
IN ADDRESSING OUR NATION'S MOST
PRESSING HEALTH CHALLENGES.
WE CHOSE FIREARM INJURY
PREVENTION AS OUR FIRST
STRATEGIC IMPERATIVE BECAUSE
RESEARCH ON THIS TOPIC IS ALI
ALIGNED WITH NINR'S UPDATED
MISSION TO LEAD NURSING RESEARCH
AND SOLVE PRESSING HEALTH
CHANCES AN INFORM PRACTICE AND
POLICY OPTIMIZING HEALTH AND
ADVANCING HEALTH EQUITY INTO THE
FUTURE.
AND BECAUSE WE BELIEVE NURSING
RESEARCH OFFERS AN IMPORTANT
PERSPECTIVE GIVEN THAT WORK TO
PREVENT FIREARM INJURIES AND
THEIR RELATED HEALTH SEQUELAE
MUST BE SITUATED WITHIN THE
SETTING NURSES PRACTICE
INCLUDING HOMES, SCHOOLS,
WORKPLACES, CLINICS, JUSTICE
SETTINGS AND THE COMMUNITY.
THIS IS CERTAINLY ONE OF OUR
NATION'S MOST PRESSING HEALTH
CHALLENGES.
CONSIDER THAT FIVE ARM DEATHS
ROSE BY 35% DURING 2020 REACHING
THE HIGHEST LEVEL EVER RECORDED
IN THE UNITED STATES.
FIREARM INJURY AND DEATH ARE
ALSO CONCERNING FROM A HEALTH
EQUITY PERSPECTIVE.
IN 2020 COUNTIES WITH THE
HIGHEST POVERTY LEVEL HAD
HOMICIDE RATES 4.5 TIMES AS HIGH
AS COUNTIES WITH THE LOWEST
POVERTY LEVEL AND MORE THAN HALF
OF ALL BLACK TEENS WHO DIED IN
2020 WERE KILLED BY FIREARMS.
THE URGENCY OF THIS PROBLEM IS
ONLY INCREASING.
FOR EXAMPLE, PUBLISHED JUST THIS
YEAR SHOW SOCIAL VULNERABILITY
IS STRONGLY ASSOCIATED WITH
PEDIATRIC SHOOTING INCIDENTS.
YOU CAN SEE IN THE HEAT MAP THAT
DISPLAYS THE CDC'S SOCIAL
VULNERABILITY INDEX AND THE TOP
ROW AND PEDIATRIC SHOOTING
INCIDENTS IN THE BOTTOM ROW.
AND YET PEDIATRIC PRIMARY CARE
SCREENING FOR FIREARM ACCESS OR
PREVENTION COUNSELING STILL
RARELY OCCURS IN EVEN THE MOST
AT RISK AREAS.
AT NINR WE ARE TAKING STEPS
FORWARD IN ADJUSTING FIREARM
PREVENTION.
SO TO LEARN MORE ABOUT THE AREA
OF RESEARCH NINR HOSTED A
WORKSHOP IN NOVEMBER OF 2022.
AFTER TWO DAYS OF PRESENTATIONS
FROM LEADING RESEARCHERS IN THE
AREA WE IDENTIFIED TWO CRITICAL
THEMES.
FIRST, FIREARM VIOLENCE
PREVENTION IS A PRESSING PUBLIC
HEALTH CHALLENGE AND A MAJOR
HEALTH EQUITY ISSUE DEEPLY
INFLUENCED BY THE SOCIAL
DETERMINATES OF HEALTH WITH
STRUCTURAL AND HISTORICAL ROOTS.
SECOND, THE POTENTIAL RETURN ON
INVESTMENT FOR RESEARCH IN THIS
AREA BY NURSE SCIENTISTS AND FOR
RESEARCH RELATING TO NURSING
PRACTICE IS HIGH.
NINR STAFF TRANSLATED THESE
THEMES FROM THE WORKSHOP INTO
ACTION TO REVIEW THE FINDINGS
AND COLLAPSE THESE PRIORITIES
INTO BROADER RESEARCH AREAS WITH
THE HIGHEST SCIENTIFIC
POTENTIAL.
THREE KEY AREAS FOR IMMEDIATE
ACTION EMERGED.
FIRST, USE EXISTING RESEARCH
INFRASTRUCTURE TO EXPAND INTO
FIREARM INJURY PREVENTION.
SECOND, INVEST IN THE
DEVELOPMENT OF A CADRE OF
RESEARCHERS PREPARED TO DO THIS
WORK.
THIRD, ADDRESS THE GAP IN
RESEARCH AND COMMUNITY HEALTH
CARE.
FOLLOWING THE WORKSHOP WE FIRST
DEVELOPED TWO CONCEPTS WE
BELIEVE ADDRESS SOME OF THE
PRIORITIES SHARED WITH US BY
WORKSHOP PARTICIPANTS AND WHICH
WE SHARED WITH YOU WHEN WE
ANNOUNCED THE STRATEGIC
IMPERATIVE IN JANUARY THERE AND
THE FIRST WAS BUILDING CAPACITY
FOR FIREARM PREVENTION RESEARCH
AND THE SECOND CONCEPT GREW TO
REDUCE FIREARM INJURY AND
RELATED HEALTH SEQUELAE DURING
THE PREVENTIVE INTERVENTIONS AND
COMMUNITY HEALTH CARE SETTINGS.
ADDRESSING THIS URGENT PUBLIC
HEALTH CRISIS REQUIRES RIGOROUS
RESEARCH IN FIREARM INJURY
PREVENTION.
WORK THAT MUST BE CONDUCTED BY
HIGHLY TRAINED SCHOLARS USING
INNOVATIVE METHODOLOGICAL
APPROACHES APPROPRIATE TO THE
COMPLEX NATURE OF THE PROBLEM.
TO ADDRESS THE LACK OF
RESEARCRESEARCH
ERS PREPARED TO DO THIS WORK AND
START TO BUILD CAPACITY, WE
RELEASED A NOTICE OF SPECIAL
INTEREST IN MARCH FOR
ADMINISTRATIVE SUPPLEMENT TO T32
INSTITUTIONAL TRAINING GRANTS.
ADMINISTRATIVE SUPPLEMENTS HAVE
A RELATIVELY SHORT TURN AROUND
THIS WHICH ALLOWS A MORE NIMBLE
REASON AND WE ARE FUNDING A
SUPPLEMENT AT COLUMBIA
UNIVERSITY TO MENTOR STUDENTS
AND FIREARM PREVENTION AND
HEALTH DISPARITIES IN INJURY.
A NOTICED A FUNDING OPPORTUNITY
TO SOLICIT APPLICATIONS TO
ESTABLISH SHORT COURSES IN
FIREARM INJURY PREVENTION TO
PREPARE NURSE SCIENTISTS AND
ALIGN FIELDS CONDUCT FIREARM
INJURY PREVENTION RESEARCH.
THIS FUNDING OPPORTUNITY SHOULD
BE OUT IN THE NEXT FEW DAYS SO
STAY TUNED.
AND WE HOPE THAT THEN AWARDS
WILL BE AVAILABLE NEXT SUMMER.
SO FREQUENTLY THE FIRST HEALTH
CARE CONTACT FOR INDIVIDUALS
SEEKING CARE ESPECIALLY IN
COMMUNITIES SETTINGS ARE NURSES.
THEY ARE TRAINED AS ADDRESSING
PHYSICAL HEALTH AND IDENTIFY
RISK FACTORS FOR INJURY.
AS I MENTIONED THERE IS A
CRITICAL GAP IN RESEARCH RELATED
TO FIREARM INJURY PREVENTION AND
COMMUNITY HEALTH CARE SETTINGS.
JUST A COUPLE WEEKS AGO IN
SEPTEMBER 1 WE FUNDED A FUNDING
OPPORTUNITY FOR FIREARM INJURY
PREVENTION RESEARCH IN COMMUNITY
HEALTH CARE SETTINGS.
UNDER THIS INITIATIVE, NINR IS
INTERESTED IN CREATIVE
APPROACHES TO FIREARM INJURY
PREVENTION THAT CAPITALIZE ON
COMMUNITY HEALTH CARE SETTINGS
TO IDENTIFY RISK FACTORS, REDUCE
EXPOSURES IN INDIVIDUALS,
FAMILIES AND COMMUNITIES AND
PREVENT INJURY AND REOCCURRENCE
OF INJURY AS WELL AS MITIGATING
HEALTH DISPARITIES.
THIS OPPORTUNITY ENCOURAGES
APPROACHES THAT MAXIMIZE THE
CONTRIBUTIONS OF NURSES AND
INTEGRITIES THE PRINCIPLES OF
HOLISTIC NURSING CARE.
THE FIRST ROUND OF APPLICATIONS
IS DUE NOVEMBER 7 WITH A SECOND
ROUND OF APPLICATIONS DUE ON
JULY 26.
SO LET ME HIGHLIGHT ONE OF THE
STUDIES ALREADY IN NINR'S
RESEARCH PORTFOLIO FOCUSSED ON
FIREARM INJURY PREVENTION.
IN THIS MIXED METHODS STUDY,
RESEARCHERS ARE EXAMINING THE
MULTI-LEVEL RISK AND PROTECTIVE
FACTORS OF FIREARM INJURY RISK
AMONG ASIAN AMERICANS AND THE
RELATIONSHIP WITH NEIGHBORHOOD
STRUCTURAL LEVEL RACISM AND
DISCRIMINATION TO DETERMINE THE
MECHANISMS BETWEEN THESE FACTORS
AND FIREARM OUTCOMES.
SO WE ARE SPECIALLY EXCITED TO
SUPPORT THIS COLLABORATION
BETWEEN INVESTIGATORS AT EASTERN
MICHIGAN UNIVERSITY SCHOOL OF
NURSING AND THE UNIVERSITY OF
MICHIGAN SCHOOL OF PUBLIC HEALTH
AS WE THINK IT'S INDICATIVE OF
THE MULTI-DISCIPLINARY
COLLABORATION WE CALL FOR IN OUR
STRATEGIC PLAN AND DEEM AS
NECESSARY FOR ADDRESSING OUR
MOST PRESSING HEALTH CHALLENGES.
SO LET'S ME OF ON TO SOME
ADDITIONAL FUND -- LET'S MOVE ON
TO ADDITIONAL FUNDING UPDATES.
SINCE WE MET IN MAY WE PUBLISHED
A NOTICE OF SPECIAL INTEREST ON
NURSE BURNOUT.
WITH THIS NOSI WE'RE ENCOURAGING
THE DEVELOPMENT AND EVALUATION
OF NOVEL ORGANIZATIONAL
INTERVENTION WILL BUILD NEW
KNOWLEDGE ON HOW TO PREVENT AND
MITIGATE NURSE BURNOUT IN A WIDE
VARIETY OF SETTINGS THAT
INCLUDES HOSPITALS AND CLINICS,
SCHOOLS AND WORKPLACES, HOMES
AND LONG-TERM CARE FACILITIES,
JUSTICE AND OTHER SETTINGS.
INTERVENTIONS MAY INCLUDE THOSE
ADDRESSING KEY FACTORS IN HEALTH
CARE SETTING INFLUENCE BURNOUT
AND WELL BEING SUCH AS
BUREAUCRACY, ORGANIZATIONAL
MISSION AND VALUES, CULTURE AND
LEADERSHIP, ADMINISTRATIVE
BURDEN AMONG MANY OTHERS.
THOUGH THE PRIMARY GOAL OF THIS
NOSI IS PREVENTION OR MITIGATION
OF NURSE BURNOUT, OTHER OUTCOMES
INCLUDE THOSE SUCH AS NURSE
SATISFACTION, RETENTION,
ENGAGEMENT AND ABSENTEEISM AS
WELL AS OCCUPATIONAL INJURY,
TURNOVER AND COSTS.
IN AUGUST WE FUNDED A NOTICE TO
ESTABLISH SHORT COURSES IN
NURSING RESEARCH ON SOCIAL
DETERMINATES OF HEALTH TO
SUPPORT THE CREATION AND
IMPLEMENTATION OF SHORT COURSES
OF UP TO ONE YEAR TO DEVELOP
COHORT OF NURSE SCIENTISTS AND
SCIENTISTS IN ALIGNED FIELD TO
CONDUCT, EVALUATE RESEARCH ON
SOCIAL DETERMINATES OF HEALTH IN
SUPPORT OF THE STRATEGIC PLAN.
NURSING HAS LONG APPRECIATED
THAT HEALTH MUST BE UNDERSTOOD
WITHIN THE CONTEXT OF PEOPLE'S
LIVES AND LIVING CONDITIONS
SOCIAL DETERMINATES OF HEALTH
INTERVENED UPSTREAM AND MID
STREAM FACTORS THAT SHAPE
INDIVIDUAL POPULATION HEALTH
WITH A CRITICAL EMPHASIS ON
HEALTH EQUITY.
BY INCREASING NURSE SCIENTIST
ACCESS TO RIGOROUS
MULTI-DISCIPLINARY TRAINING AND
RESEARCH THIS INITIATIVE WILL
SUPPORT THE POWER AND POTENTIAL
OF NURSING TO ADVANCE HEALTH AND
HEALTH EQUITY FOR ALL.
IN ADDITION TO THESE NINR-LED
OPPORTUNITIES WE SIGNED ON TO
INITIATIVES OF OTHER INSTITUTES,
CENTERS AND OFFICES.
FOR EXAMPLE, WE ARE SUPPORTING
THE NATIVE AMERICAN RESEARCH
CENTERS FOR HEALTH OR NARCH.
IT WAS LAUNCHED IN 2000 TO HELP
REDUCE THE DISTRUST IN HEALTH
RESEARCH BY THE AMERICAN INDIAN
ALASKAN NATIVE COMMUNITIES,
PROMOTE HEALTH RESEARCH,
PRIORITIZE AND LED BY ELIGIBLE
AMERICAN INDIAN AND ALASKAN
NATIVE TRIBAL ENTITIES AND
ULTIMATELY IMPROVE THEIR HEALTH.
WE ALSO SIGNED ON TO A FUNDING
OPPORTUNITY THAT SUPPORTS A
COLLABORATION BETWEEN NIH AND
THE NATIONAL SCIENCE FOUNDATION.
IT SUPPORTS INNOVATIVE
HIGH-RISK, HIGH-REWARD RESEARCH
WITH THE PROMISE OF DISRUPTIVE
TRANSFORMATIONS IN BIO MEDICAL
AND PUBLIC HEALTH RESEARCH.
SO LET ME NOW TURN TO SOME NEWS
ON OUR PARTNERSHIPS AND
COLLABORATIONS.
AS YOU ALL KNOW WE CANNOT SOLVE
OUR NATION'S MOST INTRACTABLE
HEALTH CHALLENGES AND THE MOST
PERSISTENT HEALTH DISPARITIES
WITHOUT MAKING SOCIAL
DETERMINATES OF HEALTH A
PRIORITY.
SO IN 2022, NINR HELPED LAUNCH
THE NIH-WIDE SOCIAL DETERMINATES
OF HEALTH RESEARCH COORDINATING
COMMITTEE WHICH WAS CREATED OUT
OF AN URGENT NEED TO DEVELOP A
COORDINATED STRATEGY TO PROPEL
DISCOVERIES TO IMPROVE
INDIVIDUAL AND POPULATION
HEALTH, REDUCE HEALTH
DISPARITIES AND ADVANCE HEALTH
EQUITY.
GROWING OUT OF A GRASS-ROOTS
EFFORT WE STAFF ACROSS THE NIH,
THE SDOH RCC'S GOAL IS TO
ACCELERATE RESEARCH ACROSS
DISEASES AND CONDITIONS,
POPULATION, STAGES OF THE LIFE
COURSE AND SDOH DOMAINS.
IT ALSO FOCUSES ON EFFECTIVELY
LEVERAGING SDOH INVESTMENTS AND
INNOVATIONS ACROSS NIH
INSTITUTES AND SCIENCE IN THIS
FIELD RANGE FROM FOUNDATIONAL
RESEARCH TO INTERVENTION
RESEARCH TO IMPLEMENTATION
SCIENCE.
AT LAST COUNT 20 NIH INSTITUTE,
CENTERS AND OFFICES INCLUDING
NINR SERVE ON THE EXECUTIVE
COMMITTEE AND EVEN MORE ARE
REPRESENTED ON THE RCC AT LARGE
WHICH IS A CLEAR INDICATION OF
THE GROWING RECOGNITION OF THE
IMPORTANCE OF THIS AREA OF
RESEARCH.
I AM PROUD TO CO-CHAIR THIS
COMMITTEE WITH MY COLLEAGUE
DR. PEREZ-STABLE DIRECTOR OF THE
NATIONAL INSTITUTE ON MINORITY
HEALTH AND HEALTH DISPARITIES.
RECENTLY AS WE ANNOUNCED IN THE
BLOG POST, THIS COMMITTEE SHARED
A NEW CONCEPTUALIZATION OF
SOCIAL DETERMINATES OF HEALTH
WHICH WE BELIEVE CAN BE APPLIED
TO ANY AREA OF NIH SCIENCE AND
WELL BEYOND WE DESCRIBE SDOH AS
THE CONDITIONS IN WHICH PEOPLE
ARE BORN, GROW, LEARN, WORK,
PLAY, LIVE AND AGE AND THE WIDER
SET OF STRUCTURAL FACTORS
SHAPING THE CONDITIONS OF DAILY
LIFE AND WE EMPHASIZE THAT
ADDRESSING SDOH IS CRITICAL TO
POPULATION, COMMUNITY AND
INDIVIDUAL HEALTH AND ADVANCING
HEALTH EQUITY.
YOU CAN SEE MORE ON OUR BLOG
POST ON THE NINR WEBSITE.
SO I'D LOVE TO WALK YOU THROUGH
SOME OF THE KEY TENETS.
STRUCTURAL FACTORS INCLUDE
SOCIAL, ECONOMIC AS LEGAL FORCES
SYSTEMS AND POLICIES THAT
DETERMINE OPPORTUNITIES AND
ACCESS TO HIGH-QUALITY JOBS,
EDUCATION, HOUSING,
TRANSPORTATION, THE BUILT
ENVIRONMENT AND OTHER CONDITIONS
OF DAILY LIFE.
FURTHER, SDOH CAN IMPROVE,
MAINTAIN OR HINTER HEALTH
THROUGH MULTIPLE DIRECT,
INDIRECT AND INTERACTING
MECHANISTIC PATHWAYS.
SDOH MAY INTERACT WITH OTHER
DETERMINATES OF HEALTH SUCH AS
BIOLOGICAL, PSYCHOLOGICAL,
BEHAVIORAL AND ENVIRONMENTAL
FACTORS TO FURTHER PROMOTE OR
COMPROMISE HEALTH.
AND WE KNOW SDOH INFLUENCE
FAMILY AND INDIVIDUAL LEVEL
SOCIAL AND ECONOMIC
CIRCUMSTANCES SUCH AS INCOME,
EDUCATIONAL ATTAINMENT, ACCESS
TO DIGITAL TOOLS AND BROADBAND,
NUTRITION SECURITY AND HOUSING
STABILITY.
WE ALSO KNOW THAT SDOH MAY HAVE
DIFFERENT HEALTH CONSEQUENCES
WITHIN AND ACROSS POPULATIONS
DUE TO DIFFERENCES IN EXPOSURE
AS WELL AS SUSCEPTIBILITY TO
HELP PROMOTING AND HEALTH
COMPROMISE CONDITIONS OF DAILY
LIFE AND OUR CONCEPTUALIZATION
RECOGNIZES STRUCTURE FACTORS IN
RACISM, SEXISM, HOMOPHOBIA AND
CLASSISM AND OTHER
DISCRIMINATORY SYSTEMS SHAPE THE
WAY THERE'S DISTRIBUTION BASED
ON SEXUAL ORIENTATION, SOCIO
ECONOMIC POSITION OR GEOGRAPHY.
AND THEIR INTERSECTIONS AND
THROUGH IDENTITY FACTORS
HIGHLIGHT THE IMPORTANCE OF AN
INTERSECTIONAL LENS AND
APPROACHES TO SDOH RESEARCH.
AS YOU KNOW, SHIFTING GEARS,
NINR CO-LEADS THE IMPROVE
INITIATIVE WITH NICHD AND WITH
THE NIH OFFICE OF RESEARCH ON
WOMEN'S HEALTH AND WE HAVE GOT
GREAT NEWS TO SHARE.
NIH HAS AWARDED $24 MILLION IN
FIRST-YEAR FUNDING TO ESTABLISH
MATERNAL HEALTH RESEARCH CENTERS
OF EXCELLENCE.
THE CENTERS WILL WORK TOWARDS
REDUCING MATERNAL MORBIDITY AND
MORTALITY ACROSS POPULATIONS AND
PROMOTING HEALTH EQUITY.
FUNDING FOR THE CENTERS WERE
AWARDED AFTER A COMPETITIVE
PEER-REVIEW PROCESS.
THE CENTERS OF EXCELLENCE
INCLUDE 10 RESEARCH CENTERS
ACROSS THE NATION, A DATA
INNOVATION AND COORDINATING HUB
AND AN IMPLEMENTATION SCIENCE
HUB.
SO AS AN EXAMPLE OF HOW
STRUCTURAL AND SOCIAL FACTORS
ARE INTEGRATED INTO THE FUNDING
CENTERS OF EXCELLENCE, A CENTRAL
FOCUS OF THE FUNDED CENTER OF
EXCELLENCE IN WISCONSIN IS
HOUSING INSTABILITY AND IT'S
AFFECTS ON MATERNAL PHYSICAL
HEALTH AND PREGNANCY OUTCOMES.
SO DR. DIANA BIANCHI WILL HAVE
MORE INFORMATION TO SHARE FROM
THE IMPROVE INITIATIVE LATER IN
OUR MEETING BUT I DID WANT TO
MENTION THIS GOOD NEWS ABOUT THE
CENTERS OF EXCELLENCE.
THE COMPASS WILL SERVE AS
CENTRALIZED RESEARCH RESOURCES
PROVIDING TAILORED SCIENTIFIC,
TECHNICAL AND COLLABORATIVE
SUPPORT FOR COMMUNITY
ENGAGEMENT, RESEARCH CAPACITY
BUILDING AND TRAINING TO SUPPORT
COMMUNITY-LED HEALTH EQUITY
STRUCTURAL INTERVENTION PROJECTS
IN COLLABORATION WITH THE
COMPASS COORDINATION CENTER.
NIH STAFF CONDUCTED A TECHNICAL
ASSISTANCE WEBINAR SEPTEMBER 6
TO PROVIDE INFORMATION AS WELL
AS ANSWER QUESTIONS FROM
POTENTIAL APPLICANTS.
APPLICATIONS ARE DUE BY THE END
OF OCTOBER.
AWARDS HAVE NOT YET BEEN
ANNOUNCED FOR THE COMMUNITY-LED
HEALTH EQUITY STRUCTURAL
INTERVENTION SITES OR THE
COORDINATION CENTER BUT
DR. BOYCE WILL BE JOINING US TO
ANSWER YOUR QUESTIONS AND SHARE
A BIT MORE AND MORE WILL BE
COMING OUT VERY SOON ABOUT OUR
FIRST AWARDS.
I WANT TO NOW TURN TO THE
CLIMATE CHANGE AND HEALTH
INITIATIVE.
AS YOU KNOW, WE ARE ON THE
EXECUTIVE COMMITTEE FOR THIS
INITIATIVE AND WE'RE SUPPORTING
TWO CURRENT FUNDING
OPPORTUNITIES.
ONE ENCOURAGES APPLICATIONS THAT
ADDRESS THE IMPACT OF CLIMATE
CHANGE ON HEALTH AND WELL BEING.
THE OTHER SOLICITS P20 PLANNING
APPLICATION FOR CLIMATE CHANGE
AND HEALTH RESEARCH CENTERS.
THESE CENTERS WILL SUPPORT TRANS
DISCIPLINARY RESEARCH ON THE
IMPACTS OF CLIMATE CHANGE ON
HEALTH.
WE'RE ALSO FUNDING SEVERAL
STUDIES UNDER THIS INITIATIVE ON
TOPICS RANGE FROM ENVIRONMENTAL
EXPOSURES IN HEALTH TO HEAT AND
KIDNEY DISEASE.
AS YOU KNOW, WE HOSTED A CLIMATE
CHANGE AND HEALTH SCHOLAR,
DR. PATRICE NICOLAS.
SHE SPOKE AT THREE BROWN BAG
SEMINARS TO SAVE WHICH WAS ABOUT
60 STAFF EACH AND LED A SEMINAR
IN APRIL.
WE WANT TO THANK DR. NICOLAS
WITH SHARING HER EXPERTISE WITH
US AT NINR AND NIH.
AS I PROPOSED AT OUR MEETING IN
MAY, WE ALSO FORMED A WORKING
GROUP UNDER THE AUSPICES OF
COUNCIL TO FURTHER EXPLORE THIS
TOPIC.
SO LED BY NINR'S DR. JOHN
GRAYSON AND COUNCIL'S BETTY
BECKERMIRE THE GROUP WILL BE
CHARGED WITH CONSIDERING THE
CURRENT STATE OF THE SCIENCE AND
ADDRESSING PRESSING HEALTH
RESEARCH QUESTIONS AND
ULTIMATELY RECOMMENDING AREAS
WHERE NURSING SCIENCE CAN HAVE
THE BIGGEST IMPACT IN ADDRESSING
THE HEALTH AFFECTS OF CLIMATE
CHANGE.
THE CURRENT WORK GROUP ROSTER IS
SHOWN HERE AND WE ARE GRATEFUL
TO ALL OF THESE INDIVIDUALS FOR
THEIR WILLINGNESS TO CONTRIBUTE
THEIR TIME AND ENERGY TO THIS
TOPIC.
GROUP WILL MEET FOR THE FIRST
TIME AT THE END OF SEPTEMBER IN
A WEEK OR TWO AND SEVERAL MORE
TIMES OVER THE NEXT FEW MONTHS
WITH THE GOAL OF PRESENTING
RECOMMENDATIONS TO THE COUNCIL
AT THE JANUARY 24 MEETING.
WITH THE WORKING GROUP WE'RE
ALSO SEEKING COMMENTS AND
TESTIMONY FROM THE COMMUNITY AND
GENERAL PUBLIC REGARDING THE
HEALTH IMPACT OF CLIMATE
ASSOCIATED EVENTS TO IDENTIFY
RESEARCH GAPS WHERE NURSING
RESEARCH CAN MAKE A DIFFERENCE
OR PROVIDE A UNIQUE PERSPECTIVE.
THE RFI WILL BE POSTED SOON AND
WILL BE AVAILABLE FOR PUBLIC
COMMENT.
THE WORKING GROUP'S
RECOMMENDATIONS TO GATHER WITH
WHAT WE LEARN FROM THIS RFI WILL
INFORM POTENTIAL FUTURE NINR
RESEARCH INITIATIVES AND OTHER
EFFORTS IN CLIMATE CHANGE AND
HEALTH WE HOPE TO START IN 2024.
SO THE HELPING TO END ADDICTION
LONG-TERM OR HEAL INITIATIVE
WHERE NINR'S PARTICIPATING WANT
TO END OPIOIDS IN NATIVE
COMMUNITIES.
OVER THE NEXT YEARS THE NATIVE
COLLECTIVE RESEARCH EFFORT TO
ENHANCE WELLNESS WILL SUPPORT
AND CONDUCT RESEARCH.
CURRENTLY THERE'S TWO FUNDING
OPPORTUNITIES UNDER N CREW ONE
IS ADDRESSING OVERDOSE,
SUBSTANCE USE AND MENTAL HEALTH
AND PAIN.
THE OTHER FOR THE NATIVE
RESEARCH RESOURCE NETWORK.
SO IN OTHER RELATED FUNDING NEWS
THE HEAL INITIATIVE ON
PREVENTION AND MANAGEMENT OF
CHRONIC PAIN IN RURAL
POPULATIONS WHICH WAS THE
CONCEPT THAT COUNCIL APPROVED
LAST YEAR HAS FUNDED THREE
APPLICATIONS.
TWO OF WHICH ARE BEING
ADMINISTERED BY NINR.
NINR IS ALSO PARTICIPATING IN
THE HEAL INITIATIVE PARTNERSHIP
TO ADVANCE INTERDISCIPLINARY
TRAINING AND CLINICAL PAIN
RESEARCH.
THIS INITIATIVE IS TO BOLSTER
THE DWINDLING CLINICAL PAIN
RESEARCH WORKFORCE BY SUPPORTING
INTERDISCIPLINARY POST-DOCTORAL
TRAINING TO PROMOTE THE NEXT
GENERATION OF INDEPENDENT
CLINICAL PAIN RESEARCHERS.
AND I WANT TO ACKNOWLEDGE THAT
THOUGH THE PALLIATIVE CARE
RESEARCH GROUP ENDED IN JUNE
CAPACITY AND RESOURCES LIVE ON
IN THIS INITIATIVE.
CHECK OUT THE WEBSITE FOR THE
GROUP'S MISSION AND SUCCESSES.
NIH IS ONE OF THE SIX
ORGANIZATION FUNDED THIS
COOPERATIVE GROUP.
WE'RE PROUD TO HAVE BEEN ON THE
PCRC EXECUTIVE COMMITTEE AND TO
HAVE BEEN PART OF ITS
ACCOMPLISHMENT LIKE RESEARCH
SUPPORT, MENTORSHIP AND THE
CREATION OF NINE SPECIAL
INTEREST GROUPS.
THANK YOU TO EVERYONE WHO
PARTICIPATED IN THE PCRC
THROUGHOUT THE YEARS.
I ALSO HAVE NINR SPECIFIC NEWS
AND ANNOUNCEMENTS TO SHARE WITH
YOU.
NINR RESEARCHERS HAVE PUBLISHED
A NUMBER OF STUDIES SINCE OUR
LAST MEETING BUT HERE ARE SOME
FINDINGS OF NOTES.
NINR SUPPORTED STUDY FOUND
RACIAL DISPARITIES AND THE USE
OF CAESAREANS HAVING DOUBLE THE
ODDS COMPARED TO WHITE MOTHERS
OF ENDING LABOR WITH AN
UNPLANNED CAESAREAN.
IN A SECOND FINDING NINR
SUPPORTED RESEARCH FOUND UNMET
BASIC NEEDS AS PREDICTED BY FOOD
INSECURITY AND PAST
INCARCERATION AND HOMELESSNESS
RESULTED IN LOWER ODDS OF HIV
ANTIVIRAL THERAPY MEDICATION
ADHERENCE AMONG BLACK PEOPLE
LIVING WITH HIV.
LOOPING SOCIAL DETERMINATES OF
HEALTH AND SOCIAL
DISENFRANCHISEMENT TO MEDICATION
ADHERENCE.
AND LASTLY, NINR SUPPORTED
SCIENTISTS DEVELOPED A NATURAL
LANGUAGE PROCESSING SYSTEM TO
DETECT EVICTION STATUS FROM THE
VETERANS HEALTH ADMINISTRATION
NOTES.
THIS SYSTEM SUBSTANTIALLY
IMPROVED CLASSIFICATION AND THE
RESEARCHERS ARE GOING TO DEPLOY
IT AS AN EVICTION SURVEILLANCE
SYSTEM FOR THE VHA.
WE HAVE EXCITING NEWS ABOUT THE
2023 DEBUT CHALLENGE PRIZE.
EACH YEAR THE NATIONAL INSTITUTE
OF BIO MEDICAL IMAGING AND BIO
ENGINEERING AND VENTURE WELL
CONDUCT A CHALLENGE FOR
UNDERGRADUATE STUDENT TEAMS TO
DEVELOP TECHNOLOGY SOLUTIONS FOR
UNMET NEEDS IN HEALTH CARE.
FIVE NIH PARTNERS PARTICIPATED
IN PROVIDING A PRIZE EACH TO THE
TEAM WITH MOST INNOVATIVE
TECHNOLOGY AND THE RESPECTIVE
FIELDS.
THIS INCLUDES THE NIH OFFICE OF
AIDS RESEARCH AND NICHD AND NINR
AND OTHERS.
SO NINR AWARD THE 2023 DEBUT
CHALLENGE PRIZE IN THE
TECHNOLOGIES TO EMPOWER NURSES
AND COMMUNITY SETTINGS CATEGORY
TO A FOUR-WOMAN TEAM FROM
CLEMSON UNIVERSITY CALLED RAM
INC. FOR THEIR DESIGN.
IT'S A DIAPER URINALSIS
DIAGNOSTIC TEST THAT CAN BE USED
IN CLINIC OR AT HOME IT CAN SAVE
NURSES TIME AND INCREASE UTI
TESTING IN LOW-RESOURCE
SETTINGS.
WE WANT TO CONGRATULATE THESE
VERY INNOVATIVE UNDERGRADUATES.
IN JUNE, DR. TAICHI GOTO
PRESENTED AT THE 2023 NIH PAIN
CONSORTIUM SYMPOSIUM ON ADVANCES
IN PAIN RESEARCH.
IN FACT MEMBERS OF THE PAIN
CONSORTIUM SYMPOSIUM ELEVATED
HIS ABSTRACT FROM A POSTER TO AN
ORAL PRESENTATION BASED ON THE
SIGNIFICANT INNOVATION AND
QUALITY.
HIS STUDY IS EXCITING IT
PROVIDES NEW INSIGHT INTO THE
ASSOCIATION BETWEEN A SPECIFIC
POLYMORPHISM AND NEUROPATHIC
PAIN AMONG CANCER SURVIVORS.
NOT ONLY COULD THIS INSIGHT BE
USED TO ALLEVIATE PAIN BUT CAN
ALSO BE USED TO PREVENT PAIN IN
THIS GROUP AND WE'RE PROUD OF
DR. GOTO FOR HIS WORK AND
REPRESENTATION OF NURSING
SCIENCE AT THIS NIH CONSORTIUM.
LAST MONTH SUMMER FELLOWS
PRESENTED THEIR POSTERS AT THE
NIH POSTER DAY SESSIONS.
IT WAS HYBRID ONCE AGAIN.
NINR FELLOWS INCLUDING FOUR IN
THE BACHELOR'S PROGRAM AND TWO
WORKING ON THEIR DOCTORAL
DEGREES.
SOME INCLUDED A VIRTUAL REALITY
GROCERY STORE, QUANTITATIVE
ANALYSIS OF RYO1 PAIN PREDICTION
AND FOLLOWING SLEEP DIARIES.
PROUD TO HAVE THEM AT NINR OVER
THE SUMMER.
SO I'D LIKE TO SHARE SOME RECENT
NINR EVENTS.
IN JULY WE HELD OUR FINAL
DIRECTOR'S LECTURE IN OUR SERIES
IN NINR STRATEGIC LENS.
DR. STODDARD AT TO THE
UNIVERSITY OF UNIVERSITY AND
DR. KUEHNERT OF THE PUBLIC
HEALTH ACCREDITATION BOARD
ADDRESSED OUR COMMUNICATION AND
HEALTH LENS AND WE HAD 300
PARTICIPANTS SO I WANT WANT TO
THEM THEM.
IN JUNE WE CO-HOSTED A LECTURE
WITH OUR COLLEAGUES ON THE
NATIONAL INSTITUTE OF MINORITY
HEALTH AND HEALTH DISPARITIES
AND THE NIH OFFICE OF BEHAVIORAL
AND SOCIAL SCIENCES RESEARCH.
SO OUR VERY OWN COUNCIL MEMBER
PROFESSOR DANIEL DAWES SHARED
HIS EXPERTISE ON HEALTH EQUITY,
HEALTH REFORM, HEALTH SYSTEMS
TRANSFORMATION AND SOCIAL AND
POLITICAL DETERMINATES OF HEALTH
AND AFTER HE JOINED ME FOR A
Q&A.
I'M PLEASED TO REPORT WE HAD
OVER 600 PARTICIPANTS FOR
PROFESSOR DAWES LECTURE.
WE WANT TO THANK YOU ONCE AGAIN
FOR SHARING YOUR INSIGHTS WITH
US.
RECORDINGS OF BOTH LECTURES ARE
AVAILABLE ON OUR WEBSITE.
I ENCOURAGE YOU TO CHECK THEM
OUT IF YOU DIDN'T HAVE A CHANCE
TO JOIN LIVE.
I AM HAPPY TO ANNOUNCE THAT
FOLLOWING A NATIONAL SEARCH WE
HAVE SELECTED DR. COURTNEY AKLIN
AS DEPUTY DIRECTOR OF NINR AND
HAS OVER 15 YEARS OF RESEARCH
ADMINISTRATION AND RESEARCH
LEADERSHIP AT NIH AN HAS BEEN
ACTING ASSOCIATE DIRECTOR AND
WORKED AS CHIEF OF STAFF AT
NIMHD AND WORKED AT NIMS AND ADS
AND LED ACTIVITIES INCLUDING THE
IMPROVE INITIATIVE, THE MENTAL
HEALTH AND WELL BEING ACTION
TEAM AND THE RESILIENCE DOING
WELL BEING CAMPAIGN.
SHE ALSO CO-LED NIH'S COVID
INTRAACTION REVIEW AND THE
INTRAMURAL RESEARCH PROGRAM
BUDGET AND REPORTING INITIATIVE.
SHE HAS A BACKGROUND AND
INTEREST IN COMMUNITY-BASED WORK
AND BEHAVIORAL AND SOCIAL
SCIENCES RELATING TO HEALTH
DISPARITIES AND PEDIATRIC MENTAL
HEALTH.
SHE'S A LICENSED CLINICAL
PSYCHOLOGIST WITH A Ph.D. IN
CLINICAL PSYCHOLOGY FROM THE
UNIVERSITY OF MARYLAND COLLEGE
PARK AND A B.A. IN BUSINESS
ADMINISTRATION AND PSYCHOLOGY
FROM THE UNIVERSITY OF RICHMOND.
SO HER WEALTH OF KNOWLEDGE AND
EXPERIENCE AT NIH WILL BE AN
ASSET TO US HERE AT NINR.
SHE'LL BE STARTING VERY SOON BUT
NOT SOON ENOUGH ON OCTOBER 2.
I'M LOOKING FORWARD TO HAVING
ALL OF YOU MEET HER DURING OUR
NEXT COUNCIL MEETING.
I AM PLEASED TO WELCOME NEW
STAFF AND FELLOWS TO NINR.
JOSH WOLFF CAME ON AS A
SCIENTIFIC REVIEW OFFICER AND
SUSAN TOY WORKS AS A GRANT
MANAGEMENT SPECIALIST.
JULIA SEAY AND WE GAINED A
DEPUTY CIO IN OUR I.T.
DEPARTMENT AND HEALTH DESK
SUPPORT AND TWO TECHNICAL
WRITERS JOINED THE DIVISION OF
PUBLIC LIAISON TO WORK ON
SIX-MONTH CONTRACTS.
THE REST OF THE STAFF AND
FELLOWS WORK IN THE INTRAMURAL
RESEARCH PROGRAM.
SO WE'RE HAPPY TO HAVE BROUGHT
ON THREE MORE FELLOWS.
LASTLY, THERE'S LAUREN
HASHIGUCHI WHO STARTED WITH US
LAST MONTH.
WE WANT TO WELCOME THE STAFF AND
FELLOWS TO NINR.
WE ARE SAYING GOOD-BYE TO TWO
NINR STAFF MEMBERS.
DR. LOUISE ROSENBAUM WORKS IN
OUR DIVISION OF PUBLIC POLICY
AND SET TO RETIRE ON SEPTEMBER
29.
DR. SABRINA WONG HAS BEEN IN OUR
DIVISION OF INTRAMURAL RESEARCH
AND RESIGNING AT THE END OF THE
MONTH.
WE WANT TO THANK BOTH OF THEM
FOR THEIR SERVICE AND WISH THEM
ALL THE BEST ON THEIR RESPECTIVE
JOURNEYS.
WE ALSO ARE SAYING GOOD-BYE TO
DR. PATTI BRENNAN WHO WAS NOT
ONLY THE DIRECTOR OF THE
NATIONAL LIBRARY OF MEDICINE BUT
ALSO THE DIRECTOR OF THE ADVANCE
VISUALIZATION LAB AT NINR.
SHE'LL BE RETIRING AT THE END OF
THE MONTH.
SHE LED NINR FOR SEVEN YEARS THE
FIRST NURSE INDUSTRIAL ENGINEER
AND FEMALE TO LEAD THE LIBRARY.
HER UNIQUE CAREER PATH HELPED
GUIDE HER APPROACH IN
INTEGRATING ARTIFICIAL
INTELLIGENCE AND MACHINE
LEARNING AND ADVANCED PUB MED
AND CLINICAL TRIALS.gov
SPEARHEADED UNDERTAKING A MAJOR
BUILDING TRANSFORMATION MAYBE
JUST A RESTORATION.
ANYWAY, HERE AT NINR PATTI
DEVELOPED AN INTERACTIVE VIRTUAL
REALITY SIMULATIONS TO REHEARSE
PROBLEM-SOLVING BEHAVIORS TO
IMPROVE THEIR HEALTH OUTCOMES.
SO DR. SHERRY WHO CURRENTLY
SERVED AS THE DIRECTOR OF THE
NLM ASSOCIATE DIRECTOR FOR
SCIENTIFIC DATA RESOURCES HAS
AGREED TO SERVE AS THE ACTING
NLM DIRECTOR.
AND WE HAVE NEWS TO SHARE ABOUT
NIH.
THE NIH DIRECTOR'S WITNESS
AFTERNOON LECTURE SERIES KNOWN
AS WALES IS THE HIGHEST PROFILE
AT THE NIH AND WE'RE EXCITED TO
ANNOUNCE NINR SUPPORTED
INVESTIGATOR, DR. DEBRA MOSER
FROM THE UNIVERSITY OF KENTUCKY
HAS BEEN SELECTED AS A WALS
LECTURER FOR APRIL, 2024.
SHE WAS NOMINATED BY NINR AND
THE RURAL HEALTH SPECIAL
INTEREST GROUP WHICH IS
CO-CHAIRED BY DR. CALEB AND
DR. MORALES OF NIMH.
WE'LL HAVE MORE DETAILS AS WE
GET CLOSER TO THAT EVENT.
THIS YEAR NIH ANNOUNCED IT WOULD
BE ACCEPTING SUBMISSIONS FOR A
NEW INITIATIVE THAT REWARDS
ACADEMIC INSTITUTIONS FOR
ADVANCING DEIA.
NIH IS SEEKING PROGRAMS THAT
ENHANCE OUR UNDERSTANDING OF
EFFECTIVE STRATEGIES AND
PRACTICES TO CREATE CULTURES OF
INCLUSIVE EXCELLENCE AND ENHANCE
DIVERSITY, EQUITY, INCLUSION AND
ACCESSIBILITY.
NIH EXPECTS THE PRIZE
COMPETITION WILL IDENTIFY MANY
DIFFERENT APPROACHES THAT MAY BE
SCALABLE TO OTHER INSTITUTIONS
ACROSS THE HEALTH RESEARCH
ENTERPRISE.
NIN WILL AWARD 10 PRICES UP TO
$1 MILLION TOTAL THROUGH THE
COMPETITION.
TO PARTICIPATE, REGISTRATION IS
REQUIRED BY TODAY AT 5:00.
IF YOU'RE BUSY ON YOUR COMPUTER
I'LL KNOW WHY.
THAT'S 5:00 EASTERN TIME AND
BEING ACCEPTED THROUGH TUESDAY,
SEPTEMBER 26.
FOR ELIGIBILITY AND GUIDELINES
YOU CAN VISIT THE WEBSITE.
WE HAVE EXCITING NEWS ABOUT A
NEW INITIATIVE THE NIH BUILD UP
TRUST CHALLENGE SEEKS TO
INCREASE RESEARCH PARTICIPATION
BY BUILDING TRUST AND IMPROVING
ENGAGEMENT WITH HISTORICALLY
UNDER REPRESENTED COMMUNITIES.
THE BUILD UP TRUST CHALLENGE
WILL AWARD AS MANY AS 10
FINALISTS UP TO $45,000 EACH --
THAT MAY BE TOO MUCH MATH THOUGH
IT'S EASY, AND THE OPPORTUNITY
TO WIN ONE OF FOUR $200,000
PRIZES FOR PROMISING STRATEGIES
THAT INCREASE RESEARCH
PARTICIPATION AND IMPROVE TRUST
IN MEDICAL CARE IN HISTORICALLY
UNDER SERVED COMMUNITIES.
SO YOU HAVE MORE TIME ON THIS
ONE.
CAN REGISTER BY TUESDAY NOVEMBER
14.
NIH CURRENTLY HAS AN RFI SEEKING
INPUT ON ITS MISSION STATEMENT
PRESENTED HERE.
LET ME GIVE YOU A LITTLE BIT OF
BACKGROUND.
TWO YEARS AGO NIH ESTABLISHED AN
ADVISORY COMMITTEE TO THE
DIRECTOR WORKING GROUP ON
DIVERSITY AND THE SUBGROUP ON
DISABILITY HAD THIS TO SAY ABOUT
THE MISSION STATEMENT.
ONE, IMMEDIATE ACTION FOR THE
NIH TO SUPPORT DISABILITY
INCLUSION IS TO REMOVE THE
LANGUAGE OF REDUCING DISABILITY
FROM THE NIH MISSION STATEMENT.
THE CURRENT MISSION STATEMENT
COULD BE INTERPRETED AS
PERPETUATING ABLIST BELIEFS THAT
DISABLED PEOPLE ARE FLAWED AND
NEED TO BE FIXED.
THE PROPOSED MISSION STATEMENT
IS TO SEEK FUNDAMENTAL KNOWLEDGE
WITH THE NATURE AND BEHAVE OF
LIVING SYMPTOM AND OPTIMIZE
HEALTH AND PREVENT OR REDUCE
ILLNESS FOR ALL PEOPLE.
THE RFI IS OPEN TO STAFF
EMPLOYED AT NIH INSTITUTIONS
RECEIVING SUPPORT AND THE
PUBLIC.
RESPONSES ARE DUE BY MIDNIGHT ON
FRIDAY NOVEMBER 24.
SO PLEASE DO CONSIDER GIVING
FEEDBACK ON THE MISSION
STATEMENT.
WE WANT TO WELCOME DR. JANE
SIMONI WHO JOINED US IN JULY AS
THE NIH ASSOCIATE DIRECTOR FOR
BEHAVIORAL AND SOCIAL SCIENCES
RESEARCH.
AND DIRECTOR OF THE NIH OFFICE
OF BEHAVIORAL AND SOCIAL
SCIENCES RESEARCH OR OBSSR.
SHE'S A CLINICAL PSYCHOLOGIST
WITH MORE THAN 25 YEARS OF
EXPERIENCE IN RESEARCH FOCUSSED
ON HEALTH DISPARITIES AND
RESILIENCE AMONG POPULATIONS
THAT HAVE BEEN SOCIALLY
MARGINALIZED INCLUDING PERSONS
WITH HIV AND OTHER CHRONIC
ILLNESSES, LATINX AND LGBTQ AND
DR. KARINA WALTERS OF THE
CHOCTAW NATION OF OKLAHOMA IS A
SOCIAL EPIDEMIOLOGIST AND THE
KATHERINE HALL CHAMBER SCHOLAR
THET UNIVERSITY OF WASHINGTON
SCHOOL OF SOCIAL WORK.
SHE ALSO SERVED AS AN ADJUNCT
PROFESSOR IN THE DEPARTMENT OF
GLOBAL HEALTH AND THE SCHOOL OF
PUBLIC HEALTH.
SHE IS THE FOUNDING DIRECTOR OF
THE EOW INDIGENOUS WELLNESS
RESEARCH INSTITUTE.
SO WELCOME TO DR. WALTERS.
SO MANY NEW PEOPLE IT'S
EXCITING.
AND DR. JEANNE MARRAZZO HAS BEEN
HAS BEEN SELECTED FOR THE NEXT
DIRECTOR OF THE INSTITUTE OF
ALLERGY AND INFECTIOUS DISEASES.
AS THE NIAID DIRECTOR
DR. MARRAZZO WILL OVERSEE
NIAID'S BUDGET TO SUPPORT
UNDERSTANDING AND TREATMENT OF
INFECTIOUS, IMMUNOLOGIC AND
ALLERGIC DISEASES AND JOINED US
FROM THE UNIVERSITY OF ALABAMA
AT BIRMINGHAM WHERE SHE SERVED
AS DIRECTOR OF THE DIVISION OF
INFECTIOUS DISEASES SINCE 2016.
SHE IS INTERNATIONALLY
RECOGNIZED FOR HER RESEARCH AND
EDUCATION EFFORTS IN THE FIELD
OF SEXUALLY TRANSMITTED
INFECTIONS AND ESPECIALLY AS
THEY EFFECT WOMEN'S HEALTH.
SO LET'S HAVE A QUICK BUDGET
UPDATE AS WE'RE DRAWING TO A
CLOSE.
HERE'S OUR APPROPRIATIONS
HISTORY OVER THE LAST FEW YEARS.
THE PRESIDENT SUBMITTED HIS
PHYSICAL YEAR '24 BUDGET BACK IN
MARCH HIGHLIGHTING HIS
PRIORITIES TO NIH.
THE PRESIDENT'S PROPOSED BUDGET
RETAINS THE $10 MILLION IN
ACTIVE FOR HEALTH DISPARITIES
RESEARCH THAT NINR RECEIVED IN
PHYSICAL YEAR '23.
NOW, CONGRESS WILL ULTIMATELY
DECIDE THE FINAL FUNDING LEVELS
BASED ON THE HOUSE SUBCOMMITTEE
DRAFT AND IT LOOKS LIKE FUNDING
FOR 2024 WILL REMAIN FLAT.
NOW MOST INSTITUTE, CENTERS AND
OFFICES ARE REPAIRING FOR A FLAT
OR EVEN DECREASING BUDGETS IN
FISCAL YEAR '24 BUT WE'LL HAVE A
BETTER IDEA IN THE NEAR FUTURE.
SO THAT BRINGS ME TO A
CONVERSATION I'D LIKE TO HAVE AS
A WRAP-UP.
SO THAT'S ABOUT THE FISCAL YEAR
'24 AND BEYOND.
THE PRESIDENT AND CONGRESS
PROPOSED FLAT BUDGETS FOR NINR
AND FOR MOST OF NIH AS WELL IN
FISCAL YEAR '24 WITH A CAVEAT OF
COURSE WE DON'T KNOW HOW FISCAL
'24 WILL ULTIMATELY PLAY OUT IN
THE WEEKS AND MONTHS TO COME.
FOR SEVERAL YEARS NOW NIH HAS
BEEN FORTUNATE TO RECEIVE BUDGET
INCREASES FROM CONGRESS AND WE
HAVE BEEN VERY GRATEFUL FOR THAT
SUPPORT.
BUT AS WE LOOK AHEAD TO NEXT
YEAR AND THE YEARS TO COME, WE
HAVE TO RECOGNIZE THAT
CHALLENGES MAY BE ON THE HORIZON
AND WE HAVE TO PLAN ACCORDINGLY.
SO THAT'S REALLY FOR ANY
SCENARIO, ANY BUDGET INCREASES,
BUDGET CUTS EVEN FLAT BUDGETS
WHICH ARE IN EFFECT SMALLER
BUDGET CUTS BECAUSE OF THE WAY
COST OF DOING SCIENCE CONTINUES
TO INCREASE.
NOW, NIH HAS OF COURSE DEALT
WITH SIMILAR CHALLENGES IN THE
PAST BUT IT HAS BEEN SOME TIME
SO I THOUGHT IT WAS WORTH A
DISCUSSION WITH ALL OF YOU TODAY
TO HEAR YOUR THOUGHTS ON
PLANNING FOR THE YEARS TO COME.
AND WHAT STRATEGIES WE SHOULD
CONSIDER FOR OUR EXTRAMURAL
PROGRAMS.
SO WHEN I IT COMES TO TRAINING
AND SCIENCE INITIATIVES AS WE
MAKE FUNDING DECISIONS, THERE
ARE A NUMBER OF QUESTION WE
COULD CONSIDER.
SHOULD WE FUND FEWER AWARDS?
SHOULD WE PRIORITIZE NEW AND
EARLY-STAGE INVESTIGATORS?
SHOULD WE JUST CUT ALL AWARDS BY
A CERTAIN PERCENTAGE AND JUST
CALL IT A DAY OR USE A MORE PRE
VICE APPROACH?
-- PRECISE APPROACH?
SHOULD WE FUND MORE SHORT-TERM
PROJECTS TO REDUCE OUR SHORT
TERM COMMITMENTS AND DECIDING ON
A NEW RO1 COMMITS US TO FUND THE
PROJECT FOR AT LEAST THREE AND
OFTEN FIVE YEARS.
HOW SHOULD WE THINK ABOUT OUR
TRAINING AND PRIORITIES THERE?
WE'D LOVE TO HEAR YOUR THOUGHTS
ON THESE TOPICS AND THINGS WE
SHOULD CONSIDER AS WE THINK
ABOUT OUR STRATEGIES IN THE
COMING YEAR AND YEARS AHEAD.
ANY THOUGHTS?
>>I DO THINK THE TRAINING IN
THE EARLY STAGE INVESTIGATORS IS
VERY IMPORTANT.
WE DON'T HAVE ENOUGH SCIENTISTS
AND NEED MORE SO I THINK
SUPPORTING THAT IS REALLY
IMPORTANT FOR THE FUTURE
GENERATION OF NURSE SCIENTISTS.
THE OTHER PART -- AND I DON'T
KNOW HOW TO DO THIS BUT THERE
ARE RESEARCH INTENSIVE
UNIVERSITIES.
I COME FROM ONE.
AND HOW DO WE SUPPORT NURSE
SCIENTISTS THE PEOPLE GETTING
THEIR Ph.D.s IN THE NON-RESEARCH
INSENSITIVE ENVIRONMENTS BUT
MAKING IT RIGOROUS.
MAYBE PARTNERSHIPS BETWEEN
NON-RIGOROUS -- THAT'S THE WRONG
WORD, NON-RIGOROUS.
THE SETTINGS THAT WANT TO
SUPPORT THE RIGHT PEOPLE THAT
AREN'T AT THE INSTITUTIONS THAT
HAVE THE MOST INFRASTRUCTURE AND
HOW DO WE DO THAT THINKING ABOUT
THAT IN INNOVATIVE WAYS CAN HELP
SUPPORT THE NEXT GENERATION OF
HEALTH SCIENTISTS.
>>THANK YOU FOR SHARING THAT.
>>I WOULD AGREE IT'S A LITTLE
BIT OF A CONUNDRUM BECAUSE WE
DEFINITELY NEED TO SUPPORT THE
PIPELINE BUT IF THERE'S NO
SENIOR INVESTIGATORS TO SUPPORT
THE DEVELOPMENT OF THOSE PEOPLE
THEY'RE GOING TO STRUGGLE.
I LIKE TO THE IDEA OF THINKING
OF WAYS TO PARTNER INSTITUTIONS
SO MOST EFFECTIVELY MAKE USE OF
THE INVESTMENTS NINR MAKES.
>>I'D LIKE TO SECOND
DR. STONE'S COMMENTS.
I THOUGHT ABOUT YOUR
PRESENTATION TODAY.
I LOVE THE FACT THAT YOU
APPROACHED HEALTH INEQUITIES AND
I LOVE THE IDEA OF YOU BEING
BOLD IN ADDRESSING THE
UNDERRATED ISSUES IN RESEARCH IN
PARTICULAR CLIMATE CHANGE AND
SOCIAL DETERMINATES OF HEALTH.
I THINK IF PUSH COMES TO SHOVE,
I WOULDN'T WANT TO SEE THOSE TWO
CRITICAL AREAS YOU MENTIONED ON
THE CHOPPING BLOCK.
I THINK THEY'RE CRITICAL.
PERHAPS YOUR POINT ABOUT MAYBE
FUNDING FEWER AWARDS TO ENSURE
WE DON'T LOSE THE GAINS THAT WE
MAY MAKE IN THESE OTHER AREAS
THAT ARE CRITICAL TO HEALTH
EQUITY.
>>I HAD A QUESTION REGARDING
THE NEW MECHANISMS TABLE.
I WAS WONDERING AND IT WAS ON
THE MEETING MATERIALS, I
WONDER -- I DIDN'T RECALL SEEING
SMALLER TYPE INTERVENTIONS AND
SO I THINK THAT'S ONE OF THE
BEAUTIFUL THINGS HAVE YOU GOING
ON IS YOU HAVE THAT FOCUS ON
CHANGE AND SPECIFICALLY SYSTEM
CHANGE, COMMUNITY CHANGE BUT
THEY'RE ALL BIG GRANTS AND SO
I'M WONDERING IF THAT MIGHT BE
POSSIBLE BECAUSE IT ALSO MIGHT
ALIGN IF YOU RETAIN MORE FOCUS
ON THE EARLY STAGE AND THAT
DEVELOPMENT PERIOD FOR THEM TO
GET UP TO A LARGER GRANT THOUGH
I DO AGREE WITH DR. MUNRO WE
NEED THE SENIOR PEOPLE AS WELL.
>>THANK YOU, SHANNON.
DR. STONE AND MUNRO, I THINK THE
IDEA OF FINDING WAYS TO CREATE
THESE PARTNERSHIPS GIVEN THAT WE
KNOW TO CHANGE THE NARRATIVE WE
HAVE TO CHANGE THE NARRATORS AND
EVEN AT THE MOST ELITE RESOURCED
INTENSIVE PLACES WE DON'T
NECESSARILY HAVE THE BROADEST
AND WIDEST DIVERSITY OF
DIFFERENT VOICES AT THE TABLE.
AND I THINK CREATING THOSE
BRIDGES BETWEEN MINORITY-SERVING
INSTITUTIONS AND HBCUs AND
PLACES JUST IN OUR COMMUNITIES
OF INVESTMENT WE TALKED ABOUT
MISSISSIPPI DELTA AND APPALACHIA
AND TRIBAL LANDS, FINDING WAYS
TO CONNECT AND LOOKING AT
DISTRIBUTION OF THE MOST
RESOURCE INTENSE PLACES ARE BUT
NOT IN THOSE PLACES.
TRYING TO CREATE THE BRIDGES I
THINK IS SOMETHING THAT TO ME
SEEMS LIKE A REALLY GOOD
STRATEGY AND A GOOD WAY FOR US
TO BE STRATEGIC AND SMARTER.
-- SMART.
>>IN THINKING ABOUT THIS IN ALL
THE TWO MINUTES I'VE BEEN
THINKING ABOUT IT, ONE OF THE
WAYS THE NOSI FOR FIREARM
SUPPLEMENTS WAS REALLY GOOD BUT
I CAN SEE A NOSI FOR T32s TO GET
SOMEBODY THAT'S MINORITY OR HBCU
TO BRING THEM IN NOT TO YOUR
PROGRAM, THEY GO THROUGH ANOTHER
PROGRAM BUT GET MENTORSHIP
THROUGH A T32 AND OTHER PROGRAM.
AND IT SEEMS LIKE SOMETHING THAT
COULD BE DONE THAT WOULD REACH
OUT TO OTHER PEOPLE TO GET THEM
THEIR EXPERIENCE.
GRANTED, I THOUGHT ABOUT IT ALL
TWO MINUTES.
>>THANK YOU FOR THESE IDEAS.
ANYTHING ELSE YOU WANT TO SHARE?
YOU CAN ALWAYS REACH OUT TO US
AT ANY TIME TO LET US KNOW YOUR
THOUGHTS AND WE'LL KEEP YOU
POSTED OF COURSE.
THANK YOU FOR THIS.
THIS WAS HELPFUL.
THANK YOU.
ALL RIGHT.
SO I DO WANT TO ACKNOWLEDGE
COLLEAGUES AT NINR, JOANIE
DAWSON AND EMILY BARROS IN
COMBINING THAT FOR THE UPDATE.
I WANT TO THANK MY COLLEAGUES AT
NINR AND ON COUNCIL FOR ALL YOUR
SUPPORT OF THE INSTITUTE SO YOU
CAN ALWAYS REACH OUT TO US
ANYTIME INCLUDING AT THE E-MAIL
ADDRESS YOU SEE HERE AND WE'LL
GET YOUR E-MAIL TO THE RIGHT
PERSON.
DR. JOANIE RUTTER IS THE
DIRECTOR OF THE NATIONAL CENTER
FOR ADVANCING TRANSLATIONAL
SCIENCES,
ALSO KNOWN AS NCATS. DR. RUTTER
OVERSEES THE PLANNING AND
EXECUTION OF THE CENTER'S
COMPLEX,
MULTIFACETED PROGRAMS THAT AIM
TO OVERCOME SCIENTIFIC AND
OPERATIONAL BARRIERS IMPEDING
THE
DEVELOPMENT AND DELIVERY OF NEW
TREATMENTS AND OTHER HEALTH
SOLUTIONS. UNDER HER DIRECTION,
NCATS SUPPORTS INNOVATIVE TOOLS
AND STRATEGIES TO MAKE EACH STEP
IN THE TRANSLATIONAL PROCESS
MORE EFFECTIVE AND EFFICIENT,
SPEEDING RESEARCH ACROSS A RANGE
OF DISEASES, WITH A PARTICULAR
FOCUS ON RARE DISEASES. BY
ADVANCING THE SCIENCE OF
TRANSLATION, NCATS HELPS TURN
PROMISING
RESEARCH DISCOVERIES INTO
REAL-WORLD APPLICATIONS THAT
IMPROVE PEOPLE'S HEALTH. IN HER
PREVIOUS
ROLE AS THE NCATS DEPUTY
DIRECTOR, SHE COLLABORATED WITH
COLLEAGUES FROM GOVERNMENT,
ACADEMIA, INDUSTRY, AND
NONPROFIT PATIENT ORGANIZATIONS
TO ESTABLISH ROBUST INTERACTIONS
WITH
NCATS PROGRAMS.
BEFORE JOINING NCATS, DR. RUTTER
SERVED AS THE DIRECTOR OF
SCIENTIFIC PROGRAMS FOR THE ALL
OF US
RESEARCH PROGRAM, WHERE SHE LED
SCIENTIFIC PROGRAMMATIC
DEVELOPMENT AND IMPLEMENTATION
EFFORTS TO BUILD A NATIONAL
RESEARCH COHORT OF AT LEAST 1
MILLION U.S. PARTICIPANTS TO
ADVANCE
PRECISION MEDICINE. DURING HER
TIME AT NIH, SHE ALSO HAS LED
THE DIVISION OF NEUROSCIENCE AND
BEHAVIOR AT THE NATIONAL
INSTITUTE ON DRUG ABUSE, OR
NIDA. IN THIS ROLE, SHE
DEVELOPED AND
COORDINATED RESEARCH ON BASIC
AND CLINICAL NEUROSCIENCE, BRAIN
AND BEHAVIORAL DEVELOPMENT,
GENETICS, EPIGENETICS,
COMPUTATIONAL NEUROSCIENCE,
BIOINFORMATICS, AND DRUG
DISCOVERY. SHE ALSO
COORDINATED THE GENETICS
CONSORTIUM AND BIO SPECIMEN
REPOSITORY.
TODAY SHE WILL SHARE NCATS
COLLABORATIONS WITH NINR.
WELCOME DR. RUTTER.
>>THAT WAS A VERY GENEROUS
INTRODUCTION.
THANK YOU.
THANK YOU FOR INVITING ME TODAY
AND I DIDN'T REALIZE YOU'RE SO
TALL.
I'M PULLING THIS MICROPHONE
DOWN.
YOU'RE A GIANT.
I HAD NO IDEA.
I'M HERE TO TALK TO YOU A LITTLE
BIT ABOUT WHAT WE'RE DOING AT
NCATS AND HOW IT INTERSECTS
QUITE WELL WHAT YOU'RE DOING IN
THE NURSING INSTITUTE.
TO DO THAT I WANT TO TELL YOU A
LITTLE BIT ABOUT WHO WE ARE AND
WHAT WE DO AND SOME OF OUR GOALS
AND ASPIRATIONS I SUPPOSE OVER
THE NEXT 10 YEARS AND TALKS
ABOUT THE HIGHLIGHTS THAT WE
HAVE RELATED TO NURSING RESEARCH
AND POTENTIAL OPPORTUNITIES I
THINK DOWN THE ROAD.
I'M GOING TO JUMP IN.
BURY GO I WANTED TO LET YOU
KNOW -- BEFORE I GO I WANTED TO
LET YOU KNOW I USE QR CODES
BECAUSE YOU CAN TAKE A PHOTO AND
YOU CAN HAVE IT TO PER USE LATER
ON.
I WANTED TO MAKE SURE YOU HAVE
ACCESS TO A LOT OF THE
INFORMATION I'LL BE RELAYING
TODAY.
SO A LITTLE BIT ABOUT NCATS IS
THAT THE CHALLENGE THAT WE THINK
ABOUT QUITE A BIT IS A PUBLIC
HEALTH CHALLENGE IN THAT WE HAVE
OVER 10,000 DISEASES THAT ARE
OUT THERE AND ONLY 5% HAVE A
TREATMENT OR A CURE.
AND WITH THAT THE TIME IT TAKES
TO DEVELOP TREATMENTS OR
THERAPIES TO GET INTO CLINICAL
TRIALS IS ABOUT 10 OR 15 YEARS
AND THEY'VE BEEN GETTING INTO
MEDICINE CABINETS ANOTHER 10 TO
15 YEARS.
IT CAN TAKE A LONG TIME AND AT A
BUDGET OF ABOUT $2.6 BILLION
THAT'S A LOT OF TIME AND MONEY.
NOT ONLY THAT, PROBABLY ONE OF
THE MORE DIRE STATISTICS HERE IS
THAT NINE OUT OF 10 TIMES A
PROMISING THERAPEUTIC CANDIDATE
THAT ENTERS CLINICAL TRIALS
FAILS.
60% OF THE TIME IT FAILS IN
PHASE II AND THE EFFICACY PHASE
AND THE OTHER 35% IT FAILS IN
PHASE 1.
SO THE SAFETY SAFE.
THE SAFETY EFFICACY WE'RE JUST
NOT DOING A VERY GOOD JOB PRE
CLINICALLY TO BE MORE PREDICTIVE
IN REACHING THE PEOPLE THAT HAVE
THESE THERAPIES.
THIS IS A BIG PROBLEM WE CAN
START TO TACKLE IN A SYSTEMATIC
WAY AND A BIG POINT OF WHAT
NCATS IS ABOUT.
OUR MISSION IS TO TURN RESEARCH
OBSERVATIONS INTO HEALTH
SOLUTIONS THROUGH TRANSLATIONAL
SCIENCE.
WE LIKE TO TALK ABOUT THE IDEA
AROUND THE PIPELINE THERE'S
BARRIERS THE BOTTLE NECKS THAT
PREVENT US FROM MOVING QUICKLY
DOWN THE ROAD.
IF WE CAN TACKLE THOSE
BOTTLENECKS OR BARRIERS WE'D
THEN BE ABLE TO MOVE MORE THINGS
THROUGH THAT PIPELINE.
THIS IS A GRAPHIC ILLUSTRATION
OF THIS YOU GET THE IDEA THIS IS
WHAT WE NEED TO DO IS START TO
ADDRESS THE BOTTLENECKS.
THROUGH TRANSLATIONAL SCIENCE WE
WANT TO USE TRANSLATIONAL
RESEARCH IN THE PROJECTS FOR ANY
SPECIFIC RESEARCH PROGRAM WE'RE
DOING TO BE THE EXAMPLE OF WHAT
WE'RE DOING FASTER AND BETTER
AND EFFICIENTLY AND ADDRESS THE
LONG STANDING BOTTLENECKS TO
REACH PEOPLE FASTER.
IF WE CAN DO THAT IN ANY GIVEN
PROJECT ON THE NEXT PROJECT WE
CAN START TO APPLY THE LEARNINGS
AND START TO CHIP AWAY AT THE
TIME FRAME.
I WANTED TO PROVIDE YOU SOME
EXAMPLES OF WHAT THE BOTTLENECKS
ARE.
I CAN SAY BOTTLENECKS ALL I WANT
BUT THE ONE SIZE FITS ALL
APPROACH TO CLINICAL TRIALS.
WE'RE STARTING TO GET OUT OF
THAT MOLD.
WE HAVE LOW ENROLLMENT AND
DIVERSITY IN CLINICAL TRIALS.
IT'S A LONG STANDING PROBLEM.
COLLECTIVELY IN A LOT OF THE
WORK DR. ZENK IS DOING THROUGH
COMMON FUND PROGRAMS AND OTHER
AREAS ACROSS THE NIH, WE'RE
STARTING TO GET AT HOW WE CAN
RELATE AND ENHANCE COMMUNITY
ENGAGEMENT TO TACKLE THESE SORTS
OF ISSUES.
THESE ARE SOME OF THE PROBLEMS
BUT THEY'RE ADMINISTRATIVE
PROBLEMS AND WORKFORCE PROBLEMS
AND SCIENTIFIC PROBLEMS.
A LOT OF TIMES IT'S NOT THE
SCIENTIFIC PROBLEMS IT'S THE
ADMINISTRATIVE AND OPERATIONAL
ONES THAT ARE PRETTY
CHALLENGING.
.
WE TAKE THE WHOLISTIC VIEW OF
TACKLING THE PROBLEMS TO
UNDERSTAND HOW TO MAKE THINGS GO
MORE EFFICIENTLY.
THESE ARE SOME OF THE SOLUTIONS.
WE'RE WORKING ON AN NCATS IN
PURPLE AND I WANT TO HIGHLIGHT
SOME AS I GO THROUGH THE
PRESENTATION TODAY.
ALL IN ALL, THIS IS HOW WE THINK
WE CAN REALLY ADDRESS BRINGING
MORE TREATMENTS FOR ALL PEOPLE
MORE QUICKLY AND TURNED THIS
INTO OUR THREE AUDACIOUS GOALS
OF MORE TREATMENTS, ALL PEOPLE
MORE QUICKLY.
5% OF THE TREATMENTS WITH
DISEASES WITH A TREATMENT.
WHAT IF WE CAN BRING THAT UP TO
25%.
FIVE-FOLD INCREASE OF DISEASES
WITH TREATMENTS?
THAT'S SOMETHING THAT IS
AUDACIOUS AND WE'VE BEEN AT 5%
FOR A VERY LONG TIME BUT WE HAVE
NEW TOOLS AND TECHNOLOGIES AND
WE HAVE THE SKILL AND ABILITY TO
BE ABLE TO BRING MORE TREATMENT
FOR ALL PEOPLE MORE QUICKLY.
I BELIEVE WE HAVE THE ABILITY TO
DO THIS.
I WOULD RATHER FAIL AT 25% THAN
SUCCESS AT 6%.
THIS IS WHY WE NEED TO HAVE THAT
AUDACIOUSNESS THERE.
FOR ALL PEOPLE, THIS IS EXACTLY
WHAT IT ENCOMPASSES,
DRAMATICALLY INCREASING
INCLUSIVITY ACROSS EVERY AREA
FROM TRAINING AND WORKFORCE
DEVELOPMENT AND P.I.s LEADING
DIFFERENT STUDIES THROUGH
INCREASING DIVERSITY IN ALL THE
WORK WE DO NOT JUST CLINICALLY
BUT PRECLINICALLY AND WHAT WE
MEAN BY FOR ALL PEOPLE.
WE NEED TO MAKE A DIFFERENCE
HERE AND LASTLY MORE QUICKLY.
WE WANT TO ENABLE DIAGNOSTICS
AND THERAPEUTICS TO REACH PEOPLE
TWICE AS FAST.
AND AN EXAMPLE HERE A TIDBIT OF
INFORMATION IS MUCH OF THE WORK
WE DO AT NCATS FOCUSES ON RARE
DISEASES.
THIS IS A BIG AREA FOR US TO USE
AS A NORTH STAR OF HOW WE LOOK
AT TRANSLATIONAL SCIENCE AND
WITH THOSE RARE DISEASES IT
TAKES ABOUT SEVEN TO TEN YEARS
ON AVERAGE FOR A PERSON WITH A
RARE DISEASE TO BE DIAGNOSED.
WE CAN CUT THAT TIME IN HALF
THAT WOULD ADD A HUGE AMOUNT OF
VALUE FOR THE RARE DISEASE
POPULATIONS.
GIVEN THE TIME IT TAKES TO
DIAGNOSE SOMEBODY WITH A RARE
DISEASE THEY AGED OUT OF A
WINDOW OF WHERE THEY MIGHT HAVE
MODIFYING THERAPIES.
THIS IS A CRITICAL PROBLEM FOR
US TO REALLY START TO ADDRESS.
THESE ARE SOME OF THE IDEAS WE
WANT TO TACKLE ALONG THE WAY AT
NCATS.
SOME KEY APPROACHES UNDERSTAND
WHAT IS SIMILAR ACROSS DISEASES
DISPLAYING MULTIPLE DISEASES AT
A TIME WITH OVER 10,000 DISEASES
IF WE GO ONE DISEASE AT A TIME
WE'LL BE HERE FOR A LONG TIME.
WE AREN'T HERE FOR A LONG TIME.
WE NEED TO FIGURE OUT SOMETHING
ELSE THAT WILL MAKE THIS GO
FASTER AND BETTER.
WE WANT TO DEVELOP MODELS THAT
BETTER PREDICT A PERSON'S
REACTION TO A THERAPY.
SO THIS IS A LOT OF THE EFFORT
THAT WE'RE DOING IN THE PRE
CLINICAL SPACE.
WE KNOW RODENTS AREN'T REALLY
HUMANS AND THIS IS PART OF THE
ISSUE WE NEED TO ADDRESS.
AT THE SAME TIME, THAT'S THE
GOLD STANDARD RIGHT NOW.
SO WE NEED TO FIGURE OUT HOW TO
BUILD MODELS THAT CAN BETTER
RECAPITULATE THE HUMAN
CONDITION.
WE NEED TO ENHANCE CLINICAL
TRIALS AND STUDIES SO THE
RESULTS AND PEOPLE IN THEM MORE
ACCURATELY REFLECT THE PATIENT
POPULATION OF WHAT WE'RE TRYING
TO STUDY AND THIS SOUNDS EASY
BUT IT'S NOT AND WE NEED TO DO A
LOT BETTER IN TERMS OF OUR
EFFORT TO GET THERE.
AND LASTLY WE WANT TO LEVERAGE
REAL WORLD DATA AND EVIDENCE TO
ADDRESS THE PUBLIC HEALTH NEEDS
AND THAT'S A BIG IMPETUS AS WELL
AS WHAT WE'RE DOING IN THE
SPACE.
I'LL ALSO SHOW THE NCATS BUT AT
A GLANCE.
THIS IS THE PIE OF NCATS AND YOU
SEE ABOUT 68% TO 78% IS
DEDICATED AND A LINE ITEM
DEDICATED OUR CLINICAL AND
TRANSLATIONAL SCIENCE AWARD
PROGRAM.
A FLAGSHIP PROGRAM AT THE NIH
AND AT NCATS.
THE LARGEST PROGRAM AT NIH.
WE'RE THRILLED TO BE ABLE TO
STEWARD THE WORK THAT GETS
CONDUCTED UNDER THIS PARTICULAR
PROGRAM.
THIS IS ABOUT 63 DIFFERENT
INSTITUTIONS IMPORTANT IN
ADDRESSING THE SCIENCE ACROSS
THE COUNTRY AND BUILDING THAT
INFRASTRUCTURE TO DO THE WORK WE
NEED TO DO AND ACROSS THE OTHER
AREAS AT NCATS IS THE REMAINING
BUDGET IN THE PURPLE PART OF THE
PIE AND THAT'S ABOUT DRUG
DEVELOPMENT AND REPURPOSING AND
HIGH THROUGHPUT SCREENING AND
EARLY TRANSLATION AND LATE
TRANSLATION THROUGH PRE-IND
PHASES AND TISSUES ON CHIPS, 3-D
PRINTING, DIAGNOSTICS.
THESE ARE ALL THE AREAS WE
SUPPORT THROUGH THE OTHER PART
OF THIS BUDGET INCLUDING THE
TRAINING AND EDUCATION PROGRAMS
WE SUPPORT AS WELL.
SO I WANTED TO JUST GIVE YOU A
SENSE WE'RE A $923 MILLION
CENTER AND AGAIN THE BULK OF
THAT IS REALLY AROUND BUILDING
THE INFRASTRUCTURE TO SUPPORT A
LOT OF THESE ACTIVITIES.
SO NOW I JUST WANT TO GIVE YOU A
SENSE OF SOME OF THOSE PRE
CLINICAL, CLINICAL AND OTHER
DATA SCIENCE APPROACHES WE'RE
DOING THAT I THINK INTERSECT
QUITE WELL WITH WHAT THE NURSING
INSTITUTE RESEARCH INTERESTS ARE
AS WELL.
I'M GOING TO START ON THE
PRE-CLINICAL SIDE.
I MENTIONED THE IDEA THAT 90%
EVALUATE AND THAT MICE AREN'T
PEOPLE, RODENTS AREN'T PEOPLE.
TWO CELL LINES AREN'T REFLECTIVE
OF THE PHYSIOLOGICAL CONDITION.
WE'RE NOT DOING A GREAT JOB
DOING THIS.
SO WHAT NCATS IS WORKING ON IN A
VERY LARGE WAY IS TO UNDERSTAND
HOW CAN WE BETTER
PHYSIOLOGICALLY RECAPITULATE THE
CONDITION ON A CHAMPION OR IN A
3-D PRINTED WAY.
WE'RE INCREASING THE COMPLEXITY.
THE KINDS OF CELLS WE CAN PULL
TOGETHER THAT ARE MULTIPLE CELL
TYPES THAT CREATE STEROIDS AND
ORGANOIDS AND PRINT THESE IN
WAYS THAT PROPERTY THE TISSUE
SYSTEM AND LOOK AT THAT MORE
COLLECTIVELY AND WHOLISTICALLY
IN A RESEARCH ENVIRONMENT AND
INCREASE THE COMPLEXITY YOU DO
ON A CHIP AND YOU REDUCE YOUR
ABILITY TO DO HIGH THROUGHPUT
SCREENING AND DON'T WANT TO LOSE
THAT CAPABILITY WHILE MAXIMIZING
OUR ABILITY TO RECAPITULATE IN
THE PHYSIOLOGICALLY RELEVANT
CONDITION.
WE'RE DEVELOPING NEW
TECHNOLOGIES TO BETTER PREDICT A
PERSON'S RESPONSE TO A
PARTICULAR TREATMENT OR HOW TO
UNDERSTAND PERHAPS DISEASES IN
DIFFERENT WAYS AND BE ABLE TO
EVALUATE THAT MORE EFFECTIVELY.
ONE OF THE PROGRAMS WE SUPPORT
IS A SPACE PROGRAM WE CREATED
THESE TISSUE CHIPS FOR JUST
ABOUT EVERY ORGAN IN THE HUMAN
BODY.
WHAT'S INTERESTING THOUGH IS
WHAT WE LEARNED FROM OUR COUNTER
PARTS AT NASA WHEN THEY SEND
THEIR ASTRONAUTS INTO THE SPACE
STATION THEY COULD SPEND MANY
MONTHS IN THE SPACE STATION AND
ALMOST NEARLY IMMEDIATELY START
TO EXPERIENCE SOME DISEASE
CONDITIONS LIKE THEY HAVE THEIR
IMMUNOCOMPROMISED FOR A BIT.
THEY HAVE THEIR HEART FUNCTION
STARTS TO DETERIORATE, THEIR
MUSCLE FUNCTION STARTS TO
DETERIORATE.
THEY EXPERIENCE BONE LOSS.
THE GOOD NEWS IS WHEN THEY
RETURN TO EARTH IT GOES BACK TO
NORMAL.
IT CAN BE REGENERATED IN A WAY
BUT THAT MICROPHYSIOLOGICAL
CHIPS THAT GO INTO SPACE CAN
DETECT THOSE DIFFERENCES IN THE
CELL TYPES WE SEND UP INTO SPACE
IN THAT LOW EARTH ORBIT GRAVITY.
THE MICROGRAVITY ENVIRONMENT
TURNS OUT TO BE CRITICAL AND
TELLS US A LOT ABOUT THE AGING
PROCESS AND FOR A LACK OF BETTER
PROCESS IS WHAT WE'RE CALLING
THESE ISSUES THESE AGING ISSUES.
SO WHEN WE GET THESE CHIPS BACK
TO SPACE AND THE CAPSULE ON THE
LOWER RIGHT WE'RE ABLE TO
EVALUATE DIFFERENT MARKERS
BETWEEN THE SYSTEMS WE'RE USING
AND A LOT OF TIMES WE IDENTIFY
DIFFERENT AREAS OF INFLAMMATION
THAT ARE CRITICAL AND SEEING
UPTICKS IN HOW THE LABORATORY
RESPONSES ARE BEING TWEAKED A
LITTLE BIT AND THAT MAY BE PART
OF THE ISSUE AND WHAT'S CAUSING
THE PROBLEMS.
BY DOING THIS WE'RE ABLE TO
LEARN AND UNDERSTAND IN THIS
ENVIRONMENT IN A MORE FASTER WAY
THAN WE WOULD EVER BE ABLE TO DO
ON EARTH WHAT THOSE MIGHT BE AND
HOW TO IDENTIFY PARTICULAR AREAS
WHERE WE CAN FOLLOW-UP FOR
THERAPEUTIC DEVELOPMENT.
THAT'S WHY THIS PROGRAM IS SO
IMPORTANT AND THAT PARTNERSHIP
WITH NASA HAS BEEN CRITICAL IN
ALLOWING US TO BE ABLE TO DO
THIS.
THEY'RE INTERESTED HOW THEY CAN
EXAMINE HOW TO PUT PERHAPS
PEOPLE IN MARS AND HOW ARE THEY
GOING TO LIVE IN SPACE FOR THAT
LONG AMOUNT OF TIME?
CAN THEY?
WHAT OTHER ISSUES DO WE NEED TO
LOOK FOR?
THESE ARE QUESTIONS WE CAN WORK
TOGETHER ON IN ADDRESSING.
IT'S BEEN A VERY VALUABLE
PARTNERSHIP.
THE OTHER AREA I THINK I
MENTIONED WE WORK ON IT'S
ADVANCING ON MY SCREEN BUT NOT
ADVANCING THERE.
>>SO ANOTHER AREA IS RARE
DISEASES.
NCATS IS A HOME FOR RARE DISEASE
BUT WE DON'T DO THIS ALONE.
RARE DISEASES AFFECT JUST ABOUT
EVERY SYSTEM, ORGAN, DISEASE
THAT NIH STUDIES.
AND SO WE PARTNER WITH THE OVER
10 OR 11 DIFFERENT INSTITUTES
AND CENTERS ACROSS THE NIH TO
REALLY HELP US ADDRESS ISSUES
AROUND RARE DISEASES.
WHAT I WANTED TO TELL YOU HERE
IS WHY ARE RARE DISEASES SO
IMPORTANT?
I KNOW I PROBABLY DON'T NEED TO
TELL THIS AUDIENCE BUT
UNDERSTANDING THE MAGNITUDE OF
THE ECONOMIC BURDEN OF RARE
DISEASES IS IMPORTANT.
WE LOOKED AT INDIVIDUAL MEDICAL
COSTS FOR PEOPLE WITH RARE
DISEASE AND WHEN WE COMPARED
THEM TO PEOPLE WITHOUT A RARE
DISEASE THE MEDICAL COSTS WERE
THREE TO FIVE TIMES HIGHER IN
RARE DISEASE PATIENTS THAN IN
NON-RARE DISEASE PATIENTS.
WHEN YOU ADD THAT ON TO THE
NUMBER OF RARE DISEASES THAT WE
HAVE IN THIS COUNTRY, ABOUT 25
TO 30 MILLION IT TRANSLATES TO
MEDICAL COSTS OF AROUND $400
BILLION PER YEAR FOR THE RARE
DISEASE POPULATION.
NOW, WHEN YOU ADD ON TO THAT THE
HOME CARE NEEDED, THE
HOSPITALIZATIONS NEEDED AND
OTHER CARE ASSOCIATED WITH NOT
NECESSARILY DIRECT MEDICAL COSTS
BUT INDIRECT MEDICAL COSTS IT
GOES UP TO A TRILLION DOLLARS
PER YEAR IN TOTAL COSTS FOR THE
RARE DISEASE POPULATION.
SO THIS IS A PUBLIC HEALTH
CHALLENGE WE HAVE.
ONE OF THE AREAS WE'RE
INTERESTED IN IS
QUINTESSENTIALLY A
PLATFORM-BASED PROBLEM.
WE'RE COUNTING ON THE FACT THAT
GIVEN THERE ARE OVER 10,000 RARE
DISEASES ABOUT 80% OF THOSE ARE
CAUSED BY A SINGLE GENE
MUTATION.
A SINGLE GENE.
SO WITH THAT INFORMATION WE KNOW
THAT PERHAPS GENE THERAPY, GENE
EDITING, THESE SORTS OF
GENETICALLY DRIVEN MODALITIES
FOR TREATMENTS COULD BE
SIGNIFICANT FOR RARE DISEASE
POPULATION.
IF WE DEVELOP A PLATFORM-BASED
APPROACH FOR THESE MODALITIES
FOR THERAPEUTICS PERHAPS THAT
CAN DEMOCRATIZE FOR MORE TO
EXPLORE THESE AND WE HAVE THREE
PROGRAMS IN THIS AREA AND I'M
GIVING THANK YOU QR CODES
BECAUSE I'M NOT GOING TO BE ABLE
TO DO ANY OF THEM JUSTICE.
THEY'RE IN VARIOUS STAGES OF
DEVELOPMENT.
SOME ARE MORE ON THE DEVELOPMENT
SIDE, SOME ARE GETTING MORE
CLOSELY TO THE CLINICAL TRIALS
SIDE AND THAT WILL BE
SIGNIFICANT I THINK AND THE LAST
ONE HERE WE'RE ABOUT A YEAR OUT
FROM OUR FIRST CLINICAL TRIAL
FOR A GENE THERAPY WHERE WE'RE
USING THE SAME AAV VIRUS FOR TWO
DIFFERENT GENE THERAPY GENES TO
SEE IF WE CAN STREAMLINE AND THE
ABILITY TO DEVELOP THE
STREAMLINED APPROACHES FOR
REGULATORY UNDERSTANDING OF THE
CAPSID DELIVERY DECIDE TO CREATE
A WAY IN WHICH OTHER PEOPLE CAN
LEARN AND USE TEMPLATED APPROACH
FOR THE REGULATORY DEVELOPMENT
OF DELIVERING MECHANISM WHEN
THEY JUST NEED TO FOCUS ON A
THERAPEUTIC MECHANISM.
WITH THAT PERHAPS YOU CAN CUT
DOWN THE TIME OF REGULATORY NEED
ONE THE APPROVAL.
THAT'S ONE EXAMPLE HOW WE'RE
TRYING TO EXPLORE THE
PLATFORM-BASED APPROACHES FOR
THERAPEUTIC DEVELOPMENT.
WE HAVE OTHER APPROACHES IN GENE
THERAPY THROUGH A CONSORTIUM AND
WE'RE PART OF THE COMMON FUND
PROGRAM FOR GENE EDITING.
LOOK AT THE QR CODES TO LEARN
MORE.
WHAT I'LL ALSO SAY IS THIS IS
GOING TO MEAN WE WILL NEED
DIFFERENT WORKFORCE COMMUNITIES
TO HELP US TRANSLATE INTO THAT
THERAPEUTIC DEVELOPMENT.
THAT MEANS NURSES, THAT MEANS
PHARMACY STAFF, THAT MEANS
STATISTICIANS, ETCETERA.
THIS IS GOING TO BE A KEY AREA
FOR US MOVING FORWARD.
I WANT TO END ON TALKING A
LITTLE BIT ABOUT THE CTSA
PROGRAM.
WE HAVE 63 DIFFERENT
INSTITUTIONS ACROSS THE COUNTRY
FOCUSSED ON DEVELOPING THE
INFRASTRUCTURE FOR WHAT WE DO IN
THIS SPACE.
I ALSO WANTED TO TELL YOU ABOUT
THE POPULATION OF NURSES IN THE
CTSA PROGRAM.
WE HAVE FOUR P.I.s WITH NURSING
DEGREES AND FOUR INSTITUTIONS
THAT HAVE AND ASSOCIATED WITH A
NURSING SCHOOL AND 24 NURSING
DEGREES IN TERMS OF SCHOLARS AND
TRAINEES AND I'M GOING TO TALK
ABOUT A FEW OF THOSE.
WE ALSO HAVE A VARIETY OF PILOT
PROJECTS RELATED TO NURSING
DEGREES WITH NURSING INTERESTS.
I'M EXCITED TO SEE THE DEPTH AND
BREADTH WE HAVE WITHIN THE CTSA
PROGRAM AND ALLOWS US TO HAVE
POTENTIAL OPPORTUNITIES FOR
FURTHER COLLABORATION.
THIS IS REALLY WHAT THE CTSA
PROGRAM DOES.
THEY HAVE THESE LOCAL STRENGTHS
IN THEIR OWN COMMUNITIES BUT
THEY COLLECTIVELY CAN ENABLE
RESPONSES TO A NATIONAL PUBLIC
HEALTH CHALLENGE THE OPIOID
CRISIS OR PANDEMIC OR COMMUNITY
ENGAGEMENT NEEDS OR TELEHEALTH
OR TELEMEDICINE OR WORK IN
GENOMICS AND RARE DISEASES.
SO THINKING MORE OPERATIONALLY
IN THINKING OF AN IRB PLATFORM
THAT CAN BE MORE STREAMLINED.
THOSE ARE SOME OF THE AREAS WE
HELPED TO SUPPORT.
I THINK THE GRAPH ON THE UPPER
RIGHT HAND CORNER THERE IS
REALLY FOCUSSED ON WEARABLE
DEVICES.
I WANT TO GET TO WHY I WANTED TO
HIGHLIGHT THAT IN JUST A MOMENT.
I WANTED TO JUST TOUCH SOME OF
THE COMMUNITY ENGAGEMENT
ACTIVITY THE CTSA PROGRAM DOES.
THIS IS ANOTHER AREA WHERE
PARTNERSHIPS IN THIS SPACE ARE
GOING TO BE CRITICAL.
WE CAN'T DO THIS ALONE.
THE CTSA'S CAN'T DO THIS ALONE
AND OTHER PROGRAMS ACROSS THE
NIH CAN'T DO THIS ALONE.
ONE PROGRAM WITHIN THE CTSA IS A
TRIAL INNOVATION NETWORK.
WHERE DESIGNING CLINICAL TRIAL
TO DISSEMINATION OUTREACH, WE
HAVE TOOLS AND RESOURCES TO HELP
PEOPLE DEVELOP THE FULL GAMUT OF
WHAT THAT MIGHT ENTAIL AND SOME
RESOURCES ARE IN THE QR CODE
ABOVE AND BRINGING THE VALUE
PROPOSITION TO UNIVERSITY WHAT
PART OF WHAT WE'RE TRYING TO DO.
I WANT TO GIVE A LITTLE BIT OF
RENDITION OF A COMPELLING STORY
AND THE QR CODE FOR THE VIDEO IS
SHOWN HERE TOO.
THIS IS A COMMUNITY ADVISORY
BOARD MEMBER OF ONE OF THE CTSA
PROGRAMS AT U.C. DAVIS AND PART
OF A NATIONAL ACADEMY STUDY.
IN THE VIDEO SHE TALKS ABOUT THE
IDEA OF GOING INTO A COMMUNITY
THAT WAS DOCUMENTED AS A FOOD
DESERT.
WHEN SHE WENT INTO THE COMMUNITY
TO TALK ABOUT THESE ISSUES OF
BEING IN A FOOD DESERT SHE FOUND
THE COMMUNITY DESERT WASN'T A
PROBLEM BUT THE COMMUNITY DIDN'T
FEEL SAFE WALKING IN THE STREET
AND THE SIDEWALKS ARE BROKEN AND
CRACKED, YOU CAN'T PUSH
STROLLERS DOWN THEM.
THESE SIMPLE FIXES WOULD GO A
LONG WAY TO ENHANCING THE
COMMUNITY'S OUT THERE AND
ENABLING THEM TO BE MORE
SELF-SUFFICIENT AND PERHAPS NOT
BEING MISLABELLED AS BEING IN A
FOOD DESERT BUT BEING A VIBRANT
COMMUNITY.
THESE ARE THE KINDS OF THINGS
THE TALKS ABOUT AND WHERE THE
PROGRAM CAN GO OUT AND LEARN
THESE SORTS OF THINGS.
ANOTHER KEY PROGRAM IS ONE THAT
DR. ZENK LEADS THROUGH THE
COMMON FUND PROGRAM CALLED
COMPASS AND WE RECENTLY
SUPPLEMENTED AN AWARD THROUGH
OUR CTSA PROGRAM THROUGH THE
COMMUNITY THROUGH THE
MEHARRY-VANDERBILT COMMUNITY
ENGAGED RESEARCH CORE AND WE'RE
GOING TO LEARN FROM ONE ANOTHER
AND BE ABLE TO BUILD A STRONGER
WAY TO ENHANCE THE COMMUNITY
ENGAGEMENTS THAT ARE NEEDED.
NOW, I WANTED TO GIVE YOU
ADDITIONAL HIGHLIGHTS FROM THE
CSTS PROGRAM FROM THE NURSING
STANDPOINT.
YOU PROBABLY HEARD SOME OF THESE
STORIES ALREADY.
I WON'T SPEND TOO MUCH TIME ON
THEM BUT I'M PRETTY PROUD OF
THEM.
THIS IS SHANINA KNIGHT THINKING
OF WAYS TO ENHANCE HYGIENE OF
OLDER ABUTS.
PUTTING THE HYGIENE EQUIPMENT ON
HOSPITAL BEDS.
IT'S BRILLIANT AND EASY.
SHE WAS THE WINNER OF A 40 UNDER
40 LEADER IN MINORITY HEALTH
AWARD.
SO I'M SUPER THRILLED SHE'S
GETTING RECOGNIZED IN THAT WAY.
ANOTHER SUCCESSFUL STORY IS
ALEXUS DUNN-AMORE LOOKED AT
MATERNAL MORTALITY CRISIS IN THE
U.S. AND COVID AND THIS IS AN
AREA IN IMPROVING MATERNAL
HEALTH.
I'D LIKE TO HIGHLIGHT TWO
NURSING SCHOLARS AT ROCKEFELLER.
THE ONE ON TOP HERE IS DR. POLLY
JOSEPH DOING RESEARCH ON TASTE
AND SMELL DISORDERS AND IT TURNS
OUT IT WAS IMPORTANT DURING THE
PANDEMIC.
WE WERE ABLE TO LEARN A LOT FROM
HER AND THE ONE ON THE BOTTOM IS
LOOKING AT OLDER ADULTS IN SLEEP
PATTERNS, DR. GODZIK HAS LOOKED
AT THIS AND IMPORTANT FOR US TO
SUPPORT.
AND I WANT TO HIGHLIGHT THE
IMPACT OF WEARABLES.
I THINK I TEASED ABOUT THE IDEA
OF WEARABLES.
ONE OF THE ASPECTS OF THE CTSA
PROGRAM AND THE GEORGIA CTSA IS
QUINTESSENTIAL WORKING ON THE
WEARABLES AND MOBILE
TECHNOLOGIES.
AND I THINK THAT THERE'S A LOT
OF WORK IN THE SPACE TO FILL
GAPS THAT ARE NEEDED TO MONITOR
POTENTIAL DISEASE PROGRESSION OR
ACTIVITIES AND THIS ONE IN
PARTICULAR IS ADDRESSING
LANGUAGE BARRIERS FOR PEOPLE OUT
IN COMMUNITIES AND HAVE
DIFFICULTIES IN INTERACTING WITH
PATIENTS.
THIS IS AN APP THAT HELPS
ADDRESS THAT.
BUT THERE'S MANY APPS BEING
GENERATED TO FILL THESE CERTAIN
GAPS.
I'M SHOWING TWO MORE HERE.
ONE IS FROM SCRIPPS RESEARCH
INSTITUTE LOOKING ON SYMPTOMS OF
COVID AND SYMPTOMS OF COVID
ALONG WITH USING DIGITAL HEALTH
TECHNOLOGIES AND IT TURNS OUT IF
YOU USE BOTH SYMPTOMS AND
DIGITAL TECHNOLOGIES YOU GET
MORE CONFIDENCE IN THE RESULTS.
LOOKING AT SLEEP PATTERNS, I
MENTIONED THIS IS A KEY ISSUE
AND ONE OF THE FELLOWS WORK
BEING DONE.
THIS ONE IS LOOKING AT COMPARING
SLEEP WEARABLES AND EVALUATING
THE DIFFERENT WEARABLES WE HAVE
OUT THERE FOR SLEEP AND THE
GROWING CONFIDENCE IN LOOKING AT
DIGITAL TECHNOLOGIES AND HOW
THEY'RE ABLE TO TELL US THAT A
LOT MORE DETAIL ABOUT OUR SLEEP
PATTERNS AND HOW THAT MIGHT
AFFECT OUR COMMUNITY.
THESE ARE A FEW AREAS I THINK
ARE INTERESTING AND COULD ADD A
LOT OF VALUE TO WHAT WE'RE DOING
IN BRINGING IN THE DATA.
WHAT I'M SUPER EXCITED ABOUT IS
WHEN WE LOOKED AT A VARIETY OF
THE DIGITAL TECHNOLOGIES ACROSS
THE NIH, WHAT WE FOUND IS IF YOU
LOOK AT THE PERCENT OF NIH
FUNDING BY I.C. IN THE DIGITAL
HEALTH SPACE OVER THE LAST SEVEN
YEARS IT TURNS OUT WHO'S THE ONE
ON TOP IS NINR.
AND NINR IS LEADING THE WAY IN
THIS SPACE.
NOW, IF YOU DON'T DO IT BY
PERCENT OF FUNDING PER I.C.
THERE ARE SOME THAT ARE BIGGER
IN THE SPACE BUT IT TELLS ME
THERE'S A THERE, THERE.
YOU'RE MORE FROM IN THE THERE,
THERE.
HOW DO WE THINK OF THIS AS
FERTILE GROUND TO CONTINUE
PATHWAYS FOR PARTNERSHIPS IN
COLLABORATION AND AREAS OF NEED
AND HOW DO WE COORDINATE THAT
EFFORT AND ALIGN TO CERTAIN
GOALS WE THINK ARE VALUED AND
HOW DO WE PRIORITIZE THAT WORK
AND PUT OUR SIGHT ON IT.
WE NEED THE PARTNERSHIPS WE HAVE
ACROSS THE NIH AND HHS AND OTHER
STAKEHOLDERS IN THE COMMUNITY.
WE'RE UNDERGOING A STRATEGIC
PLAN DEVELOPMENT AND THIS IS --
YOU DON'T NEED TO READ THIS
SLIDE.
THE QR CODE IS THERE IF YOU'RE
INTERESTED IN OUR DEVELOPMENT OF
THAT.
WE HAVE GONE THROUGH OVER 40
DIFFERENT ROUNDTABLES MEETING
WITH STAKEHOLDERS AND PATIENT,
PATIENT ADVOCACY GROUPS AND
ADVISORY BOARDS AND THE PUBLIC
AND WE'RE AT THE POINT WHERE WE
HAVE REQUEST FOR INFORMATION
WRITTEN AND STANDING AND WAITING
TO BE PUBLICIZED.
I HOPE I CAN CALL ON YOU AND
DR. ZENK TO FORWARD IT TO YOU TO
GIVE YOUR INPUT PERHAPS ON WHAT
YOU MIGHT SEE AS POTENTIAL FOR
INTERACTIONS WITH NCATS AND HOW
TO START TO BUILD THAT INTO OUR
STRATEGIC PLAN AS WELL.
I ASK FOR YOUR HELP AND WITH
THAT I'LL AND I KNOW I'M
PROBABLY OVER TIME BUT HAPPY TO
ANSWER ANY QUESTIONS YOU MIGHT
HAVE.
THANK YOU.
>>THANK YOU, DR. RUTTER.
I'LL ASK DR. MUNRO TO LEAD US IN
DISCUSSION.
>>THANK YOU VERY MUCH FOR YOUR
VERY INFORMATIVE PRESENTATION
AND I APPRECIATED THE HIGHLIGHTS
OF HOW NURSING RESEARCH
INTERSECTS WITH THE WORK OF
NCATS.
AND ONE APPROACH IS LEVERAGE
SIMILARITIES ACROSS DISEASES.
NURSING RESEARCH HAS BEEN WELL
POSITIONED TO CONTRIBUTE BECAUSE
IT FOCUSES OB PEOPLE'S LIVES AND
LIVING CONDITIONS ADDRESSING
HEALTH AND MENTAL HEALTH THROUGH
THE LENS OF SOCIAL DETERMINATES
OF HEALTH AND THAT COULD BE
APPLIED ACROSS THE SPECTRUM.
I CONTINUE TO BE STRUCK BY THE
INTERVENTIONS OF PHARMACOLOGIC
AND THE TIME LINE FOR DIAGNOSIS
IS TEN TO 15 YEARS AND IT HASN'T
IMPROVED VERY MUCH AND WE'RE
STUCK AT THAT NUMBER.
I THINK SPEEDING THE DELIVERY OF
EFFECTIVE TREATMENTS TO THE
PEOPLE THAT NEED THEM IS AN
IMPORTANT GOAL.
I WOULD NOTE NURSING
INTERVENTIONS TARGET FACTORS IN
RESILIENCE AND NURSE SCIENCE
TESTS PROPOSE SOLUTION CAN BE
TESTED MORE QUICKLY THAN
PHARMACOLOGIC AND THE HAND
CLEANING IS EASY AND BRILLIANT
AND CLEAR SCIENCE HAS A CLEAR
PATH TO ASSIST THE GOALS OF
NCATS TO GET MORE PEOPLE TO ALL
PEOPLE PARTICULARLY WITH A VIEW
OF HEALTH INNOVATIONS.
YOU PRESENTED NURSE SCIENTISTS
MAKE SIGNIFICANT CONTRIBUTION TO
THE NATIONAL NETWORK AND IN TURN
CTSAs SUPPORT THE DEVELOPMENT OF
THE PIPELINE OF NURSE SCIENTISTS
AND ENHANCED INTERDISCIPLINARY
TEAM SCIENCE AND THAT'S A
TRADITION I HOPE WILL CONTINUE.
MY QUESTION IS ABOUT THE
EXAMPLES THAT YOU PROVIDED OF
THE EXCELLENT PROJECTS THAT HAVE
BEEN DONE IN THE CTSAs.
NOTING THE NUMBERS, 43CTSA
INSTITUTIONS HAVE A NURSING
SCHOOL OUT OF ABOUT 60.
ABOUT TWO-THIRDS OF THEM HAVE A
NURSING SCHOOL ASSOCIATED WITH
THEM.
AND I WONDERED ABOUT THE NUMBER
OF SCHOLARS AND TRAINEES, 24
WITH NURSING DEGREES.
HOW'S THAT COMPARE TO THE TOTAL
NUMBER OF TRAINEES.
>>I DON'T KNOW THE ANSWER TO
THAT QUESTION.
THE CSTA PROGRAM TRAINS A LOT OF
TRAINEES.
SO IT'S PROBABLY ON THE LOWER
SIDE.
AND SO WITH THE IDEA THAT THERE
ARE MANY NURSING SCHOOLS
ASSOCIATED WITH CTSAs, PERHAPS
THAT'S AN AREA WE CAN REALLY
DRAW FROM AND BUILD MORE FROM.
AND I THINK THAT IS -- THAT'S
THERE.
THAT'S SOMETHING WE CAN DO VERY
EASILY IN MAKING THOSE
CONNECTIONS.
SO I THINK WHAT WE COULD DO IS
UNDERSTAND HOW IT CAN BETTER
NAVIGATE AND MAKE AWARE THE
NURSING SCHOOLS THAT THERE ARE
OPPORTUNITIES THAT ARE
ASSOCIATED WITH THE CTSA PROGRAM
FOR SCHOLARLY DEVELOPMENT IN A
VARIETY OF ACTIVITY ARE NEEDED
IN THE INFRASTRUCTURE WE SUPPORT
FOR CLINICAL RESEARCH.
I THINK THIS IS A KEY THING WE
CAN DO BUT THE OTHER THING THAT
YOU ARE POINTING TO AS WELL IS
PERHAPS THOSE 24 PEOPLE CAN BE
AMBASSADORS BACK TO THE NURSING
SCHOOLS AND TALK ABOUT WHAT THEY
DO IN THE TRAINING THEY RECEIVE
THROUGH THE CTSA PROGRAM AND
MAYBE THAT'S ONE WAY TO
HIGHLIGHT THAT EVEN MORE.
>>AND I THINK FOR EXAMPLE WE
HAVE A CTSA IN MIAMI AND WE ARE
VERY WELL CONNECTED WITH IT IN
TERMS OF THE PROGRAMS THAT ARE
OFFERED IN THOSE KINDS OF THINGS
BUT I'M NOT CERTAIN WITH THE
NUMBER OF TRAINEES WE HAVE IS
REPRESENTATIVE OF OUR POPULATION
OF SCIENTISTS.
>>YEAH.
AND IT'S A COMPETITIVE
ENVIRONMENT.
SO ONE OF THE THINGS WE CAN DO
TO HELP SUPPORT INDIVIDUALS WHO
ARE INTERESTED IN BECOMING
TRAINEES I THINK AWARENESS IS
GOING TO BE THE BIGGEST THING
BUT HOW WE REALLY MAKE SURE
THOSE ARE CONNECTION ARE KNOWN
AND UNDERSTOOD HOW TO GET INTO
THOSE PROGRAMS.
SEEMS LIKE THAT'S SOMETHING WE
COULD DO.
WOULD LOVE ANY ADDITIONAL
THOUGHTS YOU HAVE ON THAT AS
WELL IF YOU DON'T MIND E-MAILING
ME OR IF YOU HAVE THOUGHTS IN
THE FUTURE PERHAPS HOW YOUR
SCHOOL IS THINKING ABOUT THAT.
THANK YOU.
>>MY OTHER QUESTION IS ABOUT I
THOUGHT IT WAS REALLY INTRIGUING
WHEN YOU TALKED ABOUT THE GENE
TARGET THE DELIVERY PROGRAM YOU
TALKED ABOUT IT NEEDING A VERY
BROAD REPRESENTATION THE HEALTH
CARE WORKFORCE.
IN ADDITION TO THE ROLE OF
NURSES IN PERHAPS TRANSLATING
THAT TO PEOPLE WHO ARE IN THE
CLINICAL TRIALS, WHAT WOULD YOU
SEE AS THE ROLE OF NURSING
SCIENCE?
>>THAT'S A GREAT QUESTION.
IN CLINICAL TRIALS IN THE NEW
MODALITIES WE'RE USING IN GENE
THERAPY FOR EXAMPLE, WE'RE
SEEING -- IT'S BEEN A ROCKY ROAD
THE LAST 20 YEARS IN LOOKING AT
GENE THERAPIES.
WE DON'T KNOW NECESSARILY THE
SAFETY AND EFFICACY OF THESE
GENE THERAPIES.
WE THINK WE KNOW THE EFFICACY
PROBABLY A LITTLE BIT MORE BUT
THE SAFETY I THINK IS STILL WE
WANT TO MAKE SURE WE HAVE THE
VIEW OF THE WHOLISTIC PERSON
WHEN WE'RE THINKING ABOUT CARE
EVEN IF IT'S FOR A THERAPY FOR A
DISEASE ON METABOLISM, FOR
EXAMPLE.
THERE MAY BE ISSUES THAT ARISE
BECAUSE OF THE THERAPY AND THE
VIRAL VECTORS WE USE ARE
NON-IMMUNOGENIC BUT THEY'RE
REALLY NOT NON-IMMUNOGENIC AND
PERHAPS WHAT WHAT THAT DO I TO
ORGAN SYSTEMS WE CAN SEE
TOXICITIES THAT WERE UNEXPECTED
IN ORGAN SYSTEMS.
MIGHT THAT BE BECAUSE OF
UNDERLYING CONDITIONS?
HOW CAN WE UNDERSTAND MORE ABOUT
THE SYMPTOMOTOLOGY OF DISEASE
AND WE MAY BE TREAT PARTICULAR
DISEASE BUT NEED TO LOOK FOR
THINGS WE AREN'T EXPECTING AND
CAN DO THAT THROUGH THE CARE.
THAT'S GOING TO GET US PART WAY
BUT NOT ALL THE WAY.
THOSE ARE AREAS WHERE
INTERSECTIONS WITH NURSING
SCHOOLS AND TRAINING NURSES IN
THIS SPACE COULD BE REALLY
CRITICAL TO HELP ENSURE THAT WE
HAVE THE ABILITY TO CARE FOR
JUST ABOUT ANY OUTCOME THAT CAN
ARISE IN THESE KINDS OF RESEARCH
CLINICAL RESEARCH OR CLINICAL
TRIALS.
SO I THINK THAT'S ONE OF THE KEY
THINGS I WOULD SEE IS MAKING
SURE WE TRAIN A WORKFORCE TO
HANDLE UNEXPECTED PROBLEMS IN A
WAY WITH NEW MODALITIES WE DON'T
KNOW TO EXPECT.
>>YOU'RE WELCOME.
>>THAT WAS AN AMAZING OVERVIEW.
THANK YOU SO MUCH.
YES.
>>I SAW A LOT OF EMPHASIS ON
PRECLINICAL AND CLINICAL
EFFICACY WORK.
WHERE DO YOU SEE EFFECTIVENESS
FALLING WITHIN NCATS?
SO THERAPIES WE DEVELOP THAT ARE
EFFICACIOUS FAIL FROM THE
EFFECTIVENESS PERSPECTIVE?
>>AGAIN, PRIMARILY IN THE
PREDICTIVE MODELS IT'S NOT JUST
PREDICTING SAFETY BUT ALSO
PREDICTING EFFICACY.
WHAT WE CAN DO IS PUT FOR
EXAMPLE DISEASE PRIMARY CELLS
FROM PEOPLE WITH PARTICULAR
DISEASES ON THESE CHIPS AND
UNDERSTAND THOSE COMPARE TO
PEOPLE PERHAPS WITHOUT THE
DISEASE AND LOOK AT THERAPEUTIC
DEVELOPMENT BY INFUSING THOSE
THERAPIES ON THE CHIPS TO LOOK
AT BIOMARKER DEVELOPMENT, FOR
EXAMPLE, TO THINK HOW EFFICACY
MIGHT BE EFFECTED.
ARE WE SEEING A DECREASE IN
BIOMARKER BY TREATING IT WITH A
VARIETY OF DIFFERENT THERAPIES.
THAT'S ONE WAY WE'RE ABLE TO
LOOK AT THOSE AND NOW WITH THE
FDA MODERNIZATION ACT 2.0 WHICH
REDUCES THE USE OF ANIMAL MODELS
IN IND ENABLING STUDIES I
BELIEVE THE MORE PHYSIO RELEVANT
IN VITRO SYSTEMS WILL BE MORE
ELEVATED IN HOW WE CAN LOOK AT
THE EFFICACY SIDE FOR REGULATORY
PACKAGES THAT CAN BE USED FOR
THE FDA.
I THINK WE'RE A LITTLE BIT AWAY
FROM THAT AND NEEDS TO BE MORE
VALIDATION AND EXPERIMENTAL WORK
DONE BUT I THINK THAT'S THE WAVE
OF THE FUTURE.
THANK YOU AGAIN FOR THE
WONDERFUL CONVERSATION AND LOOK
FORWARD TO INTERSECTING WITH YOU
IN THE FUTURE AND PLEASE GIVE
THOUGHTS ON THE REQUEST FOR
INFORMATION.
I APPRECIATE IT.
THANK YOU.
>>THANK YOU SO MUCH,
DR. RUTTER.
ALWAYS GREAT TO SEE YOU.
I APPRECIATE YOU JOINING US AND
LOOKING FORWARD TO TALKING MORE.
THANK YOU.
SO WE ARE GOING TO TAKE A BREAK.
SO LET'S REGROUP AT 10:50
EASTERN.
THANKS.
>>THANK YOU.
I WAS SO EXCITED TO GET THE
MEETING UNDERWAY THAT I
NEGLECTED TO CALL FOR A VOTE ON
THE MINUTES FROM THE LAST
COUNCIL MEETING.
SO WE'LL DO THAT NOW.
MINUTES OF THE MAIN MEETING WERE
MADE AVAILABLE TO YOU ON THE
ELECTRONIC COUNCIL BOOK FOR YOUR
REVIEW.
MAY I HAVE A MOTION TO APPROVE.
>>APPROVE.
>>THANK YOU.
ANY SECOND?
ANY DISCUSSION?
ANY OPPOSED?
THE MOTION CARRIES.
THANK YOU.
ALSO, FOR THE MINUTES, I WOULD
LIKE TO NOTE THAT DR. ATKINS IS
PRESENT AND ALSO THAT DR.
BEKEMIRE AND
DR. PROVENCIO-VASQUEZ WAS
ANNIBLE TO BE WITH US TODAY.
THANK YOU.
>>GOOD MORNING AGAIN.
I AM DELIGHTED TO INTRODUCE OUR
NEXT SPEAKER.
OUR NEXT SPEAKER IS DR. CHERYL
ANNE BOYCE, WHO WILL SHARE
UPDATES ON THE COMMUNITY
PARTNERSHIPS TO ADVANCE SCIENCE
FOR SOCIETY INITIATIVE, OR
COMPASS.
DR. BOYCE IS THE ASSISTANT
DIRECTOR FOR RE-ENGINEERING THE
RESEARCH ENTERPRISE OFFICE OF
STRATEGIC
COORDINATION AT THE NIH COMMON
FUND. IN THIS ROLE SHE DIRECTS
NOVEL, TRANSFORMATIVE PROGRAMS
FOCUSED ON TRANSLATIONAL
SCIENCE, COMMUNITY-DRIVEN
RESEARCH, SOCIAL DETERMINANTS OF
HEALTH,
AND INCLUSIVE EXCELLENCE IN
ACADEMIC AND RESEARCH TRAINING.
SHE PREVIOUSLY SERVED AS THE
FIRST
PERMANENT CHIEF OF THE
IMPLEMENTATION SCIENCE BRANCH AT
NHLBI. DURING OVER TWO DECADES
OF
PUBLIC SERVICE, SHE HAS HELD
SCIENTIFIC LEADERSHIP POSITIONS
WITH THE NIH OD, NIDA, AND THE
NATIONAL INSTITUTE OF MENTAL
HEALTH, AS WELL AS IN THE OFFICE
OF NATIONAL DRUG CONTROL POLICY
WITHIN THE OFFICE OF THE
PRESIDENT. SHE COMPLETED HER
PH.D. AT UNC-CHAPEL HILL, HOLDS
DR. BOYCE, THE FLOOR IS YOURS.
DR. BOYCE, WELCOME.
THE FLOOR IS YOURS.
>>THANK YOU.
IN TERMS OF THE NURSING
INSTITUTE IS ONE OF THE PROUD
SPONSORS OF COMPASS.
COMMON FUND IS NOT AS COMMON AS
WE'D LIKE IN TERMS OF
OPPORTUNITIES.
I'D LIKE TO TALK ABOUT THE
OPPORTUNITIES BECAUSE THERE'S A
LOT OF INNOVATIVE OPPORTUNITIES
FOR INDIVIDUAL INVESTIGATORS IN
TERMS OF PIONEERING AND
HIGH-RISK REWARD RESEARCH WHICH
I HOPE THOSE WATCHING TODAY OR
IN THE ROOM CAN PURSUE IN THE
FUTURE.
I ALSO COME TO YOU AS THE PROUD
DAUGHTER OF A NURSE.
MY MOTHER WAS A PUBLIC HEALTH
NURSE IN NEW YORK CITY BACK IN
THE DAY AND MIDWIFE.
I'M FIRST GENERATION BORN HERE
AND I AM A DAUGHTER OF A NURSE
AND NOW I'M A CLINICAL
PSYCHOLOGIST BUT IT'S A PLEASURE
TO BE HERE AT THE NURSING
INSTITUTE.
I KNOW SHE IS LOOKING DOWN UPON
ME AND PROUD I'M FINALLY DOING
WHAT I SHOULD HAVE DONE ALL
ALONG AND HANG OUT WITH MORE
NURSES.
COMPASS STANDS FOR THE COMMUNITY
PARTNERSHIPS TO ADVANCE SCIENCE
FOR SOCIETY.
WE HOPE WE'RE DOING IN THE RIGHT
DIRECTION AND DOING SOMETHING
BEING FOCUSSED ON HEALTH EQUITY
AND WE'RE DOING SOMETHING
COMMUNITY LED.
WHEN WE STARTED COMPASS
EVERYTHING WAS DOING SOMETHING
DIFFERENT AND THEY FUNDED
COMMUNITY RESEARCH IN THE PAST.
WE HAD COMMUNITY-BASED
PARTICIPATORY RESEARCH PROGRAMS
BUT HAVE NOT A LARGE EFFORT THAT
WAS COMMUNITY LED AND SOMETHING
THAT LEVERAGED MULTI-SECTORIAL
PARTNERSHIPS.
AND WHAT'S RELEVANT IS IT'S
INTERVENING ON SOCIAL
DETERMINATES OF HEALTH IN TERMS
OF LEADERS AND IN TERMS OF NIMHD
AND ELISO IS ALSO LEADING SOME
EFFORTS ON SOCIAL DETERMINATES
OF HEALTH AND STARTING TO BUILD
THIS AREA TO MAKE AN IMPACT.
IN TERMS OF INTERVENING WE'RE
LOOKING TO IMPROVE HEALTH
OUTCOMES AND REDUCE HEALTH
DISPARITIES AND ADVANCE HEALTH
EQUITY.
WE'RE GOING TO LEVERAGE THOSE
STRUCTURAL INTERVENTIONS IN
TERMS OF CHANGING AND INFORMING
SYSTEMS AND POLICIES AND MAKING
A DIFFERENCE.
OUR RESEARCH IS NOT POLICY
RESEARCH BUT WE'RE GETTING THE
EVIDENCE TO INFORM POLICY
RESEARCH AND I'LL TALK HOW WE'LL
DO THAT WITH COMPASS.
WHAT MAKES COMMON FUND DIFFERENT
IS WHEN WE SAY COMMON IT IS
REALLY BRINGING TOGETHER
SOMETHING THAT'S UNIQUE ONE
INSTITUTE DOES NOT DO ALONE.
IT MAKES SUBSTANTIAL INVESTMENTS
AND TIME DRIVEN AND GOAL DRIVEN
AND TO CHANGE THE TRAJECTORY AND
BRINGS THE INTEREST OF MANY
INSTITUTES AT ONCE AND MOVE
SOMETHING AT A QUICK PACE AND
REMOVE RESEARCH ROAD BLOCKS
ENHANCING THE RESEARCH WORKFORCE
AND REWARDING HIGH REWARD
SCIENCE.
IT CATALYZES DISCOVERY.
IN DOING THAT WE'RE DOING
SOMETHING AT A FAST PACE THAT IF
ONE OR TWO INSTITUTES TRY TO DO
THEY JUST COULDN'T DO AND YOU'LL
SEE HOW IN TERMS OF HOW WE'RE
DOING CAMPUS.
OUR CO-CHAIRS WE'RE PROUD TO
HAVE THE DIRECTOR OF NIR AS WELL
AS DIRECTORS FROM THE NATIONAL
INSTITUTE OF MINORITY HEALTH AND
HEALTH DISPARITIES AND THE
DIRECTOR OF THE OFFICE OF
RESEARCH ON WOMEN'S HEALTH AND
ALSO HAVE THE DIRECTOR OF TRIBAL
HEALTH RESEARCH OFFICE AS ONE OF
OUR CO-CHAIR WHO'S INFORMED A
LOT OF WHATEVER WE DID IN TERMS
OF OUTREACH TO THE POPULATIONS
WHO HAVE BEEN UNDER REPRESENTED
IN RESEARCH AND IN COMMUNITY-LED
INTERVENTIONS.
THIS IS THE WORKING GROUP.
WE ALSO HAVE SO MANY OTHERS WHO
ARE SERVING AS SUBJECT MATTER
EXPERTS WHO ARE PROJECT OFFICERS
AND SCIENTISTS AND I DID
HIGHLIGHT THE STAFF WORKING
DIRECTLY IN TERMS OF THE WORK
GROUP AND REALLY IMPORTANT IS
THE GRANTS MANAGEMENT AND REVIEW
BECAUSE WE DID NOVEL THINGS IN
TERMS OF HOW WE MANAGED REVIEW
IN TERMS OF LIVED EXPERIENCE AND
HOW WE CAN FUND THINGS INVOLVING
COMMUNITY AND HAVE IMPACT.
AND THOSE WHO ARE AT NINR.
AND EVALUATE COMMUNITY-LED
HEALTH EQUITY STRUCTURAL
INTERVENTION LEVERAGE
PARTNERSHIPS ACROSS MULTIPLE
SECTOR TO REDUCE HEALTH
DISPARITIES.
THE SECOND GOAL IS TO DEVELOP A
HEALTH EQUITY MODEL FOR
COMMUNITY-LED MULTISECTORIAL
STRUCTURAL INTERVENTION RESEARCH
ACROSS NIH AND OTHER FEDERAL
AGENCIES IS AND WE THOUGHT IT
WAS VERY IMPORTANT THAT NOT ONLY
NOT ONLY DO WE HAVE
INTERVENTIONS THAT MAKE AN
IMPACT BUT TO CHANGE HOW NIH
DOES BUSINESS.
HOW CAN WE LEAVE AN IMPACT IN
TERMS OF MODELS FOR
COMMUNITY-LED RESEARCH THAT CAN
SERVE ACROSS INSTITUTES IN THE
FUTURE.
WE'LL HAVE AN EVALUATION
COMPONENT OF THE WAY WE ARE
RUNNING THE MECHANISM AND
INVOLVING COMMUNITIES SO
INSTITUTES CAN CONTINUE TO THINK
ABOUT THE FUTURE IN AN AFFECTIVE
WAY.
HOW WILL WE PUT THIS TOGETHER IN
TERMS OF OF THE PROGRAMS.
THERE'S $153 MILLION BROKEN DOWN
IN THREE XART COMPARTMENT
COMPARTMENTS AND THEY'RE
COMMUNITY-LED INTERVENTION.
WE'RE USING OTHER TRANSACTION
AWARDS.
I'M NOT SURE IF ANYBODY HEARD OF
THOSE BEFORE USUALLY THROUGH A
COOPERATIVE AGREEMENT AWARDS AND
CONTRACTS, TRAINING AWARDS
THEY'VE BEEN AUTHORIZED TO BE
USED AND BECAUSE THEY'RE MORE
FLEXIBLE THEY HAVE FEATURES THAT
ARE ATTRACTIVE FOR US TO WORK
WITH COMMUNITY.
WE ALSO WILL HAVE SOMETHING
CALLED HEALTH EQUITY RESEARCH
HUBS.
AND WE'RE GOING HAVE FIVE OF
THOSE AWARDS AND THAT'S THROUGH
AN RFA CURRENTLY OUT.
THE CHESSY AWARDS ANNOUNCEMENT
CLOSED AND WE HAVE A
COORDINATING CENTER AND THAT'S
GOING TO BE ONE AWARD AND THAT
WILL BE ANNOUNCED AND CLOSED.
THIS WILL FORM THE CONSORTIUM
FOR THE COMPASS.
FIRST LET'S TALK ABOUT THE
CHESSI INTERVENTION.
WE'LL HAVE A THREE-PHASED
APPROACH.
THE FIRST TWO YEARS AND THE
FIRST STAGE IS PLANNING.
THAT IS TO PILOT, TO PLAN THE
STRUCTURAL INTERVENTIONS
CAPACITY AND PARTNERSHIP
BUILDING AND FOR WHAT WE'RE
CALLING THE LOCAL HEALTH EQUITY
RESEARCH ASSEMBLY.
NOW, WHAT WE DECIDED IS THAT
IT'S GOING TO BE IMPORTANT I'M
AN IMPLEMENTATION SCIENTIST AND
YOU NEED TO THINK ABOUT THE
IMPLEMENTATION FROM THE START.
YOU CAN'T WAIT UNTIL YOU FINISH
THE PROJECT AND SAY OKAY LET'S
GO AND LET'S DISSEMINATE AND
IMPLEMENT AND FUND ANOTHER
PROJECT TO GET IT DONE AND HOPE
WHAT WE DID WAS GOING TO WORK
FOR YOU.
WE WANT TO THINK ABOUT THAT FROM
THE START.
HAVING HEALTH EQUITY RESEARCH
ASSEMBLY AS YOU DESIGN
INTERVENTION YOU ARE THINKING
ABOUT THE PARTNERS IN TERMS OF
THE INTERVENTION, COMMUNITY,
POLICY.
ANYBODY THAT WOULD BE NEEDED FOR
AN INTERVENTION TO WORK AND
NEEDED FOR FUTURE
IMPLEMENTATION.
AND THAT CONSISTS OF YOUR LOCAL
HEALTH EQUITY RESEARCH ASSEMBLY.
WE'LL ALSO HAVE THAT AT THE
NATIONAL LEVEL BECAUSE UP TERMS
MUCH WHAT -- IN TERMS OF WHAT WE
CAN BRING TO THE PROJECT IN TRUE
COLLABORATION WE CAN BRING TO
BEAR THE NATIONAL LEVEL
RESOURCES AND CONNECTION TO
FACILITATE SUCCESS.
AND THE NEXT IS WHERE
COMMUNITIES WILL HAVE STRUCTURAL
INVENTIONS AND THAT WILL
INFLUENCE HEALTH OUTCOMES ACROSS
MULTIPLE HEALTH CONDITIONS AND
DISEASES.
IN YEARS NINE AND 10 WE HAVE
DISSEMINATION.
ASSET THE HEALTH IMPACTS AND
LOOK AT FINDINGS AND THINK ABOUT
SUSTAINABILITY AND THAT'S OFTEN
SOMETHING WE DON'T BRILLED IN
AND SOMETHING THAT IS IMPORTANT
IN TEMS OF THE MISSION OF THIS
INITIATIVE.
AND TO PLAN FOR THE STRUCTURAL
INTERVENTION TO STAY.
NOW, THE AWARDS ARE GOING TO BE
NAMED SOON.
UNFORTUNATELY I'M NOT ALLOWED TO
TELL YOU YET BUT WHEN THE PRESS
RELEASE WE'LL MAKE SURE THOSE
ARE AVAILABLE TO YOU BUT I WANT
TO TELL YOU THEY ARE ACROSS ALL
THE SOCIAL DETERMINATES OF
HEALTH AREAS AND THEY'LL BE
AWARDED THIS MONTH AND TO TELL
YOU HOW WE WERE ABLE TO GET
THROUGH THE 25 AWARDS THAT WILL
BE NAMED.
THE SCIENTIFIC REVIEW WAS VERY
DIFFERENT AND WE INCORPORATED
THE COMMUNITY AND DID NOT USE
THE CENTER FOR SCIENTIFIC REVIEW
WE RAN IT OURSELVES AND PILOT A
DIFFERENT TYPE OF REVIEW AND
USED UP TO 200 REVIEWERS TO BE
ABLE TO ASSESS THE NUMBER OF
GRANTS WE HAD WHICH WAS
OVERWHELMING.
WE HAD A WONDERFUL RESPONSE.
WE STARTED OUT HAVING A COUPLE
TECHNOLOGY ASSISTANCE WEBINARS
BUT THE RESPONSE WAS SO GREAT
WITH THE FIRST WHERE WE HAD
ALMOST 800 PEOPLE ATTENDING WE
HAD TO ADD SIX MORE AND HAD
EIGHT TECHNICAL ASSISTANCE
WEBINARS AND AT THE END OVER
2400 PARTICIPANTS TO LEARN ABOUT
COMPASS.
SO WE DO THINK THAT COMMUNITIES
WERE WAITING AND READY FOR THIS
TYPE OF ANNOUNCEMENT AND THINK
THEY'VE BEEN WAITING FOR NIH FOR
A WHILE AND ON OUR VIDEOS ON
YOUTUBE WE MADE SURE EVERYTHING
WAS VERY ACCESSIBLE.
THE MINUTE WE POSTED THE
ANNOUNCEMENT, WE HAD
PRE-RECORDED VIDEOS AND WANTS TO
MAKE SURE PEOPLE CAN GET ACCESS
RIGHT AWAY AND WATCH IT OVER AND
OVER AND THEY DID OVER 300
VIEWS.
THEY WATCHED IT OVER AND OVER.
WE HAVE DONE EDUCATION AND
CAPACITY BUILDING FOR LEARNING
ABOUT NIH AND LEARNING ABOUT THE
PROCESS FOR COMMUNITY MEMBERS
WHO DID NOT HAVE EXPOSURE TO
NIH.
THEY MAY HAVE HAD OTHER GRANTS
LIKE CDC AND OTHER AGENCIES BUT
LEARNING ABOUT NIH AND
COMMUNITY-RESEARCH PARTNERSHIPS
THAT ARE AVAILABLE.
HOW TO THE CHESSI AWARDS HAVE A
SCIENTIFIC FOCUS ACROSS ALL THE
SOCIAL DETERMINATE AREAS AND
HAVE A STRONG APPROACH FOR
COMMUNITY-ENGAGED RESEARCH AND
HIGH POTENTIAL IMPACT FOR HEALTH
EQUITY.
THERE'S A BROAD DISTRIBUTION OF
PROJECTS AND HIGH AND LOW
COMMUNITY RESOURCE ORGANIZATIONS
AND FOCUS ON NUTRITION RESEARCH
PRIORITIES.
AND THE OTHER CRITERIA WE HAVE
FOR THE AWARDS WE'RE GOING TO
MAKE IS THEY'RE READY TO CONDUCT
STRUCTURAL INTERVENTION
RESEARCH.
THESE TWO YEARS OF INTERVENTION
DEVELOPMENT ARE FOR COMMUNITIES
AND RESEARCH PARTNERS THAT ARE
READY.
THE GRANTS ARE GOING TO
COMMUNITIES BUT THEY CHOSE THEIR
RESEARCH PARTNER.
IT'S VERY DIFFERENT.
WE KNOW THAT THIS IS A MODEL
THAT HAS NOT BEEN USED AT NIH
BEFORE.
THERE'S GOING TO BE ONE SINGLE
COORDINATION CENTER AND BE THE
PROGRAM MANAGEMENT AND
ADMINISTRATIVE WORK AND CAPACITY
BUILDING AND PAST AND TRAINING
AND WE'RE EXCITING PART OF THIS
WILL BE RESEARCH CAPACITY
BUILDING AND TRAINING AND THE
RESOURCES WILL BE MADE AVAILABLE
TO ALL AS MUCH AS POSSIBLE.
THAT WILL BE AWARDED THIS MONTH
AND THOSE THREE COMPONENTS ARE
VERY IMPORTANT IN TERMS OF NOT
ONLY BUILDING FOR THE SITES BUT
THE IDEA IS TO MAKE THE
RESOURCES AVAILABLE AS MUCH AS
POSSIBLE FOR BUILD COMMUNITIES
AND DATA THAT'S AVAILABLE SO
COMMUNITY RESOURCE CAN BUILD FOR
OTHER PARTNERING AGENCIES.
SOME WORK IS THINKING OF COMMON
DATA ELEMENTS WHERE POSSIBLE AND
TO MAKE SURE COMMUNITIES THINK
HOW CAN WE FIT INTO THE POLICIES
AND THAT'S BEEN THE ROAD BLOCK
IN RIGOR AND HOW CAN WE
TRANSLATE THIS AND MAKE IT
EASIER FOR THEM.
THESE ARE THE IMPORTANT ROAD
BLOCKS AND THE NATIONAL HEALTH
EQUITY RESEARCH ASSEMBLY WILL
HAVE REPRESENTS ASSEMBLED AND
WE'LL CONTINUE TO ASSEMBLE
NON-PROFIT FOUNDATION INTERESTED
IN THE SAME MISSION AREAS AND
THE FUNDED AWARDEES.
IF THERE'S A PROJECT LOOKING AT
SOCIAL DETERMINATES OF HEALTH
THAT IMPACTS HOUSING THAN WE
HAVE A FEDERAL PARTNER IN HUD
THAT CAN IDENTIFY LOCAL AND
REGIONAL RESOURCES TO HELP
ADVANCE THE PROJECT AND
CONTRIBUTE TO ITS SUCCESS.
SIMILAR FOR NUTRITION.
WE HAVE A FEDERAL PARTNER USDA
TO THINK DOWN THE LINE WHAT IT
MEANS FOR SUSTAINABILITY.
WE ARE THINKING FROM THE START
ABOUT IMPLEMENTATION AND
SUSTAINABILITY AS WELL AS TRYING
TO ADVANCE THE MISSION AND THINK
ABOUT THE SUCCESS OF INDIVIDUAL
PROJECT.
USUALLY WE THINK OF HUBS FOR
DATA OR FOR TRAINING WITH
COMMUNITIES WE REALIZE THE
TYPICAL DATA COORDINATION CENTER
MAY NOT BE ABLE TO DO IT ALL.
WE MAY NEED ADDITIONAL SUPPORT
AND EXPERTISE AND THERE'S FIVE
HUBS TO ASSIST THE CHESSIS IN
THINKING OF RESEARCH CAPACITY
BUILDING AND TRAINING AND
COMMUNITY ENGAGEMENT.
IN ADDITION TO THEIR RESEARCH
PARTNERS THE INTERVENTION SITES
WILL HAVE HUBS TO GO TO SO WE'RE
BUILDING INFRASTRUCTURE FOR THE
COMMUNITY INTERVENTION SITES
THAT WILL SUPPORT THEM FOR
SUCCESS.
IN TERMS OF HUBS THERE'S AN
OPPORTUNITY AND THE LETTER OF
INTENT IS DUE AT THE END OF THE
MONTH AND THE APPLICATION
DEADLINE IS OCTOBER 31 AND THE
WEB DMINAR AND MATERIALS ARE ONE
RIGHT NOW.
THAT'S STAGED TO COME LATER SO
THE INTERVENTION CENTER STARTED
FIRST.
IN ADDITION TO ALL THAT, WE
BUILT WITH COMMUNITY PARTNERS
AND HAD A NETWORK OF PEOPLE WE
DIDN'T WANT TO LEAVE BEHIND.
WE'RE ONLY FUNDING 25 SITES AND
IN TERMS OF THE MISSION AS YOU
REMEMBER THAT SECOND MISSION
AREA WAS TO THINK ABOUT THE WAY
NIH BUILDS COMMUNITY-LED
RESEARCH.
SO IN THINKING ABOUT THAT, WE
TRY TO IDENTIFY WHAT WE COULD DO
TO REALLY BUILD THAT NETWORK AND
THERE'S A LOT OF EFFORTS GOING
ON THROUGH NIH BUT WANTED TO
THINK WITH THE THREAT WORK WE
BUILT AND HOW DO WE GALVANIZE
THE EFFORTS AND WE TRY TO THINK
IN A COMMON WAY.
ONE HAS BEEN THE SEAL NETWORK
LED BY NIHD AND SHIFTED AND
CONTINUED TO LEAD COMMUNITY
ENGAGEMENT EFFORTS AND AS PART
OF THAT THEY HAVE CONSULTATIVE
RESOURCE.
AS PART OF COMPASS WE'RE
BUILDING A CONSULTATIVE RESOURCE
AND SUPPLEMENTING SEAL TO
CONSULT WITH THE NETWORK WE
BUILT THROUGH THE EFFORTS OF
COMPASS AND THE WEBINARS AND THE
NETWORK WE BUILT WE'RE GOING TO
HAVE WORKS SHOPS AND OTHER
ACTIVITIES TO CONTINUE BUILDING
THOSE COMMUNITY AND RESEARCH
PARTNERSHIPS SO THEY CONTINUE TO
THINK ABOUT FUNDING AND PROJECTS
IN THE FUTURE.
THAT WILL BE HAPPENING AND WE
HAVE A CONSULTATIVE ARM IN
PARTNERSHIP WITH SEAL THAT WILL
BE START.
PARTING.
WE'RE REALLY EXCITED BECAUSE
NCATS HAS WONDERFUL ENGAGEMENT
CORES THROUGH THE CTSAs AS SHE
PRESENTED THAT HAVE A GREAT NEW
COLLECTIVE FOR COMMUNITY
ENGAGEMENT.
AND PARTNERING WITH IT NCATS WE
HOPE TO CONNECT COMMUNITIES TO
THE NCAT SITES AND CONTINUE TO
BUILD RESOURCES ON COMMUNITY
ENGAGEMENT WITH THE
MEHARRY-VANDERBILT RESEARCH CORE
WHICH HAS A LONG HISTORY OF
DESIGNING ENGAGEMENT STUDIOS AND
A LOT OF TOOLS THAT CAN BE
USEFUL FOR THE NETWORK WE HAVE
BUILT.
SO WHILE WE'RE GOING TO BUILD
MORE OF THOSE THINGS THROUGH
COMPASS WE FELT THERE WAS A NEED
NOW TO ASSIST THE NETWORK THAT
WE HAD BUILT IN GEARING UP FOR
COMPASS AND NOT LEAVE THOSE
BEHIND THAT DON'T RECEIVE AWARDS
BECAUSE OF THE NETWORK AND THE
CAPACITY BUILT IN TERM OF
COMMUNITY IDENTIFYING RESEARCH
PARTNERS JUST TO APPLY FOR THE
AWARDS AND THINK WHAT THEY CAN
DO.
WE WANTED TO LEVERAGE THOSE RICH
PARTNERSHIPS THAT HAVE BEEN
BUILT AS PART OF COMPASS SO
WE'RE NOT LEAVING ANYONE BEHIND.
WE'RE ENGAGING THEM EVEN IF THEY
DON'T GET AWARDS THROUGH THESE
DIFFERENT TYPES OF OPPORTUNITIES
TO CONTINUE TO BUILD AND TO
CONTINUE TO BUILD CAPACITY
ACROSS NIH.
SO WE HOPE THAT WILL LEAD TO
TEMPERATURE APPLICATION TO THE
BENEFIT OF ALL OF NIH IN TERMS
OF COMMUNITY-DRIVEN AND
COMMUNITY-PARTNERED RESEARCH.
THOSE ARE TWO GREAT-BREAKING
OPPORTUNITIES WE HAVE IN TERMS
OF CAMPUS FOR THE SECOND GOAL
WHICH IS NOT TYPICAL FOR OUR
INITIATIVES.
I'M EXCITED ABOUT THE CHALLENGE
GRANTS AND AN OPPORTUNITY TO
GREAT A PRIZE AND THINK OF WAYS
TO GET GREAT IDEAS FROM THE
PUBLIC AND YOU HAVE TO BE 18
YEARS OLD AND IT CAN COME FROM
ANYONE IN THE PUBLIC.
I ENCOURAGE SOMETIMES WE DO
THESE FOR STUDENTS AND I'VE DONE
CHALLENGE GRANTS BEFORE.
THERE'S A LOT OF PEOPLE WITH
GREAT IDEAS, COMMUNITY MEMBERS
CAN TAKE PART.
I WOULD LOVE TO SEE A COMMUNITY
MEMBER WIN ONE OF THESE AWARDS
BECAUSE I THINK THEY'RE UNTAPPED
RESOURCE AND WHO BETTER TO SAY
HOW WE BUILD COMMUNITY TRUST
THAN THE COMMUNITY MEMBER THIS
IS FUNDED BY THE "ALL OF US"
RESEARCH PROGRAM AND NIBIB AND
NINDS AND OTHERS AND YOU CAN WIN
$40,000 FOR A GREAT IDEA.
WE LOVE GREAT IDEAS.
AND THE BUILD UP TRUST CHALLENGE
YOU JUST HAVE TO REGISTER BY
NOVEMBER 14.
THEY HAVE TOOLS TO HELP YOU
THINK ABOUT THE IDEA.
THIS IS ALL REALLY TO GET THE
BEST IDEAS OUT OF US AND IT'S A
GREAT THING.
YOU CAN GET PEOPLE IN YOUR
HOUSE -- IT'S A GREAT THING FOR
STUDENTS AND FOR COMMUNITY
MEMBERS TO SIT THERE AND THINK
ABOUT WHAT ARE THE WAYS THAT WE
NEED TO THINK ABOUT TO BUILD UP
TRUST AND IMPROVE ENGAGEMENT.
THIS IS ONE OF OUR BIGGEST
CHALLENGES IN TERMS OF NIH IS
TRUST.
WE NEED NEW IDEAS AND SO WHAT
BETTER WAY THAN TO SAY HOW ABOUT
LET'S GIVE YOU A PRIZE.
WE KNOW PRIZES DO WORK.
I ENCOURAGE YOU TO THINK ABOUT
DISSEMINATING THIS TO ALL YOU
KNOW AND I DON'T GET A
PERCENTAGE OF THE PRIZE BUT I
WOULD LOVE TO HEAR LATER ON, I'M
SO GLAD TO HEAR ABOUT THAT.
WE WON.
I WOULD LOVE TO HEAR SOMEONE IN
YOUR COMMUNITY MEMBERS WON THE
PRIZE OR SOMEONE FROM YOUR TEAM
OR SOME OF YOUR STUDENTS WON THE
PRIZE.
SOME OF THE BEST IDEAS HAVE COME
FROM STUDENTS IN TERMS OF
WORKING TOGETHER AND SO I CAN'T
WAIT TO SEE WHO WINS AND WHAT
THE IDEAS WILL BE BECAUSE I
CAN'T IMAGINE SOME OF THE THINGS
WE JUST HAVEN'T THOUGHT ABOUT IN
TERMS OF BUILDING TRUST BECAUSE
OF WHERE WE SIT AND WE CAN'T SEE
SOME OF THE THINGS WE'RE
MISSING.
WITH THAT I'M GOING TO CLOSE.
I'M REALLY EXCITED ABOUT
COMPASS.
I'M EXCITED ABOUT MAKING THE
AWARD ANNOUNCEMENTS SOON.
I FEEL I'M PULLING THIS GREAT
JOY IN AND WE HAVE A LOT OF WORK
TO DO AND WE'RE GOING TO NEED
EVERYONE'S GREAT IDEAS AND
PARTNERSHIP AND I PERSONALLY
WANT TO THANK SHANNON ZENK.
SHE HAS REALLY PUSHED US TO
THINK OUTSIDE THE BOX AND TO
REALLY THINK STRONGLY OF MAKING
AN IMPACT IN TERMS OF SOCIAL
DETERMINATES OF HEALTH AND
MULTISECTORIAL PARTNERSHIPS AND
INTERVENTIONS AND LEADING A LOT
OF THAT PARTNERSHIP AT NIH.
WITH THAT I'LL CLOSE AND HAPPY
TO TAKE COMMENTS AND SOME
QUESTIONS.
THANK YOU.
>>I'VE BEEN WAITING FOR THIS MY
WHOLE LIFE AND GLAD WE'RE
STEPPING INTO THIS IN TERMS MUCH
MECHANISMS AND AWARDS FUNDING.
TO RECAP QUICKLY.
DR. BOYCE PRESENTED ON THE
COMPASS INITIATIVE A NEW
APPROACH NIH IS MAKING TO TRY TO
IDENTIFY SYSTEMS AND POLICY
RELEVANT CHANGES FOR HOPEFULLY
SUSTAINABLE CHANGES IN THE WAY
HEALTH CARE IS DELIVERED AND
OTHER WAYS OF PREVENT AND
CONTROLLING THE NUMEROUS CHRONIC
CONDITIONS AFFECTS PEOPLE'S
LIVES.
I APPRECIATE THE WHOLE
DISCUSSION ON INVOLVING A LOCAL
AND NATIONAL RESEARCH ASSEMBLY
BUT THAT'S ALSO ONE OF MY
QUESTIONS.
HOW IS AN ASSEMBLY DIFFERENT
FROM OR SIMILAR TO A COALITION
OR ADVISORY COMMITTEE MANY OF US
ARE ACCUSTOMED TO HAVING ON OUR
PROJECTS?
>>THAT'S A VERY GOOD QUESTION.
THOSE ARE OFTEN SELF-DEFINED.
WE OFTEN HEAR OF ADVISORY
BOARDS.
WE GOT VERY -- WE THOUGHT A LOT
ABOUT WHAT TO CALL ITS AND IT
DOESN'T HAVE ANY KIND OF POWER
IB A USUAL WAY IN TERMS OF
DIRECTION.
THERE'LL BE THOSE KINDS OF
BODIES THAT ARE PART OF THE
GRANT AND TYPICAL STRUCTURE.
WE WANTED TO HAVE A BODY THAT
BROUGHT TOGETHER DIFFERENT
GROUPS TO HAVE THE EMPHASIS ON
THE STAINSABILITY PIECE AND THE
POLICY PIECE IN A WAY THAT WAS
UNIQUE.
I THINK COALITIONS PEOPLE DEFINE
THEM IN MANY WAYS.
WE NEED TO DO SOMETHING
DIFFERENT.
THIS IS ON WHAT YOU NEED FOR
SUCCESS AND THE PAST FOR
SUSTAINABILITY IN AN
IMPLEMENTATION SCIENCE MODEL AND
WHAT WE MODELLED FOR AND WE WERE
CONCERNED ABOUT COMMUNITIES AND
HOW TO BUILD IN SOME KIND OF
BODY THAT ALLOWED FOR LOCAL AND
NATIONAL RESOURCES FROM OTHER
AGENCIES.
THAT'S WHY WE DID IT THAT WAY
AND FOR THE SUBMISSION FOR THE
COORDINATING CENTERS THEY DID
LAY OUT HOW THEY WERE GOING TO
DO IT SO WE DID GIVE
FLEXIBILITY.
>>NEXT QUESTION IS RELATED TO
EVALUATION.
I SEE THERE'S GOING TO BE
EVALUATING THE STRUCTURAL
INVENTIONS ON WHATEVER THE
OUTCOMES MIGHT BE BUT I KNOW AS
SOMEBODY WHO LEADS THE SEVERAL
CENTER GRANTS THE EXPECTATIONS
OF ADDITIONAL EXTRAMURAL FUNDING
AND PUBLICATIONS ARE NOT
NECESSARILY THINGS THE PRIME
INSTITUTIONS ARE NORMALLY TASKED
WITH TRYING TO ACCOMPLISH.
ARE THERE OTHER WAYS OF
EVALUATING NIH IS GOING TO BE
TAKING ON HOW IT'S ARE AND ARE
THOSE METRICS PART OF IT OR NOT?
>>THEY ARE.
AS PART OF COMMON FUND THERE'S
ADDITIONAL METRICS.
THERE'S A REALLY CLEAR PLAN.
THE METRICS ARE NOT ONLY
PUBLICATIONS.
WE HAVE DIFFERENT METRICS FOR
CAPACITY BUILDING.
WE'LL HAVE DISSEMINATION
MATERIALS, EVALUATION MATERIALS.
WE HAVE CONSULTANTS REVIEWING
MATERIALS.
IT'S VERY DIFFERENT IN TERMS OF
THE WAY WE HAVE A DETAILED
IMPLEMENTATION PLAN IN TERMS OF
THE PROJECT WHICH ARE DIFFERENT.
I THINK IT GOES TO THE SECOND
AIM IN TERMS OF WHY THERE'S NOT
ONLY BE AN AIM FOR DO THE
INTERVENTIONS WORK OR NOT AND
THERE'S AN AIM HOW DO THESE
DIFFERENT COMPONENTS WORK
BECAUSE FOR COMPASS, SOME OF THE
DELIVERABLES PER SE ARE REALLY
DOES THIS WHOLE THING WORK AS
MUCH AS CAN WE SAY THIS WORKS OR
DIDN'T WORK AND WHY SO THAT WE
CAN ADVISE NIH ON HOW WILL IT
PROCEED AS AN INSTITUTE FOR
USING DIFFERENT TYPES OF
MECHANISMS IN HOW THEY INVOLVE
COMMUNITIES IN THE FUTURE AND
LOOKING AT IMPLEMENTATION
RESEARCH FOR DIFFERENT HEALTH
AREAS.
>>I'M HOPING THERE'S FOLKS WITH
PROCESS EVALUATION EXPERTISE
BECAUSE HAVING DONE THE COMPLEX
INTERVENTIONS I FIND THERE'S A
KEY COMPONENT AND CREATES SYSTEM
CHANGE FOR A DIFFERENT QUALITY
OF CARE.
IT'S A COMPONENT OF IT.
WE FOUND THAT IN THE OFFICE OF
EVALUATION MORE THAN
IMPLEMENTATION AS A TRIAL.
MY LAST QUESTION DR. BOYCE IS
RELATED TO TRANSLATION TO THE
APPROACHES WITH COMPASS AND HOW
THAT MIGHT INFLUENCE THE WAY
THINGS ARE DONE AT NIH AS IT
RELATES TO EXTRAMURAL AWARDS.
YOU MENTIONED AS ONE EXAMPLE THE
OTA IS A MORE FLEXIBLE CAN YOU
TALK ABOUT THAT AND THE EXTENT
TO WHICH IT MAY MOVE TO FUNDING
ACADEMIC INSTITUTIONS?
>>RIGHT.
OTAs HAVE BEEN USED AT OTHER
GOVERNMENT AGENCIES AND HAVE
BEEN USED WITH OTHER AGENCIES IN
THE PAST AND NIH GOT THE
AUTHORITY.
NOT ALL INSTITUTES HAVE USED
THEM.
IT'S NEW AND REQUIRES DIFFERENT
CAPACITY IN TERMS OF STAFF.
IT WAS USED DURING COVID.
I THINK AS NIH HAS TRIED TO
TACKLE NEW TYPES OF PROBLEMS AND
THAT'S WHAT WE DID.
WE'RE KEEPING TRACK AND THERE'S
BEEN CHALLENGES SO AS WE SOLVE
THEM WE HAVE A COMMUNITY
PRACTICE WITH OTHER PARTS OF NIH
AND THAT'S PART OF OUR MISSION
TO SAY WHAT WORKS AND DOESN'T
WORK SO OTHER INSTITUTES WILL
CONSIDER USING THEM FOR THE NEXT
TYPE OF PROBLEM THEY HAVE OR
WHEN THEY HAVE OBJECTIVE IN
TERMS OF HEALTH THEY SAY WHY
DON'T WE TRY AN OTA AND SEE IF
THAT WOULD WORK BETTER.
IN TERMS OF FLEXIBILITY IT'S
VERY MILESTONE DRIVEN FOR
COMMUNITY.
WE HAD LISTENING SESSIONS EARLY
ON AND WE WANT TO ASK THE
QUESTION FOR OUR COMMUNITY AND
WE THINK IT'S NICE WHEN
RESEARCHERS WANT TO PARTNER WITH
US BUT NOT SO NICE WHEN THEY
COME IN WITH THE QUESTION THEY
THINK WE WANT ANSWERED AND WE
WANTED THE MECHANISM WHERE THEY
WOULD GET THE FUNDS AND THEY
WOULD GET A PARTNER AND THE OTA
HAS DIFFERENT KINDS OF STRUCTURE
IN TERMS OF HOW THEY ACTUALLY
APPLY SO THAT'S WHY WE DID IT
THAT WAY.
THERE'S DIFFERENT STEPS SO WE
WERE ABLE TO HELP IN TERMS OF
THAT.
THE APPLICATION PROCESS WAS
CONSIDERED VERY FATEFUL AT NIH
AND WE ALSO THOUGHT ABOUT WAY
THE MILESTONES WERE DRIVEN BEING
A HIGH-RISK, HIGH-REWARD TYPE OF
PROJECT WE ALSO NEED TO HAVE
CLOSE EYES ON THIS AS WELL
BECAUSE WE DO WANT SUCCESS BUT
WE ALSO NEED TO HAVE A CLOSED
EYE IN TERMS OF SCRUTINY IN THE
PROJECT AND WE DO WANT TO MAKE
SURE IT'S SUCCESSFUL SO THAT'S
WHY WE'RE USING OTA.
IT'S CLOSELY MILE-STONE DRIVEN
AND IF YOU HAVE A GRANT ONCE A
YEAR WE HEAR FROM YOU.
THAT'S NOT THE WAY IT'S GOING TO
WORK.
WE'LL HEAR FROM THEM MORE
FREQUENTLY AND WILL HELP BECAUSE
IF THEY NEED HELP WE CAN KIND OF
SHIFT IT OR IF WE NEED TO CHANGE
MILESTONES WE CAN DO THAT.
IT'S VERY DIFFICULT TO DO THAT
WITH THE STRUCTURE OF GRANTS AS
YOU KNOW WHEN YOU HAVE TO CALL
YOUR PROJECT OFFICER IT'S NOT SO
EASY TO SHIFT AND MOVE.
WE WANT TO HELP COMMUNITIES DO
THAT AND HELP GUIDE FOR SUCCESS.
>>THANK YOU SO MUCH.
>>I HAVE A QUESTION FOR YOU.
I'M SURE A LOT OF THOUGHT WENT
INTO THIS BUT 10 YEARS OF
FUNDING, A LOT'S GOING TO HAPPEN
IN 10 YEARS WHERE IT'S SUCH A
DYNAMIC SOCIETY AND THINGS DON'T
STAY.
HAVE YOU THOUGHT ABOUT HOW
YOU'RE GOING TO FIND WHAT'S
WORKING WITH THE CHANGING
ENVIRONMENT AND THE CHANGING
CULTURAL THINGS HAPPENING.
WE'RE SO DYNAMIC I WAS THINKING
ABOUT THE 10-YEAR TIME LINE.
WHAT WAS THE THOUGHT?
>>SO AFTER FIVE YEARS WE DO
HAVE TO GO BACK AND ASK FOR THE
NEXT FIVE YEARS.
SO THAT IS SOMETHING I THINK
WE'LL NEED FIVE YEARS TO SAY
LET'S KEEP GOING.
WE'LL HAVE TO PROVE AND GO TO
OUR COUNCIL AND SAY WE'LL HAVE
TO HAVE SOME INDICATION SO THERE
IS A CHECKS AND BALANCES TO GO
ALL THE WAY TO 10 YEARS.
AND I THINK WITH THE O.T. IF
THERE'S A SITE THAT ISN'T DOING
SO WELL AND NEEDS TO STOP, THEN
WE'LL BE ABLE TO SAY, YOU NEED
TO STOP OR IF WE NEED TO ADJUST
WE NEED TO DID THAT.
IT'S MORE NIMBLE.
IT'S HARD TO DO THAT WITH THE
CURRENT STRUCTURE OF GRANTS.
WE NOW HAVE PHASED AWARDS WHICH
THIS IS A LITTLE BIT LIKE THAT
BUT IT'S HARD.
I TOO WORRY ABOUT 10 YEARS AGO
AND ALL THE DISCOVERY WE'VE HAD.
LET'S SAY THERE IS A DISCOVERY
WE CAN MAYBE BRING THAT IN AND
OFTEN WHEN GOVERNMENT IS BIG
THERE'S SILOS SO IN TERMS OF
KNOWING SOMETHING'S COMING THE
AFFECT THE STRUCTURAL
INTERVENTIONS IF SOMETHING'S
CHANGING THE STRUCTURE WE NEED
TO KNOW ABOUT THAT BECAUSE IT
WOULD AFFECT THE INTERVENTION.
>>ANY ADDITIONAL QUESTIONS FOR
DR. BOYCE?
>>THANK YOU FOR HAVING ME.
>>THANK YOU, DR. BOYCE.
I WANT TO RECOGNIZE HER FOR HER
TRANSFORMATIVE PROGRAM FOR NIH.
I'VE LEARNED SO MUCH FROM YOU
AND APPRECIATE YOUR DEDICATION
AND COMMITMENT AND ALSO WANT TO
RECOGNIZE DR. BOYCE IS THE FIRST
TO SAY THIS AND IT WAS SHOWN ON
THE SLIDE, THIS IS A HUGE
UNDERTAKING FOR NIH.
WE HAVE SO MANY AT NINR.
DR. BINEHEIM HELPED LAUNCH
CAMPUS.
-- COMPASS.
ALSO, NOW SO MANY ARE
CONTRIBUTING TO COMPASS AND SO
MANY ACROSS NIH AND IT'S A LABOR
OF LOVE.
THERE'S NO AMOUNT OF MONEY AND
COMPENSATION THAT CAN COMPENSATE
FOR THE TREMENDOUS INVESTMENT
AND COMMITMENT OF THIS TEAM.
I WANT TO ACKNOWLEDGE THEM.
THANK YOU, DR. BOYCE.
WE'LL BE OVERSEEING THE GRANTS
MANAGEMENT CENTER AND IN ARE
INVOLVED AND I HATE TO NAME
NAMES BECAUSE I FORGET PEOPLE SO
I'LL LEAVE IT THAT THE BUT I
WANT TO ACKNOWLEDGE EVERYBODY'S
CONTRIBUTIONS.
THANK YOU.
SO, WITH THAT I SEE MY COLLEAGUE
DR. SUSAN GREGURICK IN THE BACK,
MAKE YOUR WAY TO THE FRONT.
SHE'LL PROVIDE AN OVERVIEW OF
THE ARTIFICIAL
INTELLIGENCE/MACHINE
LEARNING CONSORTIUM TO ADVANCE
HEALTH EQUITY AND RESEARCHER
DIVERSITY, OR AIM-AHEAD
PROGRAM.
DR. GREGURICK WAS APPOINTED
ASSOCIATE DIRECTOR FOR DATA
SCIENCE AND DIRECTOR OF THE NIH
OFFICE OF DATA SCIENCE STRATEGY
IN 2019. UNDER DR. GREGURICK
LEADERSHIP, THE ODSS LEADS
THE IMPLEMENTATION OF THE NIH
STRATEGIC PLAN FOR DATA SCIENCE
THROUGH SCIENTIFIC, TECHNICAL,
AND
OPERATIONAL COLLABORATION ACROSS
NIH. SHE RECEIVED THE 2020
LEADERSHIP IN BIOLOGICAL
SCIENCES
AWARD FROM THE WASHINGTON
ACADEMY OF SCIENCES FOR HER WORK
IN THIS ROLE. SHE WAS
INSTRUMENTAL IN THE CREATION OF
THE ODSS IN 2018 AND SERVED AS A
SENIOR ADVISOR TO THE OFFICE
UNTIL BEING NAMED TO HER CURRENT
POSITION.
SHE WAS PREVIOUSLY THE DIVISION
DIRECTOR FOR BIOPHYSICS,
BIOMEDICAL TECHNOLOGY, AND
COMPUTATIONAL BIOSCIENCES AT THE
NATIONAL INSTITUTE OF GENERAL
MEDICAL SCIENCES, OR NIGMS. HER
MISSION IN THIS ROLE WAS TO
ADVANCE RESEARCH IN
COMPUTATIONAL BIOLOGY;
BIOPHYSICS AND DATA
SCIENCES; MATHEMATICAL AND
BIOSTATISTICAL METHODS; AND
BIOMEDICAL TECHNOLOGIES IN
SUPPORT OF
THE NIGMS MISSION TO INCREASE
OUR UNDERSTANDING OF LIFE
PROCESSES. IN THIS ROLE SHE LED
THE
INSTITUTE'S EFFORT TO REIMAGINE
NIGMS TECHNOLOGY PROGRAMS,
INCLUDING EARLY STAGE, CONCEPT
DEVELOPMENT, FOCUSED TECHNOLOGY
PROGRAMS, AND DEVELOPMENT AND
DISSEMINATION CENTERS,
THROUGH NATIONAL AND REGIONAL
RESOURCES TO SUPPORT
STATE-OF-THE-ART FACILITIES,
EQUIPMENT,
TECHNOLOGIES, RESEARCH TOOLS,
SOFTWARE, AND SERVICE.
SO WELCOME, DR. GREGURICK.
IT'S A PLEASURE TO HAVE YOU.
THANK YOU.
>>THANK YOU, DR. ZENK.
THAT'S THE BEST INTRODUCTION
I'VE HAD.
IT'S WONDERFUL TO BE HERE TODAY.
I THINK WHAT HAPPENS IS I JUST
DO NEXT.
AS DR. ZENK SAID I'M THE
DIRECTOR OF THE DATA SCIENCE AT
THE NATIONAL INSTITUTES OF
HEALTH.
I SILT WITHIN THE OFFICE OF THE
DIRECTOR AND LEAD THE OFFICE OF
DATA SCIENCE STRATEGY.
IT'S A PLEASURE TO TELL YOU
ABOUT OUR PROGRAM IN ARTIFICIAL
INTELLIGENCE AND MACHINE
LEARNING OUR CONSORTIUM AT THE
AIM AHEAD PROGRAM.
I LOVE THE LAST PRESENTATION AND
WE'LL WAIT TO ENGAGE BUT I HOPE
WE'LL FIND SYNERGIES WHEN IN I
PRESENT IN AIM AHEAD AND WHAT
YOU'RE THINKING ABOUT COMPASS AS
WELL.
SO THERE'S JUST BEEN A LOT OF
INTEREST IN ARTIFICIAL
INTELLIGENCE RECENTLY AND I'M
SURE YOU'RE INTERESTED AS WELL
AS.
I WANT TO POINT OUT A FEW
EXAMPLES HAPPEN THIS SUMMER.
THE FIRST IS THE USE OF
ARTIFICIAL INTELLIGENCE IN
PUBLIC HEALTH.
THEY LOOKED AT THE USE OF
GENERATIVE A.I. OR CHAT GPT TO
ANSWER CITIZENS QUESTIONS ON
PUBLIC HEALTH.
UTILIZING THIS METHOD, THEY
FOUND THAT WHILE GENERATIVE A.I.
CAN CONSTRUCT ANSWERS THE TRUTH
MOST INFORMATION WAS BOGUS AND
NOT IN ANY WAY ACCURATE AN
THERE'S A LOVELY PUBLICATION
THAT CAME OUT I THINK AT THE END
OF JULY.
HOW CAN WE IMPROVE A.I. TO BE
REFLECTIVE OF MEDICINE AND
HEALTH.
THERE'S A LOT OF DISCUSSION IN
THE A.I. WORLD ABOUT USING LIVE
LANGUAGE MODELS AND THERE'S A
ROBUST CLINICAL DATA SET OR
USING JUST FOUNDATIONAL MODELS
LIKE YOU SEE IN CHAT GPT.
THE DISCUSSION IS STILL GOING
ON.
THERE'S A LOVELY PAPER PRESENTED
IN THE NEW ENGLAND JOURNAL OF
MEDICINE COMPARING LARGE
LANGUAGE MODELS AND CLINICAL
MODELS FINDING STRENGTHS AND
WEAKNESSES.
I THINK THAT CAME OUT IN JULY IN
THE ISSUE OF THE NEW ENGLAND
JOURNAL OF MEDICINE.
IT'S AN INCREDIBLY ACTIVE AREA
OF RESEARCH.
I THINK IT'S AN AREA OF RESEARCH
THAT NURSING RESEARCHERS AND
NURSING PROFESSIONALS CAN ADD
QUITE A LOT OF VALUE TO AND
YOU'LL SEE WHY IN MY NEXT
SLIDES.
MOVING ON TO JUNE OF THIS PAST
YEAR, YOU SEE THERE'S A NUMBER
OF PUBLICATIONS THAT EXPLICITLY
USE CHAT GPT OR OTHER
FOUNDATIONAL MODELS IN THEIR
PUBLICATIONS.
THIS IS RESEARCH PUBLISHING
USING FOUNDATIONAL MODELS
EXPLICITLY FOR EXAMPLE, CHAT
GPT.
WHAT ARE THE TYPES OF QUESTIONS
THEY'RE LOOKING AT?
THEY GO FROM ETHICAL MEDICAL
RESEARCH TO CLINICAL PRACTICE TO
MEDICAL EDUCATION AND OTHER
ACTIVITIES SUCH AS PATIENT
EDUCATION.
THIS IS A WONDERFUL PAPER IN THE
PAPER AND THERE'S AN INTEREST IN
UNDERSTANDING HEALTH AND HEALTH
CARE AND HEALTH EDUCATION.
HOW CAN WE CAPITALIZE ON THIS
WONDERFUL OPPORTUNITY?
I PROPOSE AND I THINK I'LL FIND
YOU AGREE NURSING AND DATA
SCIENCE ARE A MAJOR MADE IN
HEAVEN.
NURSES ARE LEADERS IN USING AND
COLLECTING REAL WORLD DATA NOT
ONLY FOR RESEARCH BUT IN GENERAL
PRACTICE.
I THINK YOU'LL AGREE WITH ME
HERE THAT YOU ACTUALLY
UNDERSTAND THE DATA CHALLENGES
AT A FAIRLY DEEP WAY.
YOU UNDERSTAND SPECIFIC DATA
ELEMENTS DIFFER IN REAL PRACTICE
AND IT'S BEEN A CONUNDRUM FOR
NIH MOVING FORWARD AND USING
DATA AT AN UNPRECEDENTED DATA
BUT I THINK YOU'LL AGREE THE
DATA QUALITY AND ACCESS AND
ACCURACY AND COMPLETENESS REMAIN
AN INCREDIBLE CHALLENGE JUST
LOOKING AT ELECTRONIC HEALTH
RECORD THERE'S DIFFERENCE EVEN
WITHIN THE SAME INSTITUTION.
THIS OFTEN REQUIRES EXTENSIVE
DATA MAPPING, DATA CLEANING,
CURAT
CURATION.
IT'S TRULY A LABOR OF LOVE IF
YOU'RE IN THE NURSING
PROFESSION.
LACK OF INTEROPERABILITY
UTILIZING ACTIVITIES WE TAKE VNK
OF AND THERE'S ALWAYS NEED FOR
GREATER TRAINING OPPORTUNITIES
TO IMPROVE OUR COORDINATION AND
COLLABORATION ON DATA SCIENCE.
SO WHAT CAN WE DO TO PARTNER
TOGETHER AND HOW DOES THIS CAUSE
IMPACT.
FIRST THE PROMISES OF WHAT
HAPPENS HAPPEN IN A.I. FOR
HEALTH CARE AND HEALTH RESEARCH
AND WHAT ARE THE GREATEST
CHALLENGES AND WHAT ARE WE DOING
IN AIM AHEAD AND WHAT ARE SOME
OF OUR IMPACT AND NEW
OPPORTUNITIES GENERALLY IN A.I.
HERE AT NIH?
I THINK THAT WILL TAKE US INTO A
30 MINUTES.
I'M LOOKING FORWARD TO ENGAGING.
THE FIRST THING I WANT TO SHOW
YOU IS ONE EXAMPLE.
IT'S ONE OF MY FAVORITE
EXAMPLES.
IT'S A LITTLE DATED AND THE
PROMISE OF WHAT IT CAN DO FOR
PARTICULAR PATIENTS.
RARE DISEASES IN PEDIATRIC CASES
ARE INCREDIBLY CHALLENGING AND
OFTEN HEARTBREAKING AND YOU NEED
TO MAKE A DIAGNOSIS EARLY ON TO
GET TREATMENT.
THESE ARE INFANTS.
THEY WORKED ON DEVELOPING A
PIPELINE THAT WOULD INCORPORATE
GENETIC DATA WITH DATA IN THE
ELECTRONIC HEALTH RECORD
COMPARED TO A DATABASE UTILIZING
A.I. TO MAKE A PIPELINE TO DRAW
BLOOD SAMPLES FROM INFANTS AND
QUICKLY SEQUENCE THEM, COMPARE
THEIR GENETIC DATA TO THOSE IN
THE DATABASE AND MAKE A
PRELIMINARY DIAGNOSIS.
AND WITHIN 24 HOURS.
WHICH IS IN THE CARE OF
PEDIATRICS WITH LIFE DISEASES IS
LIVE SAVING.
THE PIPELINE THEY DEVELOPED MAY
BE PARTICULAR FOR HER
INSTITUTION AND HOSPITAL.
APPLICATION OF THIS BEYOND HER
ONE HOSPITAL NEEDS TO BE
CONSIDERED WITH RIGOR AND
THOUGHT BUT POINTS TO THE
APPLICATIONS OF USING A.I. IN
HEALTH DIAGNOSIS.
YOU WON'T BE SUR SURPRISED WHEN
I TELL YOU ABOUT ALL THE
CHALLENGES.
JUST FOR EXAMPLE OFTEN TIMES
WHEN WE ARE TRYING TO UNDERSTAND
HEALTH AND HEALTH DISEASE WE
NEED PROXIES FOR A LEADING
INDICATOR.
IT'S NOT SOMEONE FOR ALGORITHMS
TO USE A PROXY TO DIAGNOSE OR
IDENTIFY PATIENTS AT RISK.
ONE PROXY IS THE NUMBER OF TIMES
YOU HAVE TO VISIT A HEALTH CARE
CLINIC.
THAT WOULD MAKE SENSE, RIGHT.
AND WHAT YOU ARE LOOKING FOR A
LOT OF IS USING IT AS A PROXY
FOR HEALTH CARE YOU'RE LOOKING
AT SOMETHING ELSE AND YOU'RE NOT
ASSESSING THE HEALTH OF THAT
INDIVIDUAL AND THIS HAS BEEN
DOCUMENTS IN A NUMBER OF
STUDIES.
THIS IS AN EXAMPLE OF IN SENSE
OF MISLEADING DATA.
AND HERE'S EXAMPLES FROM COVID.
DIAGNOSING COVID EARLY ON BY
UTILIZING CT TEST SCANS WAS AN
IMPORTANT FACTOR AND THE MODELS
ARE TRAINED ON HEALTHY AND
COVID-INFECTED ADULTS USING CT
SCANS.
GUESS WHAT HAPPENED WHEN YOU
TRIED TO DO THAT WITH CHILDREN
THEIR LUNG ARE DIFFERENT SO THEY
WERE OVER PREDICTED TO HAVE
COVID.
GETTING THE DIAGNOSIS EARLY ON
FOR CHILDREN IS IMPORTANT.
THEY INTERACT IN THE COMMUNITY
EXTENSIVELY AND THE RISK OF
COVID INFECTION AND UNDERLYING
CIRCUMSTANCES FOR COVID IS
IMPORTANT.
SO THAT JUST GIVES A SENSE THAT
THE DATA HAS TO REPRESENT THE
TYPE OF QUESTION YOU WANT TO
ANSWER AND THIS HAS BEEN A
CONUNDRUM FOR DATA SCIENCE.
SO SOMETIMES THE DATA IS UNDER
REPRESENTED OF THE POPULATIONS.
IT DOESN'T REFLECT THE
POPULATIONS AT HAND.
OR THERE'S BIASES WITHIN THE
TRAINING DATA SET OR SOMETIMES
THE QUESTION THAT YOU'RE ASKING
IS NOT GOING TO BE ANSWERED BY
THE DATA THAT YOU HAVE AS YOU
SAW WITH THE PROXY OF USING
HEALTH VISITS FOR WELLNESS.
ANOTHER THING THAT I HAVEN'T
SAID I THINK YOU'RE GOING TO
RESONATE WITH IS THE
RESEARCHERS, THE A.I.
RESEARCHERS ARE DIFFERENT AND
THERE'S A LACK OF DIVERSITY IN
THE A.I. COMMUNITY IN
UNDERSTANDING THE DIVERSITY OF
HEALTH ISSUES INTEGRATING HEALTH
DISPARITIES RESEARCH AND
ARTIFICIAL INTELLIGENCE IS A
UNIQUE OPPORTUNITY FOR NIH.
WE'RE THE ONLY AGENCY IN MY
OPINION THAT CAN DO THAT WITH
REAL DIFFERENCES.
FINALLY, DATA NEEDS LIVED
EXPERIENCES.
IT NEEDS HISTORICAL AND CULTURAL
CONTACTS AND SOCIAL DETERMINATES
OF HEALTH AND A PERFECT EXAMPLE
WAS PUT OUT LAST YEAR IN THE
JAMA OF CARDIOLOGY IF YOU
INTEGRATE SOCIAL DETERMINATES OF
HEALTH INTO PREDICTING HEART
RATE AND FAILURE DEATHS
PARTICULARLY AMONG AFRICAN
AMERICANS MAKES A BIG DIFFERENCE
AND IT'S A GOAL FOR MY OFFICE.
THESE PROBLEMS AREN'T STATIC.
THIS IS NOT A SNAPSHOT OF
PROBLEMS.
THESE CONTINUE TO GO ON.
YOU MAY FIND WE DEPLOY AN A.I.
ALGORITHM AND WORKS FINE BUT
SLOWLY BUT SURELY IT STOPS BEING
AS ACCURATE AS YOU WOULD HOPE.
THERE'S REASONS.
THE DATA SHIFTS.
PEOPLE CHANGE AND PARTICULARLY
WHEN WE LOOK AT SOCIAL
DETERMINATES OF HEALTH, THE
HEALTH ENCOUNTERS, ENVIRONMENT,
EMPLOYMENTS AND THAT CHANGES IN
WHICH THE A.I. ALGORITHM WAS
TRAINED OR THERE'S CONCEPT
SHIFTS.
INPUT AND OUTPUT VARIABLES HAVE
CHANGE.
IF YOU'RE USING QUALITY OF LIFE
SURVEYS IT'S A BIG RISK.
THERE'S RISKS TO THINK ABOUT
WHEN WE USE A.I. FOR HEALTH
RESEARCH.
AND HHS A.I. DATA STRATEGY, A
LOT OF PROMISE HERE.
AND YOU CAN TAKE ON THE
CHALLENGE AND MAKE A BIG
DIFFERENCE BUT IT'S GOING TO
TAKE A BIG EFFORT AND YOU I HAVE
TO INTRODUCE THE AIM AHEAD
PROGRAM.
IT HAS THREE MAIN GOALS.
TO ENHANCE THE PARTICIPATION AND
REPRESENTATION OF RESEARCHERS
AND COMMUNITIES WHO ARE
CURRENTLY UNDER REPRESENTED IN
THE DEVELOPMENT OF ARTIFICIAL
INTELLIGENCE INTO THIS EQUATION.
OUR GOAL IN RESEARCH IS TO
ADDRESS HEALTH DISPARITIES AND
EQUITIES USING A.I. AND M.L. TO
THE BEST WE CAN AND IMPROVE THE
CAPACITY IN THESE COMMUNITIES.
THOSE ARE OUR THREE GOALS.
IT IS A CONSORTIUM.
AND YOU'LL GET A SENSE OF THE
IMPACT.
THIS MAP IT'S A LITTLE BIT
COMPLICATED WITH COLORINGS AND
TRIANGLES AND SQUARES AND WHAT
NOT.
IT'S A CONSORTIUM MADE UP OF
FOUR MAIN CORES.
THERE'S THE LEADERSHIP CORE.
IT'S LED FROM THE UNIVERSITY OF
NORTH TEXAS HEALTH CARE CENTER.
THE RESEARCH CORE AIMS TO
ADDRESS RESEARCH PRIORITIES AND
NEEDS THAT ARE WITH THE
COMMUNITY.
I'LL TELL BUT A CONCEPT CALLED
CO-DESIGN HOW WE DEVELOP OUR
RESEARCH PRIORITIES WITH THE
COMMUNITY.
THE TRAINING CORE AT HOWARD IS
LOOKING AT IMPLEMENT DATA
SCIENCE TRAINING CURRICULA AND
CAPACITY ACROSS OUR ENTITIES AND
OUR INFRASTRUCTURE CORE.
THIS ADDRESSES DATA, XULTING AND
SOFTWARE TO FACILITATE THE
CAPABILITIES OF A.I. AND M.L.
RESEARCH.
THERE'S NO ONE SIZE FITS ALL
INFRASTRUCTURE THAT WILL SOLVE
THE PROBLEM.
EACH COMMUNITY COMES WITH THEIR
OWN NEEDS AND LEVEL OF EXPERTISE
AND YOU HAVE TO THINK OF IT AS A
MULTIPRONGED APPROACH AIMED AT
DIFFERENT COMMUNITIES AND IT'S A
RESEARCH PROGRAM AFTER ALL.
THIS IS COLOR CODED FOR A
REASON.
YOU'LL SEE IT'S BROKEN UP INTO
DIFFERENT COMPONENTS OF THE
U.S. AND EACH HAS HUBS.
THAT'S HOW WE ENGAGE
RESEARCHERS, HOW WE ENGAGE
ACADEMIC INSTITUTIONS AND
COMMUNITY COLLEGES AND HOW WE
ENGAGE COMMUNITY.
EACH HUB IS RESPONSIBLE FOR
ENGAGING WITH THE DIFFERENT
SECTORS, SOUTHWEST, SOUTHEAST,
NORTHWEST AND NORTHEAST AND
MIDWEST.
WHEN I TALK ABOUT THE PRIORITIES
OF THOSE HUBS IT WILL MAKE MORE
SPENCE THE VISION OF AIM AHEAD
IS BASED ON THE VISION OF NORTH
STARS.
THE FIRST IS WE NEED A DIVERSE
WORKFORCE.
TIME AND TIME AGAIN RESEARCH
SHOWS IF YOU HAVE DIVERSITY IN
YOUR COMPANY THE CAPABILITY IS
GREATER THAN IF YOU HAVE A MORE
INSULAR GROUP AND IT MEANS
ENGAGING BEYOND RESEARCHERS AND
ACADEMICS AND COMMUNITY LEADERS
TO THINK OF ARTIFICIAL
INTELLIGENCE IN A DIFFERENT WAY.
THAT MEANS PARTNERING WITH
COMMUNITIES AND CO-DESIGN MEANS
YOU DEVELOP YOUR RESEARCH
PRIORITIES IN PARTNERSHIP WITH
THE COMMUNITIES.
IT'S NOT TOO DISSIMILAR FROM
WHAT COMPASS IS DOING AND THAT'S
AN IMPORTANT POINT IT'S RESEARCH
WITH THE COMMUNITY.
AND WE HAVE TO DELIVER
CAPABILITIES FOR DIFFERENT
ACADEMIC SETTINGS AND THERE'S A
COMPONENT THAT'S A.I.
INFRASTRUCTURE AND FINALLY, THIS
SAY RESEARCH PROGRAM AND IT'S A
RESEARCH AND HEALTH DISPARITIES
AND THE CONSORTIUM CAME TOGETHER
AND CHOSE PRIORITIES FOR
COMMUNITIES, CARDIOVASCULAR
DISEASE AND CANCER.
YOU'LL HEAR A LOT ABOUT THESE
TWO DIFFERENT TYPES OF
PRIORITIES.
THIS IS WHAT THE COMMUNITY TOLD
US THEY WERE MOST INTERESTED IN
RESEARCH QUESTIONS.
I THOUGHT I WOULD EXEMPLIFY WHAT
SOME OF THE RESEARCH WAS IN THE
CENTRAL HUB MAKING EXISTING
COMMUNITY DATA MORE A.I. READY.
AND THE INTEGRATING HEALTH CARE
DATA TO ADDRESS HUNG CANCER IN
NATIVE HAWAIIAN AND OTHER
PACIFIC ISLANDER POPULATIONS AND
TRAINING COMMUNITY HEALTH CARE
WORKERS IN DELIVERING
INFORMATION ABOUT A.I. AND M.L.
BECAUSE TO MANY PEOPLE IN
COMMUNITIES IT'S A BIT OF AN
UNKNOWN BLACK BOX AND THEY MAY
BE FAMILIAR WITH CHAT GPT AND
OTHERS BUT REALLY THE
UNDERSTANDING OF WHAT IT CAN AND
CAN'T DO IS IMPORTANT.
THE WEST HUB IS CONDUCTING LARGE
SCALE ANALYSIS TO ADDRESS CARDIO
METABOLIC HEALTH IN AMERICAN
INDIAN AND ALASKAN NATIVE.
I'LL TALK MORE IN A MOMENT BUT
IT'S AN IMPORTANT PROGRAM
BECAUSE OF THE RISK OF DIABETES
IN AMERICAN INDIAN AND ALASKAN
NATIVE POPULATIONS.
THIS WAS A PRIORITY FOR THEM.
AND THERE'S UPTAKE AMONG SPANISH
SPEAKING PATIENTS.
MOST OF WHAT WE DO IS IN ENGLISH
AND THE DISSEMINATION OF A.I. IS
MOSTLY IN ENGLISH BUT THE
COMMUNITIES THAT NEED THIS SPEAK
MANY DIFFERENT LANGUAGE.
WE'RE LOOKING AT INCORPORATING
LANGUAGE INTO A.I.
AND THERE'S HIGH RISK DEATH
RATES IN RURAL APPALACHIA AND
THE CLINICAL TRANSLATIONAL
SCIENCE INSTITUTE FOR DELIVERING
SOME INFRASTRUCTURE NEEDED.
THIS IS A COMPONENT OF AIM AHEAD
AND SO THIS PARTICULAR GROUP IS
LOOKING TO SEE WHAT TYPE OF
INFRASTRUCTURE WOULD HELP
APPALACHIAN CLINICAL SCIENCE
INSTITUTES.
AND FINALLY THE NORTH AND
MIDWEST HUB ARE DEVELOPING A
RISK PREDICTION FOR ALASKAN
NATIVE POPULATIONS TO IMPROVE
DIAGNOSIS AND CARE AND A CHATBOT
TO ASSIST PATIENTS WITH DIABETES
DIAGNOSIS, SELF-CARE MANAGEMENT.
IT'S A REAL CONCERN IN
POPULATIONS OF AMERICAN INDIAN
AND ALASKAN NATIVES.
ONE THING I'M PROUD OF IS THE
WAY WE ENGAGE YOUNG PEOPLE AND
EARLY CAREER LEADERS ACROSS THE
UNITED STATES.
WHILE THERE IS CORES AND HUBS
THERE'S AN OUTREACH AND THERE'S
AIM AHEAD CONNECTS THAT CONNECTS
MENTEES AND CONNECT THEM WITH
MENTORS AND COMMUNITY LEADERS,
A.I. RESEARCHERS, RESEARCHERS IN
HEALTH DISPARITIES AND EQUITY
MEMBERS ACROSS THE CONSORTIUM
AND GROUPS.
THEY HAVE THE GENERATION OF A.I.
RESEARCHERS AND GROW A NEW
GENERATION.
ENGAGING IN GRADUATE STUDENT
TRAINING AND AIM AHEAD
DISSEMINATES A NUMBER OF AWARDS,
GRADUATE FELLOW.
AWARDS AND AWARDS FOR LEADERS
AND FOR COMMUNITY MEMBERS SO
THEY CAN CONDUCT RESEARCH AND
PARTICIPATE IN AIM AHEAD.
WE HAVE 25 GRADUATE TRAINEES AND
22 EARLY YEAR INVESTIGATORS AND
26 LEADERSHIP FELLOWS FOR
EMERGING IN ACADEMIA OR IN THE
COMMUNITY TO BRING FORWARD NEW
IDEAS IN A.I. AND 46 HEALTH CARE
WORKERS AND THEY COULD BE
NURSING PRACTITIONERS, PUBLIC
HEALTH RESEARCHERS INTERESTED IN
THIS PROGRAM AS WELL.
I'LL TELL YOU ABOUT WHAT SOME OF
THE RESEARCHERS ARE DOING IN AIM
AHEAD.
FOR EXAMPLE, AMY WATERMAN IS AT
HOUSTON METHODIST INSTITUTE IS
LOOKING AT KIDNEY TRANSPLANT
DERAILERS TO PREDICT TRANSPLANT
DROP OUT RATE AMONGST AFRICAN
AMERICANS AND HISPANIC PATIENTS.
SHE'S WORKING WITH CLINICAL AND
COMMUNITY-LED FOLKS WITH
MULTI-ETHNIC POPULATIONS TO
BUILD THOSE INTO HER A.I. MODEL
SO SHE CAN HELP PREDICT WHO IS
AT RISK FOR DROPPING OUT OF
KIDNEY TRANSPLANTS.
ANOTHER IS FROM THE UNIVERSITY
OF NORTH TEXAS, EVALUATING
BIASSED AND PREDICTIVE
ALGORITHMS AMONG OLDER ADULTS
WITH CANCER ALSO TAKING
MAGNESIUM SUPPLEMENTS AND
INTEGRATING MULTIPLE DATA
SOURCES, SOCIAL DETERMINATES OF
HEALTH AND OTHER DIVERSE TYPES
OF DATA INCLUDING POPULATION
DATA FROM RURAL POPULATIONS.
DR. STOKES IS ADDRESSING
INTERSECTIONS IN UNDER DIAGNOSED
AND UNDER RECOGNIZED ISSUES IN
THE COMMUNITY AND MITIGATING
BIAS IN THE APPLICATION OF A LOT
OF AT THE INTERSECTION.
FINALLY, JAINING IS LOOKING AT
AMERICAN INDIAN AND ALASKAN
NATIVES AND THESE ARE A FEW OF
THE EXAMPLES.
I WON'T PLAY THE VIDEO IT'S
WORTH WATCHING.
TO DEVELOP A.I. RISK ASSESSMENT
MODELS FOR THOSE WITH BLOOD
CLOTS AND CANCER.
IF YOU WANT TO WATCH IT IT'S
PRETTY INTERESTING.
WHAT I'M SUPER EXCITED ABOUT IS
THE WORK IN PARTNERSHIP WITH A
COMPANY IN BIRMINGHAM, ALABAMA
CALLED ACCELERATE.
AND IT ENGAGES WITH THE
BIRMINGHAM COMMUNITY AND
AIM-AHEAD CLOEGZ TO REALLY --
COLLEAGUES AND IDENTIFY
OPPORTUNITIES IN A.I. TO IMPACT
THE COMMUNITY IN BIRMINGHAM,
ALABAMA WHO MAY HAVE DIFFERENT
HEALTH QUESTIONS THAN SOMEONE IN
TEXAS.
WE HAVE DIFFERENT COMMUNITY
NEEDS.
WE HAVE TO GET IN THERE WITH THE
COMMUNITY.
WHAT ARE ETHICAL AND BIASES
CHALLENGES WITHIN A.I.
THERE'S REAL NUANCE IN
DEVELOPING DATA AND ENABLES
RECALL UNDER REPRESENTED
COMMUNITIES TOE CONTRIBUTE TO
THE CONVERSATION.
YOU CAN'T FIND SOLUTIONS IF YOU
CAN'T BE HEARD.
IT TAKES A COMMUNITY AND THERE'S
A WONDERFUL VIDEO BY A NEWS
STATION IN BIRMINGHAM, ALABAMA
WHO INTERVIEWED THE PEOPLE AND
I'M EXCITED TO SHARE IT WITH
YOU.
FOR US IT'S A METRIC OF SUCCESS
HOND THE IMPACT OF SUCCESS AND
HOW DO WE ENGAGE IN THESE
COMMUNITIES.
LASTLY, I WANT TO TELL YOU
THERE'S OTHER THINGS HAPPEN IN
MY OFFICE AND IN THE A LOT OF
-- A.I. SPACE AND WITH WE'VE
SUPPLEMENTED EXISTING NIH
RESEARCHERS INTERESTED IN THIS
SPACE TO DEVELOP ETHICAL
FRAMEWORKS AND LOOK AT BIAS AND
RISK MITIGATION IN A.I. AND M.L.
THESE ARE EXAMPLE AWARDS ONE AT
THE GEORGE WASHINGTON UNIVERSITY
AND EXPLAINING TRUST MODELS TO
DETECT BIAS.
ANOTHER IS FROM THE UNIVERSITY
OF TEXAS HEALTH CENTER, HE'S
LOOKING AT INTEGRATING GENETICS
WITH NEURO IMAGING DATA AS A WAY
TO INTEGRATE AND UNDERSTAND
DETECTION OF ALZHEIMER'S DISEASE
AND DR. HOLDER FROM EMORY IS
LOOKING AT INTEGRATING CARDIO
METABOLIC DATA IN TIME SO I CAN
DETECT SEPSIS EARLY ON AND
INTERESTING WORK AND
CONGRATULATIONS TO ALL THE
RESEARCHERS AT THE FOREFRONT OF
ETHICAL AND DEVELOPMENT OF
ADDRESSING A.I. AND FINALLY WHAT
ARE SOME THINGS ON THE HORSON?
WE'LL -- HORIZON?
IT WAS JUST PRESENTED TO THE
COUNCIL OF COUNCILS.
SOME THINGS HAPPENING IN THE
FUTURE I HOPE WE CAN GET EXCITED
ABOUT ARE DEVELOPING SOCIAL AND
ETHICAL SOLUTIONS FOR A.I.
CREATING AND VALIDATING
APPROACHES FOR SYNTHETIC
APPROACHES FOR A.I. AND LOOKING
AT FOUNDATIONAL AND LARGE
LANGUAGE MODELS TO ACCELERATE
BEHAVIORAL RESEARCH AND
TECHNOLOGIES TO ENHANCE THE
TRANSLATION OF DATA TO
KNOWLEDGE.
KNOWLEDGE GRAPHS AND ENHANCING
OUR CAPACITY AND CAPABILITIES
THROUGH A.I. PARTNERSHIPS AND
COMPASS IS A PERFECT EXAMPLE OF
THE WORK THAT'S GOING TO HAPPEN
AND MAKING A SLICE OF THAT PIE
FOR A.I. MAY BE COOL.
AND FINALLY I WANT TO LEAVE YOU
WITH A PICTURE OF MY FRIEND AND
COLLEAGUE DR. PATTI BRENNAN WHO
IS RETIRING AT THE END OF THE
MONTH.
SO FAD FOR ALL OF US WHO SAID
THIS IS TAKEN FROM HER 2015
PUBLICATION IN THE JOURNAL OF
NURSING SCHOLARSHIP, NURSING
NEEDS BIG DATA AND BIG DATA
NEEDS NURSING SO WITH THAT I'D
SAY LET'S ENGAGE AND I'M HAPPY
TO TAKE SOME QUESTIONS.
>>THANK YOU.
I'VE ASKED DR. STONE TO LEAD OUR
DISCUSSION.
>>STIMULATING DISCUSSION AND
TALK AND THE PROBLEMS YOU BRING
UP WITH A.I. AND CHANGING AND
THE TOUCH OF DATA BIASES AND THE
CONCEPT AND ENGAMING THE
RESEARCH AND IT'S REAL.
NO DOUBT ABOUT IT.
SOME ARE A MARRIAGE MADE IN
HEAVEN.
I COME FROM A UNIVERSITY WITH A
LARGE DATA SCIENCE COHORT OF
RESEARCHERS LED BY A FEW AND
MANY THINGS YOU'VE TALKED ABOUT
HAS BEEN TALKED ABOUT BY A GROUP
OF INTERNATIONAL RESEARCHERS
WHEN THEY DISCOVERED HUMAN
CENTER
CENTERED TALKING ABOUT BIASES IN
DIFFERENT NOTES.
I DO KNOW SOME NURSE SCIENTISTS
THAT ARE USING NATURAL LANGUAGE
PROCESSING AND SPEECH VISION TO
LOOK AT PROBLEMS AND WHY PEOPLE
DON'T ACCEPT PALLIATIVE CARE AND
USE SPEECH RECOGNITION BY HAVING
THE AND ANOTHER NURSE WITH AN
RO1 LOOKING AT HOW THERE COULD
BE STIGMATIZING REMARKS IN OB
NOTES THAT CONTRIBUTE TO THE
POOR MATERNAL HEALTH OUTCOMES OF
MINORITY WOMEN.
IT'S VERY IMPORTANT AND TALK
ABOUT ALGORITHMS THAT SUPPORT
HEALTH EQUITY.
I THURCHBLGS THE CO-DESIGN IS
VERY IMPORTANT BECAUSE WE NEED
TO MAKE SURE A LOT OF WORKS AND
IS USER FRIEND FRIENDLY AS WELL
IT IMPACTS WORK FLOW BECAUSE
ELECTRONIC HEALTH RECORDS ARE
NOT THAT EASY IN THE CLINICAL
SETTING.
ONE OF THE THINGS AND THIS GETS
TO WHERE YOU TALKED ABOUT
CONCEPTS.
ONE THING THE OTHER ARTICLE
TALKED ABOUT THEY CALLED IT "IN
THE WILD."
I THINK OF IT AS COMPARATIVE
EFFECTIVENESS LIKE REAL WORLD
RESEARCH THEY CALL
IMPLEMENTATION SCIENCE.
WHAT DO WE NEED AS NURSES OR ANY
SCIENTISTS TO DO TO MAKE SURE
THE TRANSLATION OF THE A.I.
SYSTEMS WORK IN THE DYNAMIC
SOCIETY AND ANYTHING YOU CAN
TALK ABOUT THANK YOU.
THOSE ARE GRET QUESTIONS AND
GREAT COMMENTARY.
I'M FAMILIAR WITH THE WORK AND
IT'S VERY MORE WARD THI-- FORWA
THINKING.
FOR US WE NEED TO UNDERSTAND AND
THIS IS WHERE NURSES COME IN
HANDY, WHEN THE A.I. ALGORITHM
IS IMPLEMENTED AND PREDICTIVE
AND HELPFUL VERSUS WHEN IT'S NOT
PROVIDING CORRECT INFORMATION.
SOMETIMES WE CALL THAT GROUND
TRUTHING.
WE NEED TO UNDERSTAND THAT A.I.
CAN'T BE JUST TRANSPLANTED FROM
ONE SITE TO ANOTHER.
OFTEN TIMES IT'S VERY
CHALLENGING THOUGH I KNOW IT'S
THE HOLY GRAIL.
TESTING AND VALIDATING AND
ASSESSING THE HUMAN IN THE LOOP
CONCEPT WHERE WE'RE USING NEW
DATA AND IT TAKES SOMEBODY ON
THE GROUND AND UNDERSTANDS THE
DATA AND UNDERSTANDING THE
PATIENTS.
OFTEN PEOPLE KNOW IN THEIR CUT
WHAT'S COG -- GOING ON AND WE
NEED TO TAKE THE HUMAN
EXPERIENCE AND INTEGRATE THAT
INTO THE WAY WE WORK WITH AND
DELIVER A.I.
AT LEAST IN MY OPINION I THINK
THAT'S A NICE STRATEGY.
>>ONE OF THE OTHER THINGS YOU
MIGHT BE IS NURSING IN THE
ARTIFICIAL INTELLIGENCE
LEADERSHIP COLLABORATIVE.
NURSING LEADERS IN ARTIFICIAL
INTELLIGENCE HAVE BEEN THINKING
ABOUT THIS AND THEY DO REITERATE
MANY OF THE CHALLENGES YOU HAVE
BUT IT'S NICE TO KNOW WE HAVE
NURSING LEADERS THINKING ABOUT
THAT.
WIN OUR T32s THE TWO AT COLUMBIA
HAVE DATA SCIENCE COMPONENTS,
MACHINE LEARNING AND NATURAL
LANGUAGE PROCESSING.
AND I UNDERSTAND EMORY'S NEW T32
ON WOMEN'S HEALTH HAS A DATA
SCIENCE COMPONENT.
THIS AREA IS SO RIGHT WE NEED TO
ENCOURAGE AND FIND WAYS TO HAVE
MORE NURSING LEADERS INVOLVED
WITH IT.
AND ANYTHING WE CAN DO -- MAYBE
IT'S THROUGH THE CTSAs OR HAVING
MORE NURSES INVOLVED WOULD BE
GREAT AND I KNOW THERE'S NURSING
SCIENTIST ARE MENTORS BUT I
DON'T KNOW ABOUT NURSING
STUDENTS INVOLVED IN ANYTHING WE
CAN DO TO GET THEM INVOLVED OR
THOUGHTS ABOUT THAT I'D LIKE TO
HEAR.
>>ABSOLUTELY.
IN THE STRATEGIC PLAN THERE'S A
CALL OUT FOR EXISTING T32s AND
AUGMENT THEM AND THERE'S AN
OPPORTUNITY.
I WAS THRILLED TO BE PART OF THE
COUNCIL OF COUNCILS FOR OBSSR
WILL PUT OUT A PROGRAM THAT
INTEGRATES DATA SCIENCE AND
BEHAVIORAL AND SOCIAL STUDIES.
I THINK THIS IS A GREAT
OPPORTUNITY TO CAPITALIZE ON THE
PUSH FOR DATA IN A.I. TO ENHANCE
OUR EXISTING TRAINING PROGRAMS.
WE ALSO PARTNER WITH THE CTSRs
AND I THINK WE'LL MOVE OUT TO
THE CTSAs IN TRAINING AND
INTRAOPERABLE RESOURCES BECAUSE
IT'S A GREAT WAY TO THINK OF
STRUCTURED ELECTRONIC ELECTRONIC
HEALTH RECORD DATA AND HOW IT
CAN BE USED.
THERE'S AN OPPORTUNITY TO MOVE
FORWARD AN MAKE RAPID PROGRESS
AND WE SUPPORT A PROGRAM CALLED
SMART AND CONNECTED HEALTH WHERE
YOU ARE NURSING RESEARCHERS
DEVELOPING NEW DATA AND
TECHNOLOGIES TO IMPLEMENT IN THE
HEALTH CARE SETTINGS.
SO SHUT OUT TO THE PROGRAM AND
OUR PARTNERSHIP AND THAT'S A
PROGRAM WITH NSF.
>>THANK YOU SO MUCH FOR YOUR
COMMENTS.
THAT'S ALL I HAVE.
AS WE START TO LINK TO OMICS AND
BIGGER DATA DO WE HAVE TO
REVISIT THAT?
>>WE'RE LOOKING AT THAT
COMPONENT OF WHAT WE CALL
IDENTIFICATION AND IT'S USED AS
A COMMON PRACTICE AND ONCE THAT
IS DEIDENTIFIED IT'S NO LONGER
CONSIDERED PATIENT DATA JUST
DATA, DATA.
ONCE YOU RELINK IT WITH GENOMICS
THERE'S SOME CONCERNS ESPECIALLY
IN MANY COMMUNITIES OF UNDER
SERVED COMMUNITIES IN AMERICAN
INDIAN AND ALASKAN NATIVE THE
POTENTIAL FOR REIDENTIFICATION
IS HIGH.
WE'RE RE-LOOKING INTO THAT.
YOU'LL SEE WORK IN TERMS OF
SECURE SYSTEMS THAT WILL MAKE
SURE THAT DATA IS HELD AT A HIGH
SECURITY LEVEL AND WE'RE LOOKING
AT THE ROLE OF REIDENTIFICATION
AND THE PATIENT PRIVACY.
>>I'M CURIOUS BECAUSE IT CAME
UP IN A CONVERSATION WE WERE
HAVING LAST WEEK.
IN SOME OF THE INTERVENTIONS
WE'VE DONE AND BEING ABLE TO
FEEDBACK THE DATA TO CLINICIANS
IN A FEDERALLY QUALIFIED HEALTH
CENTER THAT STARTED CHANGING
THEIR PRACTICES INCLUDING HOW
THEY WERE USING THE E.H.R. AND
I'M CURIOUS IF ANYBODY KNOWS OF
ANY RESEARCH ANYBODY'S DOING
ONCE THEY USE THE NATURAL
LANGUAGE PROCESSING ON OTHER
HARE DATA THAT'S NOT AS
QUANTIFIABLE, DOES IT CHANGE
THEIR PRACTICES IN ANY WAY?
IS ANYONE LOOKING AT THAT IN
TERMS OF HOW THAT MIGHT IMPACT
QUALITY OF CARE?
I THINK THE ANSWER'S YES AND
MAYBE IN THE RESEARCH COMMUNITY
BUT IT'S CERTAINLY HAPPENING IN
THE LARGER HEALTH CARE SYSTEM
SUCH AS OTHERS WHERE THE RISK OF
DOCTOR BURN OUT IS HIGH AND
THERE'S HOOKING AT THE USE OF
A.I. IN THE CARE ITSELF.
THAT'S ACTUALLY HAPPENING.
IT'S AN INTERESTING AND
WONDERFUL FIELD OF RESEARCH THAT
I THINK NEEDS MORE ACADEMICS TO
LOOK AT THESE QUESTIONS.
>>ALSO IN THE PALLIATIVE CARE
SERVICES OF NEW YORK WHERE
THEY'RE DOING THE SPEECH
RECOGNITION BECAUSE THE NURSE
SERVICES OF NEW YORK HAD A
DEMONSTRATION PROJECT TO OFFER
PALLIATIVE CARE AND FOUND OUT A
LARGE PERCENTAGE OF PATIENTS
WEREN'T ACCEPTING IT.
THIS IS THE TRANSLATIONAL PIECE
WE NEED A LOT.
CLEARLY WE NEED TO DO MORE OF
IT.
IT WON'T BE ME BUT SOMEBODY
ELSE.
>>ANYTHING ELSE, LAST CHANCE?
ALL RIGHT.
WE'LL LEAVE IT AT THAT.
DR. GREGURICK THANK YOU FOR
JOINING US.
>>THANK YOU SO MUCH AND ENJOY
THE CONVERSATIONS TODAY.
I HOPE TO CONTINUE TO ENGAGE.
IT WAS LOVELY AND THANK YOU FOR
THE INVITATION.
>>THANK YOU SO MUCH.
ALL RIGHT.
WE MADE IT TO LUNCH.
WE'VE DONE IT.
WE WILL RECONVENE AND WE'RE
BREAKING NOW AT 12:16 EASTERN
AND WE'LL RECONVENE AT 12:50.
SEE YOU IN ABOUT 35 MINUTES.
WELCOME BACK, EVERYONE.
OUR NEXT SPEAKER, DR. NONI
BYRNES, WILL DISCUSS CSR'S
INITIATIVES RELATED TO
STRENGTHENING REVIEW
PANEL DIVERSITY, ADDRESSING
BIAS, AND EVALUATING PANEL
QUALITY.
AS DIRECTOR OF NIH'S CENTER FOR
SCIENTIFIC REVIEW, SHE LEADS A
STAFF OF ABOUT 600 AND IS
RESPONSIBLE FOR OVERSEEING A
MAJORITY OF THE NIH PEER REVIEW
PROCESS.
CSR HANDLES THE RECEIPT AND
REFERRAL OF ALL APPLICATIONS TO
NIH AS WELL AS THOSE TO OTHER
AGENCIES
WITHIN HHS, SUCH AS THE CDC AND
FDA. CSR REVIEWS ABOUT
THREE-QUARTERS OF ALL NIH GRANT
APPLICATIONS IN MORE THAN 1,200
REVIEW MEETINGS EACH YEAR.
BEFORE BEING APPOINTED CSR
DIRECTOR IN 2019, DR. BYRNES
SERVED IN A VARIETY OF ROLES
THERE,
INCLUDING SCIENTIFIC REVIEW
OFFICER, REVIEW BRANCH CHIEF,
DIVISION DIRECTOR, ACTING DEPUTY
DIRECTOR
AND ACTING DIRECTOR. SHE HOLDS A
PHD IN ANALYTICAL CHEMISTRY FROM
EMORY UNIVERSITY. BEFORE
JOINING NIH, SHE WORKED IN THE
PHARMACEUTICAL INDUSTRY, WHERE
SHE CONDUCTED RESEARCH IN
BIOANALYTICAL METHODS
DEVELOPMENT FOR PHASE 3 CLINICAL
TRIALS AND PROVIDED OVERSIGHT OF
CONTRACTS WITH CLINICAL RESEARCH
ORGANIZATIONS.
SO IT'S A PLEASURE TO HAVE YOU,
DR. BYRNES.
WELCOME.
>>THANK YOU SO MUCH.
THANKS FOR THE KIND
INTRODUCTION.
GREAT.
VERY NICE.
OKAY.
SO THANK YOU SHANNON, TO
EVERYONE FOR THE INVITE.
IT'S GREAT TO BE HERE.
I'M GOING TO JUST WALK YOU
THROUGH SOME OF CSR'S
INITIATIVES THAT ARE
MULTIDIMENSIONAL INITIATIVES TO
STRENGTHEN THE PEER REVIEW
PROCESS.
BEFORE I DO THAT I WANT TO TELL
YOU ABOUT THE CSR.
IT'S ONE OF THE 22 INSTITUTES
AND CENTERS OF NIH.
WE HAVE A SINGULAR MISSION.
THE BROADER GOAL IS TO IDENTIFY
THE STRONGEST SCIENCE FOR NIH TO
FUND AND DO THAT THROUGH
ENSURING NIH GRANT APPLICATIONS
GET FAIR, INDEPENDENT, EXPERT
AND TIMELY SCIENTIFIC REVIEWS
THAT ARE FREE FROM INAPPROPRIATE
INFLUENCES.
SHANNON MENTIONED A LITTLE BIT
OF THIS AND TO GIVE A SCOPE THE
CSR REVIEWED ABOUT 60,000
APPLICATIONS IN THE PAST FISCAL
YEAR THREE-QUARTERS OF THE
APPLICATIONS REVIEWED THROUGH
THE ASSISTANCE OF OVER 19,000
REVIEWERS AND 1200 MEETINGS.
IT'S A LARGE OPERATION.
IN ADDITION TO OUR STANDING
STUDY SECTIONS WHICH IS WHAT
PEOPLE ASSOCIATE WITH CSR WE RUN
MORE SPECIAL EMPHASIS PANELS
THAN ANY OTHER PLACE IN NIH AND
STANDING PANEL.
BECAUSE WE'RE TASKED WITH
SPECIAL INITIATIVES TRANS-NIH OR
OUT OF THE OFFICE OF THE
DIRECTOR.
THESE ARE SOME EXAMPLES BUT
THERE'S OTHERS AS WELL.
STARTING IN 2019 WE HAD THE
STRATEGIC FRAMEWORK ON WHICH WE
BASE OUR INITIATIVES AND
ACTIONS.
IT'S BEEN IN PLACE MORE THAN
FOUR YEARS NOW.
IT'S IN THREE DOMAINS.
THE BROADER GOAL IS TO OPTIMIZE
PEER REVIEW AND ENSURE WE'RE
GETTING HIGH QUALITY OUTPUT OUT
OF PEER REVIEW.
THE SO ON THE TOP RIGHT YOU SEE
STUDY SECTIONS.
SO THE STRUCTURE OF STUDY
SECTIONS AND THE SCOPE OF STUDY
SECTIONS AND THE BOUNDARIES VERY
MUCH DRIVE THE OUTCOMES.
YOU CAN HAVE A STUDY SECTION IN
AN AREA THAT'S KIND OF DYING AND
10% OF THAT IS STILL GOING TO
GET A FUNDAL SCORE AND LIKELY
GET FUNDED.
THE OTHER SIDE YOU MAY HAVE
REALLY HIGH IMPACT RESEARCH OR
GROWTH AREAS ALL COMPETING WITH
EACH OTHER IN A STUDY SECTION
AND ONLY 10% OF THAT IS GETTING
FUNDED.
SO IT'S REALLY A VERY CRITICAL
PART OF CONTROLLING OUTPUT OF
PEER REVIEW.
IN ADDITION TO THAT, ON THE LEFT
IS REVIEWERS BECAUSE YOU CAN
HAVE A PERFECTLY SCOPED STUDY
SECTION BUT THE QUALITY OF
REVIEWERS RECRUITMENT AND
TRAINING AND ALL OF THAT VERY
MUCH AFFECTS THE OUTPUT OF PEER
REVIEW.
AND THEN EVEN IF YOU HAVE
PERFECT REVIEWERS, WELL MATCHED
EXPERTISE, WELL TRAINED, GREAT
STUDY SECTIONS, THERE'S INHERENT
ISSUES IN THE PROCESS THAT CAN
ALSO AFFECT THE OUTCOMES
INCLUDING INTEGRITY OF THE
PROCESS AND OTHER PROCESS ISSUES
YOU SEE.
I'M GOING TO BE TALKING ABOUT
SOME OF THOSE.
AND THEN OUR UNDERLYING
FOUNDATION AND OUR OPERATIONAL
PRINCIPLES ARE ENSURING WE DO
EVERYTHING WITH ALL OF OUR
ACTIONS ARE DONE WITH
TRANSPARENCY AND THE PUBLIC WE
USE DATA TO DRIVE OUR DECISIONS.
WE HAVE HAD CONSIDERABLE
STAKEHOLDER ENGAGEMENT THAT'S
BEEN UP SINCE 2019 AND OF COURSE
NOTHING CAN HAPPEN, ALL OF THOSE
ARE STAFF ARE CRITICAL TO
CARRYING OUT OUR ENTIRE MISSION
AND SO WE'VE INVESTED A LOT OF
EFFORT IN STAFF ENGAGEMENT AND
TRAINING AND STAFF DEVELOPMENT.
OKAY, SO TODAY I'M GOING TO
TOUCH ON SOME TOPICS AND WHAT I
WANT TO TALK ABOUT TODAY ONE IS
INQUIRE OUR STUDY SECTION
RESTRUCTURING.
TALKING ABOUT THE SCOPE AND SIZE
OF THE STUDY SECTIONS.
AND THEN A COUPLE CHANGES TO
PEER REVIEW CRITERIA AND RPG
GRANTS AND ONE FOR NRSA
APPLICATION GRANTS AND ONE ON
DIVERSIFYING COMMITTEES.
STARTING WITH ENQUIRE IS
EVALUATING PANEL IN REVIEW.
THIS WAS LAUNCHED IN 2019 AND
IT'S A VERY SYSTEMATIC
DATA-DRIVEN PROCESS TO LOOK AT
ABOUT 20% OF ALL STUDY SECTIONS
IN CLUSTERS NOT RELATED TO OUR
ORGANIZATIONAL STRUCTURE BUT
REALLY HOW THE SCIENCE OVERLAPS.
AND THE GOAL IS IF WE DO 20%
EVERY YEAR AND WE'RE ON TRACK
THAT ALL OF OUR STUDY SECTIONS
WILL BE VAULTED IN FIVE YEARS
AND START THE CYCLE AGAIN.
SO EVERY STUDY SECTION GETS A
LOOK.
IT'S A TWO-STAGE PROCESS.
THE FIRST STAGE IS BE AN
EXTERNAL SCIENTIFIC EVALUATION
PANEL.
WE GET -- OUR BROADER GOAL IS TO
GET PEOPLE WHO ARE BROAD AND DO
NOT HAVE A VESTED INTERESTED IN
THE EXISTENCE OF ONE PANEL
BECAUSE THEN ALL WE GET IS
ADVOCACY.
WE'RE ACTUALLY LOOK FOR INPUT
FROM THE EXTERNAL COMMUNITY HOW
THE SCIENCE MAPS ON TO THE --
HOW THE STUDY SECTION SCOPE MAPS
ON TO THE CURRENT STATE OF THE
SCIENCE AND HELP IDENTIFY
EMERGING AREAS.
WE ALSO GIVE THEM FREE REIN.
THEY CAN GET RID OF STUDY
SECTIONS, MERGE THEM, CREATE NEW
ONES AND GIVE THEM A NUMBER OF
DATA AND SOME ARE LISTED HIRE
AND THERE'S A WHOLE LOT MORE.
FOLLOWING THAT THERE'S A REPORT
AND RECOMMENDATIONS FOR
RESTRUCTURING COMMITTEES,
FORMING NEW ONES AND GETTING RID
OF SOME STUDY SECTIONS AND THE
SECOND STAGE IS PROCESS
EVALUATION AND HERE WE HAVE OUR
INSTITUTE AND CENTER
STAKEHOLDERS COME IN TO AN NIH
PANEL AND THEY LOOK AT FUNCTION
BECAUSE LIKE I SAID, YOU CAN
HAVE A PERFECTLY SCIENTIFICALLY
STRUCTURED STUDY SECTION BUT HOW
THE FUNCTION AFFECTS OUTCOMES.
HERE TOO THE PANEL THE SECOND
PANEL PROCESS EVALUATION PANEL
IS PROVIDED WITH THE REPORT OF
THE FIRST PANEL AS WELL AS OTHER
TYPES OF DATA LIKE APPLICATION
TRENDS, HOW ESIs DO SUCCESS
RATES FOR ESIs AND WE
INCORPORATE PROGRAM OFFICER
FEEDBACK THROUGH SURVEYS THAT GO
OUT RIGHT BEFORE CLUSTER IS
EVALUATED TO HEAR FROM PROGRAM
STAFF AS TO WHAT THE ISSUES ARE.
AND THEN WE HAVE THESE STUDY
SECTION SITE VISITS BY
NON-CONNECTED PARTIES.
THE WHOLE PROCESS IS OVERSEEN BY
OUR SCIENTIFIC DIVISION
DIRECTORS.
I WON'T GO THROUGH THIS A WHOLE
LOT BUT SIMPLY TO SAY THERE'S
MULTIPLE STEPS THAT FOLLOW THE
ADVISORY COUNCIL APPROVAL
BECAUSE WE HAVE TO TAKE TIME TO
DO SOME MOCK REFERRALS TO
PREPARE GUIDELINES, SCIENTIFIC
OVERLAP STATEMENTS AND FINALLY
MOVE STUDY SECTION MEMBERS
WHEREVER THEY'RE EXPERTISE IS
NOW MOVING.
SOME OF THESE ARE VERY SHUFFLED.
IT TAKES 12 TO 18 MONTHS FROM
THE TIME WE HOLD OUR FIRST EX
TERM PANEL MEETING TO WHERE WE
HAVE RESTRUCTURED SETTINGS.
THUS FAR WE'VE EVALUATED ABOUT
152 STUDY SECTIONS EITHER
COMPLETED OR IN PROCESS.
THESE ARE SOME OF THEM AND SOME
MAY BE FAMILIAR TO YOU.
THERE'S COMMITTEES WHERE NINR
STEMS APPLICATION WERE
RESTRUCTURED AND EXPANDED AND
THOSE WERE SOME OF THE EARLIER
ONES BUT THESE ARE SOME OF THE
CLUSTERS THAT WE HAVE DONE.
EACH HAVING 10 TO 15 STUDY
SECTIONS IN IT.
IN GENERAL, THE PROCESS RESULTS
IN QUITE A BIT OF CHANGE IN
STUDY SECTIONS.
PEOPLE TAKE IT SERIOUSLY AND
RECOMMEND REAL RESTRUCTURING.
WE HAVE ELIMINATED SMALLER
BOUTIQUE PANELS WHERE THERE'S
NOT THAT MUCH COMPETITION.
WE HAVE REFRESHED SCIENTIFIC
GUIDELINES AND FORMED NEW STUDY
SECTIONS.
THESE ARE JUST SOME EXAMPLES.
THERE'S A WHOLE LOT MORE LATE
STAGE THERAPEUTICS WAS A GAP
AREA IN FACT AS SOON AS WE
FORMED THAT STUDY SECTION AFTER
ENQUIRE IT WAS OVER SUBSCRIBED,
80 TO 90 APPLICATIONS.
THERE WAS A NEED.
SOCIAL DETERMINATES OF HEALTH
WAS DISCUSSED AND THE THOUGHT
FUNNELING IT INTO ONE STUDY
SECTION IS NOT CALLED FOR BUT
APPLIES TO A NUMBER OF FIELDS.
THOSE GUIDELINES AND THE
EXPERTISE HAS BEEN INCORPORATED
INTO MULTIPLE STUDY SECTIONS.
MOBILE HEALTH TECHNOLOGIES IS AN
EMERGING AREA AND CANCER
IMMUNOTHERAPY.
WE ALREADY HAD TWO COMMITTEES
HANDLING THAT BUT THERE WAS SO
MUCH INTEREST AND SO MANY
APPLICATIONS COMING IN THAT A
THIRD WAS FORMED.
THERE'S A WHOLE LOT MORE ON OUR
WEBSITE ABOUT THIS PROCESS AND
WHAT HAS EMERGED.
OKAY.
SO SHIFTING GEARS TO THE PROCESS
PART WHICH IS THE REVIEW
CRITERIA THAT WE'RE USING FOR
RESEARCH PROJECT GRANT
APPLICATIONS.
SO THE BROADER GOAL OF THIS
EFFORT WAS TO LOOK AT THE REVIEW
CRITERIA AND REMEMBER THESE ARE
NOT PERSONALS WE'RE EVALUATING
BUT SCIENTIFIC RESEARCH THAT'S
BEING PUT IN FRONT OF COMMITTEES
AND WE WANT TO OPTIMIZE THE
DE-IDENTIFICATION OF RESEARCH.
THE FIRST GOAL, THE FIRST WAY TO
DO THAT IS TO REMOVE ALL THE
ADMINISTRATIVE AND POLICY
CONFINES ITEMS ADDED TO THE PEER
REVIEWER WHICH WE HEARD
REVIEWERS ABOUT, WHY ARE YOU
MAKING ME DO THIS?
IN THE END IT'S BURDEN ON THE
REVIEWERS AND LESS ATTENTION ON
WHAT WE WANT TO USE THEM FOR
WHICH IS THEIR SCIENTIFIC ADVICE
AND THAT'S THE PURPOSE OF PEER
REVIEW.
THEN THE OTHER PART IS THE
INVESTIGATOR AND THE ENVIRONMENT
CRITERION.
THAT BECOMES PROBLEMATIC AND
BIASES CREEP IN BECAUSE PEOPLE
START INVESTIGATING THE
INVESTIGATOR AND THE INSTITUTION
WHERE REALLY WHAT WE'RE LOOKING
FOR IS TO EVALUATE THE RESEARCH
AND INVESTIGATOR AND ENVIRONMENT
IN THE CONTEXT OF THAT RESEARCH.
CAN THEY DO THE WORK?
ARE THE RESOURCES AVAILABLE?
THAT'S REALLY DIFFERENT THAN
TELL US WHAT YOU THINK ABOUT THE
INVESTIGATOR OR HOW GREAT IS THE
INSTITUTION.
SO IT'S REALLY THE REPUTATIONAL
BIAS ASPECT WE WERE LOOKING TO
ADDRESS THERE.
HERE'S A QUICK SNAPSHOT OF THE
CHANGES COMING TO PEER REVIEW
FRAMEWORK FOR RESEARCH PROJECT
GRANTS.
THE FIVE REVIEW CRITERIA WHICH
WE'RE REQUIRED TO USE LEGALLY,
SIGNIFICANCE, INVESTIGATION
APPROACH AND ENVIRONMENT ARE
BEING RESHUFFLED INTO THREE
FACTORS.
IF YOU THINK ABOUT IT, SHOULD IT
BE DONE, CAN IT BE DONE AND WILL
IT BE DONE.
FACTOR 1 IS IMPORTANCE OF THE
RESEARCH.
I'LL TALK ABOUT THE PROCESS.
THIS WAS NOT SOMETHING WE
DEVELOPED IN CSR.
IT WAS VERY MUCH UP PARTNERSHIP
WITH THE EXTERNAL COMMUNITY AND
WORKING GROUPS.
SO THE FIRST ONE IS IMPORTANCE
OF THE RESEARCH WHICH IS SCORED
AND THAT INCLUDES SIGNIFICANCE
IN INNOVATION.
INNOVATION AND SIGNIFICANCE BOTH
OF THEM WERE WHEN WE GOT
FEEDBACK WE HEARD THESE ARE
PROBLEMATIC CRITERIA FOR PEOPLE
TO INTERPRET AS A TECHNICAL
INNOVATION, CONCEPTUAL.
DOES EVERYTHING NEED TO BE
INNOVATIVE BUT IS IT IMPORTANT?
MY COLLEAGUE WAS HERE EARLIER,
SUSAN GREGURICK, DATABASE
ENVIRONMENT IS NOT THAT EXCITING
BUT REALLY IMPORTANT.
HOW DO WE DEAL WITH THINGS LIKE
THAT?
WHAT ABOUT BREADTH OF RESEARCH
AND COMMUNITY-BASED RESEARCH IF
THE IMPACT IS ON A SMALLER
COMMUNITY BUT REALLY IMPORTANT
FOR THAT COMMUNITY.
SO THERE'S MULTIPLE WAYS IN
WHICH THIS BECOMES CONFUSING.
WHAT THIS DOES IS ONE SCORE IS
NEEDED FOR THE REVIEWER'S
ASSESSMENT AND EACH IS SCORED.
RIGOR AND FEASIBILITY HAS THE
APPROACH AND WE RENAMED FACTOR 3
TO EXPERTISE AND RESOURCES
BECAUSE THAT'S WHAT WE WANT
EVALUATORS TO EVALUATE IN
MATERIALS OF THE PROJECT.
THAT ONE IS NOT GOING TO BE
SCORED BECAUSE WHEN YOU HAVE
NINE BINS BIAS CREEPS IN.
HAVE YOU DEATH BY A THOUSAND
CUTS.
HARVARD, ONE, HBCU HAS ALL THE
RESOURCES AVAILABLE TO DO THE
WORK, THREE, IT'S NOT BAD BUT
IT'S A THREE.
WHEN YOU MAKE IT A BINARY CHOICE
PEOPLE HAVE TO PUT UP OR NOT.
SO THEY HAVE TO THEN SAY, YEAH
IT MEETS CRITERIA.
AND THOSE THAT AFFECT OVER ALL
IMPACT SCORE REMAIN.
AND MOST ADDITIONAL REVIEW
CONSIDERATIONS WHICH NEVER HAVE
HAD ANY BEARING ON OVER ALL
SCORE HAVE BEEN TAKEN AWAY FROM
PEER REVIEW.
THERE'S NO POINT IN HAVING
SCIENTIFIC EXPERTS CONVENED AND
SPEND THEIR TIME ON THINGS WE
DON'T NEED THEM FOR.
FOUR CLINICAL TRIALS AND HUMAN
TRIAL RESEARCH THE COMMITTEE AND
OUR EXTERNAL ADVISORS AS WELL AS
INTERNAL NIH FELT IT SHOULDN'T
BE BE AN AFTER THOUGHT IN
ADDITIONAL CRITERIA BUT A STUDY
RIGOROUS IF IT DOESN'T INCLUDE
THE BROADER POPULATION.
I THINK THAT WAS REALLY
IMPORTANT.
THAT IS NOW BEING INCORPORATED
INTO THE SCORED FACTOR TWO.
AND THERE'S INITIAL INPUT
GATHERS THROUGH BLOG POSTS.
PEOPLE REALLY WANTED TO SAY AND
WE GOT A HUGE RESPONSE BECAUSE
WHEN YOU TALK ABOUT PEER REVIEW
EVERYTHING HAS AN OPINION AND WE
GOT IT.
BUT THEY WERE THOUGHTFUL.
WE NEEDED TO HEAR THAT.
WE FORMED TWO ADVISORY COUNCIL
WORKING GROUPS THEY HAD
OVERLAPPING MEMBERSHIP AND
LOOKED AT NON-CLINICAL TRIALS
WHICH IS THE VAST MAJORITY OF
NIH APPLICATIONS AND CLINICAL
TRIALS WHICH IS 10% OF NIH
APPLICATIONS.
WE PROVIDED THEM WITH THE
REGULATORY LEGAL GUARDRAILS AND
THEY HELD A NUMBER OF VIRTUAL
MEETINGS THROUGH THE PANDEMIC.
THEY WORKED VERY HARD AND IT WAS
FULLY APPROVED BY THE FULL
ADVISORY COUNCIL.
FOR JUST OVER A YEAR AFTER THAT,
AN INTERNAL HIGH LEVEL
EXTRAMURAL TOOK THE
RECOMMENDATIONS AND MADE SOME
MODIFICATIONS AND THAT WAS
APPROVED BY NIH LEADERSHIP.
WE PUT THIS OUT AS AN RFI WHEN
WE HAD SLIGHTLY MORE DEVELOPED
RECOMMENDATIONS AS AN R FFI AND
LOT OF WHAT WE GOT WAS THE
PUBLIC WAS SUPPORTIVE.
THAT WASN'T SURPRISING GIVEN WE
HAD GOTTEN A LOT OF INPUT AT THE
FRONT END.
IMPLEMENTATION IS PLANNED FOR
APPLICATIONS RECEIVED JANUARY
2025 FOR OCTOBER COUNCIL.
THERE'S A NUMBER OF NEXT STEPS
TO SOCIALIZE THE CHANGE FOR
COMMUNITY AND REVIEWERS AND OUR
OWN NIH STAFF SO STAY TUNED FOR
THAT AND THERE'S A LOT OF
SYSTEMS CHANGES THAT ARE
INVOLVED.
I WANT TO THANK OUR ADVISORY
COUNCIL WORKING GROUPS FOR WHAT
I THINK ARE EXCELLENT
ADJUSTMENTS TO CURRENT REVIEW
CRITERIA.
I'LL GO THROUGH THIS A LITTLE
FASTER.
FELLOWSHIP WE ALSO LOOKED AT
FELLOWSHIP REVIEW CRITERIA AND
HERE OF COURSE THE BROADER GOAL
FOR NRSA FELLOWSHIP IS FOR THE
MOST PROMISING FELLOWSHIP AND
THE SAME REPUTATIONAL BIAS IN
RPGs COMES THROUGH IN
FELLOWSHIPS.
IT FAVORS LEAD INSTITUTIONS,
SENIOR WELL-KNOWN SPONSORS.
SO WE CONDUCTED A DATA ANALYSIS
WITH ONE YEAR OF DATA BECAUSE WE
HAD FORMED A WORKING GROUP.
THEY WANT THE DATA AND WE JUST
CAPTURED THE PREVIOUS YEAR'S
DATA AND 6,000 APPLICATION AND
SURE ENOUGH EVERYTHING PEOPLE
FELT WAS TRUE.
THE DATA SHOWED WHICH IS
FELLOWSHIP APPLICATIONS COME
FROM A LARGE NUMBER COME FROM A
SMALL NUMBER OF INSTITUTIONS
THOSE THAT SUBMIT A LARGE NUMBER
OF APPLICATIONS, THOSE
INSTITUTIONS TEND TO DO BETTER
IN PEER REVIEW AND THEN THE
OUTCOMES AS DIRECTLY RELATED HOW
GOOD THE OUTCOME IS DIRECTLY
RELATED TO HOW SENIOR THE
SPONSOR IS.
I'VE TOLD YOU THE RESULTS AND
WE'RE LIMITED ON TIME WHAT THIS
SHOWS ON THE RIGHT-HAND SIDE IS
15 INSTITUTIONS FOR THAT 26,000
APPLICATIONS WITH ONE-YEAR
PERIOD AND 15,000 INSTITUTIONS
SUBMITTED THIS MANY APPLICATIONS
AND EVERYTHING IN THE MIDDLE AND
THIS SHOWS HOW SKEWED IT IS.
OUTCOMES, THOSE INSTITUTIONS
THAT SUBMITTED 100 PLUS HAD THE
LOWEST NON-DISCUSSED RATE.
THAT'S THE DARK BAR, 35% OF THE
BOTTOM RIGHT.
THE HIGHEST HIGH IMPACT RATE AND
THOSE THAT DIDN'T SUBMIT MANY
APPLICATIONS AND THERE'S NOT AS
MUCH AS INFRASTRUCTURE AND
KNOWLEDGE IN CERTAIN
INSTITUTIONS.
THERE'S THE SPONSOR RANKS.
LOOK AT THE FIRST TOP FOUR BARS
UP THERE.
IF YOU'RE AN ASSISTANT PROFESSOR
AND A SPONSOR, YOUR TRAINEE HAS
A 55% CHANCE FOT BEING
DISCUSSED.
FULL PROFESSORS, 39.7% HIGH
IMPACT AND A VAST MAJORITY ARE
BEING SUPPORT FULL PROFESSORS
AND WE HEARD JUNIOR FACULTY
CANNOT GET AN RSA FUNDED
TRAINEES IN THEIR LABS.
YOU LOOK AT THE OTHER CATEGORY
THAT DOES EVEN BETTER THAN FULL
PROFESSORS AND WE DUG INTO THAT
A LITTLE BIT AND THAT'S PROVOST
AND DEANS.
IT'S VERY MUCH RELATED TO THE
RANK.
WE DID THIS THROUGH A WORKING
GROUP WAS TO CHANGE THE
FELLOWSHIP REVIEW CRITERIA WHICH
IS TO FOCUS ON THE INDIVIDUAL
APPLICANT, THE STRENGTH OF THE
SCIENCE AND THE QUALITY OF THE
TRAINING PLAN AS IT RELATES TO
THE APPLICANT.
SO THESE ARE THE CURRENT REVIEW
CRITERIA ON THE LEFT.
THE PROPOSED REVIEW CRITERIA
ACTUALLY CONSOLIDATE THESE INTO
THREE CRITERIA.
THE FIRST ONE IS VERY MUCH
APPLICANT FOCUSSED THE POTENTIAL
AND THE GOALS OF THE APPLICANT
AND THE PREPAREDNESS OF THE
APPLICANT.
SECOND ONE IS MUCH MORE FOCUSSED
ON THE SCIENTIFIC PROJECT THAT
IS BEING USED TO TRAIN THE
APPLICANT.
AND IT HAS ELEMENTS OF THE
SPONSOR BECAUSE IT'S ALSO
SCIENTIFIC RESOURCES AVAILABLE
TO THE APPLICANT.
AND THIRD IS TRAINING PLAN AND
TRAINING RESOURCES.
THE SECOND RECOMMENDATION IS TO
REVISE THE FELLOWSHIP
APPLICATION WHICH IS THE
INFORMATION THAT REVIEWERS HAVE
PROVIDED.
THE RESEARCH TRAINING PLAN THE
SCIENTIFIC PROJECT DOES NOT
CHANGE.
IT'S STILL REQUIRED TO EXPLAIN
THE SCIENCE AND NEEDS TO BE
SOLID.
THERE SHOULD BE RESPONSIBLE
CONDUCT OF RESEARCH AND OTHER
KINDS OF TRAININGS IN THERE.
THE MAIN SECTIONS HAVE REALLY
BEEN REVISED AND A COUPLE THINGS
I'LL POINT TO UNDER THE
APPLICANT SECTION THE
RECOMMENDATION IS TO NOT HAVE
GRADES.
THAT WAS SOMETHING THAT CAME
THROUGH LOUD AND CLEAR FROM THE
COMMUNITIES AND WORKING GROUPS
AND THE IDEA THE UNDERGRADUATE
GRADES ARE NOT REALLY AN
INDICATOR OF SUCCESS SAY IN
POST-DOCTORAL RESEARCH.
IN FACT WHEN THEY'RE PROVIDED
PEOPLE THEY'RE USED FOR B PLUS
IN ORGANIC CHEMISTRY SOPHOMORE
YEAR VERSUS A B.
AND THE OTHER THING IS
ELIMINATING THE FINANCIAL
SUPPORT OR THE SPONSOR FUNDING
THIS IS MEANT TO SUPPORT THE
TRAINEE AND THE FINANCIAL
SUPPORT CAN PUT THE SPONSORS ON
AN UNEVEN FOOTING WHERE PEOPLE
HEAVILY FUNDED OR HAVE BIG
FACTORY LABS TEND TO DO BETTER.
THERE'S MORE.
THE BROADER GOAL IS TO MAKE THE
INFORMATION VERY TARGETED AND
THE TRAINING TARGETED SO YOU
CAN'T USE BOILER PLATE LANGUAGES
THAT WE'RE SEEING NOW IN LETTERS
OF SUPPORT AND SUCH.
ONE NEW ITEM BEING RECOMMENDED
IS TO ALLOW AN OPTIONAL
STATEMENT OF SPECIAL
CIRCUMSTANCES.
FOR EXAMPLE, IN COVID-19
PROVIDES ONE EXAMPLE OF WHERE
SOMETHING HINDERED THE
TRAINING'S PROGRESS AND ANOTHER
COULD BE THEY WERE HARASSED IN
THE LAB AND HAD TO MOVE MIDWAY
FROM THE LAB.
THOSE THINGS TO BE ALLOWED AS
OPTION BUT NOT REQUIRED.
SO WE'RE STILL DISCUSSING THAT
INTERNALLY.
SIMILAR TO THE OTHER RPG PROCESS
WE DID CONVENE A CSR ADVISORY
COUNCIL WORKING GROUP AND I
CHARGED THIS IN SEPTEMBER OF
'21.
AND THEN WE GATHERED AGAIN
THROUGH BLOG POSTS INFORMATION
AND PROVIDED THOSE DATA AND THE
CONTENT ANALYSIS TO THE WORKING
GROUP AND A LOT MORE DATA I
SHOWED YOU AND THEN THEY MADE
THESE RECOMMENDATIONS THE FULL
ADVISORY COUNCIL APPROVED.
FOLLOWING THAT IT WAS APPROVED
BY I.C. DIRECTORS AND NIH
LEADERSHIP.
WE OPENED AN RFI THAT JUST
CLOSED IN JUNE.
THE REPORT SHOULD BE AVAILABLE
HOPEFULLY THIS WEEK.
AGAIN THE MAJORITY OF SUPPORTIVE
OF THE CHANGES BECAUSE WE GOT
INPUT ON THE FRONT END ANYWAY.
SAME IMPLEMENTATION TIME LINE
FOR NOW IS OUR GOAL.
WE HAVE OUR COUNCIL MEMBERS AND
STAFF FROM ACROSS NIH AS WELL AS
A NUMBER OF AD HOCS.
OKAY.
I'D LIKE TO NOT JUST SIMPLIFIED
REVIEW NOW PEOPLE WANT ME TO
COME AND TALK ABOUT WHAT'S
CHANGING IN REVIEW CRITERIA BUT
INEVITABLY THE QUESTION COMES
THAT'S NOT ENOUGH TO CHANGE TO
REALLY AFFECT FAIRNESS OF
REVIEW.
IT'S A PIECE OF IT.
NOW I DON'T AFFECT THOSE
ASSIGNMENTS AND I WANT TO TALK
ABOUT OUR BROADER EFFORTS IN
FAIRNESS.
CSR CONDUCTS INCOMING CHAIR
ORIENTATION EVERY YEAR IN NINE
TO TEN SESSIONS AND WE HAVE 90
INCOMING CHAIRS WE HAVE TWO-YEAR
TERMS IN THE CYCLE.
EVERY YEAR HALF CYCLE OFF.
WE SPEND A FAIR AMOUNT OF TIME
LOOKING AT THE INFLUENCE OF THE
CHAIR PROMOTING FAIRNESS CULTURE
THAT'S POSITIVE AND INCLUSIVE
AND A LOT OF SPENT IN
INTERACTIONS WITH EACH OTHER AND
THERE'S A SLIDE SET AND VIDEO
SAMPLES AVAILABLE ON THE WEBSITE
YOU'RE WELCOME TO TAKE A LOOK AT
IT. IN 2021, CSR LAUNCHED A BIAS
AWARENESS TRAINING FOR
REVIEWERS.
I BELIEVE THAT WAS SENT OUT TO
COUNCIL NOW.
THIS IS 30-MINUTE TRAINING
DELIVERED FOUR WEEKS PRIOR TO
THE REVIEW MEETING.
WE'RE TRYING TO PREVENT THE
BIASES WE KNOW ARE OUT THERE IN
THE BIOMEDICAL COMMUNITY AND
RESEARCH COMMUNITY WHICH IS A
MICROCOSM OF THE COMMUNITY.
19,000 INDIVIDUALS OUT THERE.
SO WE'VE HAD 22,000 REVIEWERS,
TAKEN THE TRAINING.
IT'S BEEN WELL RECEIVED.
WE'VE DONE SIGNIFICANT SURVEYING
AND THE TRAINING IS REFERRED TO
DURING THE MEETING BY BYSTANDERS
SAYING THAT'S NOT ALLOWED
BECAUSE THAT'S WHAT WE LEARNED
IN THE TRAINING.
AND WANT IT TO BE REQUIRED FOR
ALL NIH REVIEWERS NOT JUST CSR
SO THAT'S GOING TO BE HAPPENING
SOON FOR FEBRUARY/MARCH
MEETINGS.
THE FULL SURVEY ANALYSIS IS
AVAILABLE ON OUR WEBSITE.
AND THERE WAS AN EXTERNAL
ADVISORY COUNCIL WORKING GROUPS.
IT'S LOOKING AT SCENARIO-BASED
TRAINING BEFORE, DURING AND
AFTER THE MEETING AND THESE ARE
ALL ACTUAL CASES.
I HOPE ALL OF WHEN YOU SERVED ON
COMMITTEES ARE LUCKY ENOUGH NOT
TO FIND ANY CASE STUDIES.
UNFORTUNATELY THEY'RE ALL REAL
CASE STUDIES BASED ON CASES
WE'VE SEEN AND TAKEN ACTION ON.
THEY WANTED WAYS TO HANDLE
INTEGRITY VIOLATION.
IF YOU GO TO A CONFERENCE AND
SAYS I KNOW YOU WERE A REVIEWER
ON MY COMMITTEE, HOW DID THIS GO
AND KEEP AN EYE OUT WHAT DO THEY
DO IN THE MOMENT BECAUSE YOU
WANT TO BE COLLEGIAL BUT THIS IS
REALLY CRITICAL TO MANAGE THIS
WELL.
WE'RE NOT UNDER ANY ILLUSIONS
WITH 16,000 APPLICATIONS AND
THERE'S CASES OF BIASES GOING ON
WE'RE NOT PERFECT ALL THE TIME
AND THERE'S BIASES IN STUDY
SECTIONS.
THERE MAY BE DISRESPECT OR LOOK
OF INCLUSION.
WE WANT TO HEAR ABOUT IT.
WITH 1200 MEETINGS WE'RE NOT
GOING TO BE EVERYWHERE AND WE
WANT TO HEAR ABOUT IT.
THIS IS OUR CHIEF DIVERSITY
OFFICER AND WHO TO GO TO TO
REPORT.
SENIOR MANAGEMENT AND THE
SCIENTIFIC DIVISION DIRECTOR
TAKE A LOOK.
IF WE AGREE THERE WAS A BIASSED
AR FLAWED REVIEW AND I WOULD SAY
HALF THE TIME THEY'RE RIGHT IF
SOMETHING WENT WRONG OR IT WAS
AN INAPPROPRIATE STATEMENT OR
SOMETHING, WE REVIEW THE
APPLICATION IN THE SAME COUNCIL
ROUND BECAUSE WE DON'T WANT TO
DISADVANTAGE THE APPLICANT IN
TERMS OF HIS OR HER FUNDING.
AND THE REVIEWER MESSED UP AND
ADDED A BIAS STATEMENT ONE OF
OUR DIVISION DIRECTORS WILL CALL
THE REVIEW AND SAY YOU MADE THIS
STATEMENT.
THIS RESULTS IN A COMPLETE
REVIEW BECAUSE IT WAS
INAPPROPRIATE.
THEN WE WAIT FOR THE REACTION.
THE REACTION THE VAST MAJORITY
OF THE TIME IS CONTRITION,
SORRY, I SHOULDN'T HAVE DONE
THIS, I WILL PAY MORE ATTENTION.
THAT'S CULTURE CHANGE.
A SMALL PERCENTAGE OF THE TIME
THEY ARGUE AND IT GIVES MORE
INFORMATION ABOUT THE REVIEWER
AND WE ALWAYS HAVE DISCRETION ON
WHO WE CHOOSE OR DON'T CHOOSE TO
INVITE.
FINALLY WE'LL TALK ABOUT
DIVERSIFYING REVIEW COMMUNITY.
THE GOAL IS TO BROADEN THE POOL
OF REVIEWERS.
WHY SROs GO TO FIND REVIEWERS
AND WE HAVE NICE DATABASES.
BUT THEY ONLY HAVE NIH
REVIEWERS.
WE WANT TO BROADEN THAT POOL AND
ADDED A NUMBER OF SOURCES, DATA
SOURCES, OTHER AGENCIES AND NSF,
OTHER RESEARCHERS.
SOCIETY RECOMMENDATIONS.
WE ENCOURAGE SCIENTIFIC SOCIETY
TO SUBMIT NAMES OF QUALIFIED
PEOPLE AND EARLY CAREER
REVIEWERS, ALL THAT IS AVAILABLE
IN A USER-FRIENDLY FORMAT FOR
SROs TO SEARCH QUICKLY WHEN
THEY'RE LOOKING FOR REVIEWERS.
WE NEED MORE THAN TOOLS.
WE NEED TO CHANGE THE CULTURE AS
WELL WE'VE TALKED ABOUT HOW
CRITICAL IT IS FOR NIH TO HEAR
DIVERSE PERSPECTIVES IN
IDENTIFYING THE STRONGEST
SCIENCE AND YOU'LL GET
DERIVATIVE SCIENCE AND LINKING
IT TO THE QUALITY OF OUTPUT
REVIEW IS LINKED TO DIVERSITY.
AND DEMOGRAPHIC, GEOGRAPHIC VERY
IMPORTANT AND SCIENTIFIC
BACKGROUND.
FOUR PEOPLE FROM THE SAME LAB
MAY NOT GIVE DIVERSE
PERSPECTIVES AND WE WANT
EXPERIENCED REVIEWERS AND LESS
EXPERIENCED AND SOME FRESH FACES
EVERY TIME.
OUR STANDING STUDY MEMBERSHIP
HAS LOTS OF OVERSIGHT BUT OUR
ISSUE IS SPECIAL EMPHASIS
PANELS.
THAT'S BECAUSE SPECIAL EMPHASIS
PANELS ARE GATHERED AD HOC.
THAT'S WHEN PEOPLE LEAN TO THE
TOOLS THEY KNOW.
THAT'S WHO THEY REACH OUT TO AND
WHERE THE TOOLS BECOME
IMPORTANT.
WE ALSO RAISED COLLECTIVE
AWARENESS AND SET EXPECTATIONS
AN SHARE PANEL-LEVEL DATA WITH
MANAGEMENT AND STAFF.
IT'S ALL AVAILABLE FOR ALL OF
OUR STAFF.
AND PEER-TO-PEER SHARING OF
STRATEGIES BECAUSE WE HAVE SROs
VERY GOOD AT IDENTIFYING BROAD
POOL OF REVIEWERS AND HAVING
THEM SHARE WITH EACH OTHER HAS
BEEN SUCCESSFUL.
TO SHOW YOU A LITTLE BIT OF DATA
STARTING WITH WOMEN THESE ARE
CSR APPLICATIONS AND 2013
THROUGH THE MOST RECENT CBS
ROUND.
AROUND 35% OF P.I.s ARE WOMEN.
THAT'S THAT'S NOT THAT DIFFERENT
FROM WHAT YOU SEE NIH WIDE.
THE MEMBERSHIP HAS ALWAYS BEEN
ENRICHED BECAUSE WE PAY A LOT OF
ATTENTION AND HAVE HISTORICALLY
PAID A LOT OF ATTENTION.
THE SPECIAL EMPHASIS PANEL THE
QUICK AD HOC REVIEWERS WE WERE
CONCERNED ABOUT AND THERE YOU
SEE A REAL SHIFT AS SROs GO TO A
BROADER POOL EVERY TIME THEY
RECRUIT FOR AN AD HOC.
AND THIS IS FOR NIH WIDE DATA
AND AGAIN MORE ENRICHED IN TERMS
OF MEMBERSHIP BECAUSE WE PAY
ATTENTION TO THAT.
THIS WAS LOWER THAN WHAT YOU
WOULD CALL A BENCHMARKING
AGAINST THE APPLICANT RATE.
AT THE WEREN'T BEING INVITED AS
MUCH AND AFTER THE EFFORT MADE
YOU CAN SEE A CHANGE IN THE
CONTINUUM TO GO UP.
THE SEP REVIEWERS ARE ALSO
LINKED TO MEMBERSHIP BECAUSE
ONCE PEOPLE TRIED THEM OUT AND
SEE THEY'RE REALLY GOOD, THEY
PUT THEM ON AS MEMBERS.
SO IT'S ALL KIND OF LINKED.
THERE'S DATA AND ANALYSIS AND
REPORTS AND I INVITE YOU TO TAKE
A LOOK.
I'M HAPPY TO TAKE QUESTIONS.
>>ALL COUNCIL MEMBERS WILL
RECEIVE AN E-MAIL TOMORROW
INVITING THEM TO COMPLETE CSR'S
BIAS AWARENESS TRAINING FOR
REVIEWERS, DR. BYRNES MENTIONED.
IT'S NOT REQUIRED BUT I KNOW
MANY WILL BE INTERESTED IN THAT.
I WANT TO THANK CSR FOR MAKING
THAT AVAILABLE.
THANKS AGAIN, DR. BYRNES.
I ASKED DR. LEE TO LEAD US IN
DISCUSS.
>>THANK YOU, DR. BYRNES FOR A
WONDERFUL OVERVIEW AND IT'S
QUITE A BIT OF INFORMATION.
I WON'T BE ABLE TO ASK ABOUT ALL
OF THE MOST IMPORTANT POINTS.
AND WE CAN APPRECIATE THE
TRAINING INITIATIVES ON ONE END
AND ON THE OTHER END THE FORMAL
DIRECT BIASSED REPORTING
MECHANISM WHEN THERE'S A KNOWN
INCIDENT.
IN ADDITION TO THE CRITICAL
ELEMENTS HAS THERE BEEN
CONSIDERATION TO RANDOM AUDITING
OR FEEDBACK THAT CAN BE GIVEN
DIRECTLY TO THE SROs OR
REVIEWERS ON HOW THEY USE THE
SKILLS GAINED IN THE TRAINING.
>>GREAT QUESTION.
I THINK WHAT YOU MEAN BY
AUDITING IS OVERSIGHT.
>>WE HAVE SROs AND DIVISION
DIRECTORS.
WE HAVE A PRETTY RIGOROUS
EVALUATION FOR SROs AND OUR
SENIOR STAFF ATTEND MEETINGS AND
ATTEND FEEDBACK.
THE LARGEST NUMBER OF BIAS
INSTANCES WE GET DON'T COME FROM
THE EXTERNAL COMMUNITY.
THEY COME FROM US.
WOE HAVE HEIGHTENED AWARENESS
AND OUR NUMBERS SHOW MOST OF IT
COMES FROM THE SRO.
SOMETIMES THEY'LL COME BACK AND
SAY THIS DOESN'T GO WELL AND
THERE'S A DISCUSSION WITH
LEADERSHIP OR THEIR MANAGEMENT
AND THE RE-REVIEW IS DONE.
AND THE MORE FORMALIZED THINGS
YOU SEE THROUGH ENQUIRE.
>>AND HAS CSR CONSIDERED ANY
TECHNOLOGIES THAT CAN BE USED TO
DETECT OR FURTHER AUTOMATE THE
DETECTION OF BIAS?
AND DEFECTED ON THE FLY GIVEN
THE MULTIPLE CONSTRAINS ON
ENERGIES AND TIME.
>>WE HAVE A DIVISION OF DATA
AND TECHNOLOGY THAT IS VERY MUCH
LOOKING AT EVALUATING CRITIQUES
IN A MORE AUTOMATED MACHINE
LEARNING AUTOMATED WAY TO FLAG
ISSUES.
IN THE END WE STILL NEED THE
HUMAN TO LOOK AT IT TO SEE IF
IT'S VALID.
THE PROCESSES THEY'RE DEVELOPING
ARE UNDER TEST AND WE'RE TRYING
TO SEE IF THEY'RE VALID AND WHAT
THEY FLAG FOR US IS ACTUALLY
VALID.
IT'S VERY MUCH SOMETHING WE'RE
LOOKING AT.
>>IN REVIEW FOR ME AND OTHERS
IT WAS HELPFUL TO BE REMINDED OF
THE REGULATORY GUARDRAILS
INCLUDING THE REGULATIONS THAT
OUTLINE THE FIVE KEY ELEMENT
HAVE TO BE PART OF THE REVIEW
CRITERIA BUT I'M THINKING FOR
THE RESEARCH PROGRAM GRANTS AND
THE FACTOR THREE OF THE
EXPERTISE AND RESOURCES THAT
WILL INCLUDE THE FOREIGN
INVESTIGATOR AND ENVIRONMENT
CONSIDERATIONS THAT WILL NO
LONGER BE SCORED.
AND SPEAK ABOUT WHO ARE AGAINST
FACTOR 3 AS SOMETHING THAT
SHOULD STILL BE SCORED.
>>GREAT QUESTION.
I WOULD SAY AND THE BULK IN THE
MIDDLE ALL AGREED IT'S A GOOD
IDEA.
THERE WERE PEOPLE WHO THINK IT
DOESN'T GO FAR ENOUGH WE NEED TO
BLIND.
UNLESS YOU CAN BLIND REVIEWS
YOU'RE NOT DOING ANYTHING.
THERE'S MULTIPLE ISSUES WITH
BLINDING WE CAN HAVE A LONGER
DISCUSSION ON.
WE'RE DOING A PARTIAL BLINDING
EXPERIMENT AS PART OF THE COMMON
FUND PROGRAM BUT THERE'S A
MULTI-STAGE VIEW AND VERY LABOR
INTENSIVE AND SCALING IT UP IS
NOT THAT PRACTICAL.
THE OTHER PART WAS WELL, IF
YOU'RE NOT SCORING THE
INVESTIGATOR MATTERS AND YOU
SHOULD BE SCORING ENVIRONMENT
BECAUSE THOSE THINGS MATTER.
THEY'RE PART OF THE MAIN FACTORS
OF SCORING.
AND WE WANT TO HEAR IF THERE'S
GAPS AND THAT SHOULD AFFECT THE
OVER ALL IMPACT OR MOVE IT DOWN.
I THINK A LOT OF WILL HAPPEN IN
THE TRAINING TO ADDRESS THOSE
CONCERNS.
I DON'T THINK WE NEED A
NINE-POINT SCORING SCALE TO MAKE
INVESTIGATOR COUNT.
>>GREAT.
MY FINAL QUESTION BEFORE I OPEN
IT TO MY OTHER COLLEAGUES IS
RELATED TO THE ENQUIRE.
YOU SPOKE OF RENEW AND REVISED
STUDY SECTIONS LIKE THE SOCIAL
DETERMINATES OF HEALTH AND WHERE
ARE THEY IN THE 12th TO 18th
MONTH TIME LINE FROM INITIATION
TO IMPLEMENTATION TO GET A SENSE
OF WHEN IT WILL BE READY FOR
PRIME TIME?
>>I THINK MOST OF THOSE ARE
ALREADY IMPLEMENTED OR HAVE
RECENTLY BEEN IMPLEMENTED.
I THINK ONE OF THE FIRST ONES WE
DID IN 2020 AFFECTED NINR MOST
WHICH IS -- I DON'T KNOW THE
NAMES OF THE STUDY SECTIONS,
SHANNON PROBABLY DOES MORE, THE
CLINICAL CARE AND DIFFERENT
SETTINGS AND SOME WERE IN
RESPONSE TO THE STAFF ON THE
SECOND LEVEL OF INQUIRY REVIEW.
THOSE ARE FUNCTIONING WELL AND
SLIGHTLY OVER SUBSCRIBED TO ME
IT'S A HEALTHY THING THE
CLINICAL ONE I THINK IS CHAIRED
BY A NURSE IF I'M NOT MISTAKEN.
THOSE THOSE RELEVANT TO THE I.C.
ARE DONE.
>>THANK YOU, DR. BYRNES AND I'M
HAPPY TO OPEN IT UP TO OTHER
MEMBERS OF COUNCIL.
>>THANK YOU FOR AN INTERESTING
PRESENTATION.
I'VE KNOWN ABOUT THE CHANGES
BECAUSE IT'S OUT IN THE
SCIENTIFIC COMMUNITY AND
PRESENTED HERE BUT I DO THINK WE
AND THE EDUCATION THAT GOES OUT
AROUND THAT MAKING SURE PEOPLE
ARE EMPHASIZING, EVEN THE
STRUCTURE OF SIGNIFICANCE BEING
IMPORTANT AND THE STRUCTURE WILL
HAVE TO CHANGE.
WHAT'S THE EDUCATION FOR THE
SCIENTIFIC COMMUNITY TO MAKE
SURE THEY'RE RESTRUCTURING THE
GRANTS APPROPRIATELY IN THE NEXT
YEAR?
>>FIRST, I COMPLETELY AGREE
WITH YOU.
CHANGING THE APPLICATION
STRUCTURE IS A LONGER TERM
PROJECT BECAUSE IT GOES TO OMB,
WHATEVER THAT IS, SOME HIGHER
LEVEL APPROVALS, IT'S PART OF A
BIG PACKAGE.
WE DIDN'T WANT TO HOLD UP THESE
REVIEW CHANGES BUT I THINK ONE
THING WE GOT BACK FROM THE RFI
RESPONSE IS THE REAL CRITICAL
NEED TO SOCIALIZE THE CHANGES IN
THE BROADER COMMUNITY.
SO WE HAVE WEBINARS FOR
APPLICANTS, WE HAVE WEBINARS FOR
REVIEWERS AND STAFF AND WE'RE
SPENDING THE NEXT YEAR AND A
HALF FOCUSSED ON THAT.
HOPEFULLY IT WILL MITIGATE SOME
OF IT.
IT WILL MATCH UP WITH THE
APPLICATION.
THANK YOU, THAT WAS AN AMAZING
PRESENTATION.
I ENJOYED HEARING ABOUT THE
UPDATES.
I HAD A FOLLOW-UP QUESTION
REGARDING FACTOR 3.
ENVIRONMENT WAS IMPORTANT FOR
THE COMMUNITY-BASED WORK
HAPPENING.
IN THE STUDY SECTION THAT WAS
PART OF THE ENVIRONMENT AND DO
THAT HAVE LETTERS OF SUPPORT
FROM PEOPLE THEY'LL DO WORK
WITH.
>>WAS THIS AN RO1?
>>YES.
>>I DON'T MEAN TO PICK ON
HARVARD.
HARVARD IS GREAT BUT RIGHT KNOW
THE COMMENTS WE SEE IS HARVARD
IS A GREAT SCHOOL AND WHAT WE
WANT THEM TO SO WHAT YOU'RE
TALKING ABOUT.
WHAT IS IT IN THE CONTEXT OF THE
PROJECT THEY'RE TRYING TO
ACHIEVE.
IT IS APPROPRIATE OR NOT?
THAT WOULD BE DROP DOWN GAP
IDENTIFIED AND HEAR SOME THINGS
MISSING AND THAT SHOULD AFFECT
THE OVER ALL SCORE.
OKAY.
>>WE'RE AT THE LAST GDP ITEM OF
OPEN SESSION.
COULDN'T BE HAPPIER TO BE
WELCOMING DR. DIANNA BIANCHI.
SHE'S GOING TO SHARE UPDATES ON
NIH'S PREGNANCY CAUGHT COMES FOR
EVERYONE FOR THE IMPROVE
INITIATIVE.
IN HER ROLE AS NICHD DIRECTOR,
DR. BIANCHI OVERSEES THE
INSTITUTE'S RESEARCH ON
PEDIATRIC HEALTH
AND DEVELOPMENT, MATERNAL
HEALTH, REPRODUCTIVE HEALTH,
INTELLECTUAL AND DEVELOPMENTAL
DISABILITIES, AND REHABILITATION
MEDICINE, AMONG OTHER AREAS.
THESE EFFORTS INCLUDE MANAGING A
STAFF OF APPROXIMATELY 1,400 AND
AN ANNUAL BUDGET OF
APPROXIMATELY $1.5 BILLION.
DR. BIANCHI HAS HAD A BUSY
TENURE SINCE JOINING NICHD IN
2016. SHE SPEARHEADED EFFORTS ON
THE
2019 NICHD STRATEGIC PLAN, WHICH
OUTLINES GOALS AND ASPIRATIONS
TO GUIDE THE INSTITUTE'S
RESEARCH. SHE ALSO OVERSAW THE
CRAFTING AND VETTING OF THE
INSTITUTE'S NEW VISION
STATEMENT—&QUOT;HEALTHY
PREGNANCIES. HEALTHY CHILDREN.
HEALTHY AND OPTIMAL LIVES”—AS
WELL AS ITS
NEW MISSION STATEMENT, WHICH
UNDERSCORES NICHD'S DIRECTIVE
SINCE ITS FOUNDING: “TO LEAD
RESEARCH AND TRAINING TO
UNDERSTAND HUMAN
DEVELOPMENT”—AND INCORPORATES
GOALS FOR ALL
FACETS OF NICHD—TO IMPROVE
REPRODUCTIVE HEALTH, ENHANCE THE
LIVES OF CHILDREN AND
ADOLESCENTS, AND OPTIMIZE
ABILITIES FOR ALL.
THANK YOU FOR JOINING US TODAY.
IT'S MY PLEASURE TO WELCOME
DR. BIANCHI AND I'LL TURN THE
FLOOR OVER TO YOU.
THANK YOU.
>>THANK YOU AND I WANT TO THANK
THE WEATHER GODS BECAUSE I GOT
OUT OF BOSTON IN TIME AND I WANT
TO TALK ABOUT COLLABORATIVE
EFFORTS WITH NINR AND ONE OF OUR
BIGGEST COLLABORATIVE EFFORTS
HAS BEEN IN THE
CROSS-FERTILIZATION OF
PERSONNEL.
THERE'S A NUMBER OF PEOPLE IN
THE ROOM WHO ARE EX-NICHDERS AND
THAT'S GREAT BECAUSE WE CAN
SHARE KNOWLEDGE ABOUT OUR
VARIOUS INSTITUTE CULTURES AND
CONTINUE TO WORK TOGETHER.
I'M CONTROL OF THE SLIDES, IS
THAT CORRECT?
I'LL TALK ABOUT AND THAT WAS AN
OVERVIEW OF THE NICHD AND THEN
I'LL SPEND THE BULK OF MY TALK
ON THE IMPROVE INITIATIVE AND
THEN A FEW THINGS THAT ARE
IMPORTANT AT NICHD THAT ALSO
REPRESENT COLLABORATIVE EFFORTS
AND AREAS IN WHICH WE'RE FUNDING
NURSING RELATED RESEARCH.
SHANNON MENTIONED OUR MISSION
STATEMENT.
IT WAS PREVIOUSLY LONG AND DARK.
WHEN WE REFRESHED THE MISSION WE
WANTED TO EMPHASIZE THE
POSITIVE.
THE MISSION EXTENSIVELY WORKED
ON BY PEOPLE ON OUR COUNCIL
MARKETING AS WELL AS SCIENTIFIC
MEMBERS OF THE COUNCIL HAD TO
INCORPORATE EUNICE KENNEDY
SCHRIEVER'S VISION AND IMPORTANT
TO GO BACK TO THE 1962 STATEMENT
THAT INITIATE THE INSTITUTE AND
HUMAN DEVELOPMENT SAY BIG PART
OF THAT.
IS A BIG PART OF THAT.
PEOPLE ASKED US WHY DIDN'T WE
PUT PREGNANCY IN OUR MISSION
STATEMENT.
WE DIDN'T BECAUSE WE'RE MORE
THAN PREGNANCY RELATED AND COVER
EVERYTHING FROM CONCEPTION TO
CONTRACEPTION FROM ABORTION
FAMILY DYNAMICS AND PREGNANCY
AND POST-PART TUM HEALTH.
WE'RE INTERESTED IN PARTUM
HEALTH AND WE'RE NOT THE ONLY
INSTITUTE THAT FUNDS CHILDREN'S
HEALTH AND ALMOST ALL INSTITUTES
AND CENTERS HAVE SOME INTEREST
IN CHILDREN'S HEALTH WE FORMED A
COORDINATING COMMITTEE WHICH
BRINGS TOGETHER SENIOR
REPRESENTATIVES EVERY OTHER
MONTH REPRESENTING THEIR
PORTFOLIO IN CHILD HEALTH THE
HOME FOR THE NATIONAL CENTER FOR
NATIONAL REHABILITATION
RESEARCH.
BELIEVE IT OR NOT WE HAD NO
STRATEGIC PLAN.
CAN YOU IMAGINE RUNNING IT'S NOW
A $1.7 MILLION INSTITUTE.
CAN YOU IMAGINE RUNNING A
COMPANY OF THAT SIZE WITH NO
STRATEGIC PLAN.
THERE WAS NO STRATEGY PLAN FOR
AT LEAST 20 YEARS.
IN 2019 WE STARTED OUT WITH 270
DIFFERENT SCIENTIFIC TEAMS AND
EVENTUALLY WHITTLED IT DOWN TO
THESE FIVE UNDERSTANDING THE
CELLULAR STRUCTURAL DEVELOPMENT
OF REPRODUCTIVE HEALTH AND
THERE'S INTEREST IN FEMALE
REPRODUCTIVE HEALTH AND HAVE $30
MILLION IN MALE REPRODUCTIVE
HEALTH AND MALE CONTRACEPTION
AND ALL THINGS IN THAT PORTFOLIO
WHICH ARE VERY IMPORTANT AS
WELL.
I'LL TALK A LITTLE BIT ABOUT
PREGNANCY IS STRESS TESTIFIED
FOR LIFE LONG WELLNESS.
WE WANT PEOPLE WHO ARE BECOMING
PREGNANT TO ENTER PREGNANCY
HEALTHY AND KEEP THEM HEALTHY
THROUGHOUT THEIR LIFE SPAN.
WHEN WE DID A STRATEGIC PLAN WE
REALIZED THERE HADN'T BEEN A BIG
EMPHASIS ON ADOLESCENCE AND THE
TRANSITION FROM ADOLESCENCE TO
YOUNG ADULTHOOD.
THAT WAS A MAJOR ADDITION TO OUR
PORTFOLIO.
LASTLY WITH THE FOCUS ON OUR
TARGET POPULATIONS WE REALIZED
THERE WAS A GAP IN TERMS OF
REALLY SHOWING VARIOUS
THERAPEUTICS AND DEVICES WERE
SAFE TO USE IN PREGNANT PEOPLE
AND CHILDREN AND PEOPLE WITH
DISABILITIES.
I'LL TALK ABOUT THAT A LITTLE
BIT AT THE END.
THE BULK OF THE TALK IS ABOUT
THE IMPROVE INITIATIVE
IMPLEMENTING A MATERNAL HEALTH
AND PREGNANCY OUTCOMES VISION
FOR EVERYONE.
IT SAYS 32 INSTITUTES AND
CENTERS AND OFFICES ARE
INVOLVED.
IT'S TRULY NIH WIDE BUT THE BULK
OF THE WORK IS DONE BY OUR
WONDERFUL STAFF AT NICHD AND
NINR AND THE OFFICE OF RESEARCH
ON WOMEN'S HEALTH.
AND IT'S A LITTLE CONFUSING
BECAUSE THERE'S MOVING PARTS BUT
IF YOU KEEP THE DONUT PUZZLE
GRAPHIC IN MIND I'LL GO THROUGH
EACH OF THESE PIECES.
I DON'T THINK I NEED TO TELL
ANYBODY IN THE AUDIENCE WE ARE
FACING A PUBLIC HEALTH CRISIS IN
MATERNAL MORBIDITY AND MORTALITY
WHERE MOST THE DEVELOPED WORLD
IS DECREASING RATES OF MATERNAL
MORBIDITY AND MORTALITY, THE
U.S. IS INCREASING.
AND IT'S PARTICULARLY TRAGIC
GIVEN OUR RESOURCES AND THE FACT
THAT 84% OF PREGNANCY-RELATED
DEATHS ARE PREVENTIBLE AND IT'S
EVEN HIGHER IN PEOPLE OF
AMERICAN INDIAN AND ALASKAN
NATIVE BACKGROUNDS.
SO WE NEED TO DO SOMETHING AND
WE'RE PASSIONATE ABOUT THIS.
THE CAUSES OF PREGNANCY RELATES
DEATHS VARY ACCORDING TO THE
BACKGROUND.
POSTPARTUM HEMORRHAGE IS THE
LEADING CAUSE OF DEATH OF PEOPLE
OF ASIAN BACKGROUNDS AND PEOPLE
WHO ARE BLACK OR AFRICAN
AMERICAN, CARDIOVASCULAR
COMPLICATIONS EITHER RELATED TO
HYPERTENSION, PRE-ECLAMPSIA
DURING PREGNANCY OR POSTPARTUM
CARDIO MYOPATHY HAVE THE HIGHEST
CAUSES OF DEATH AND OTHER
BACKGROUNDS MENTAL HEALTH AND
INFECTION.
THE LAST YEAR STATISTICS WERE
AVAILABLE IS OVER 1200 MATERNAL
DEATHS.
WHAT MANY MAY NOT REALIZE IF
YOU'RE NOT WORKING IN THIS AREA
IS THE MAJORITY OF THE DEATHS
ARE OCCURRING POSTPARTUM.
I'M A NEONATOLOGIST AND I'VE
BEEN IN THE ROOM WHERE THERE'S
MEDICAL ISSUES ONGOING BUT IF
YOU LOOK AT THE STATISTICS, 65%
OF MATERNAL DEATH ARE NOW
OCCURRING BETWEEN ONE DAY AND A
YEAR POSTPARTUM.
THIS PROVIDES AN OPPORTUNITY TO
REALLY TARGET THAT TIME PERIOD.
I'LL USE WOMEN AND PEOPLE
INTERCHANGEABLY RECOGNIZING NOTE
ALL PEOPLE GIVING BIRTH ARE
PEOPLE WHO IDENTIFY AS WOMEN.
PEOPLE WHO HAVE GIVEN BIRTH ARE
TYPICALLY UNDER STATE MEDICAID
PROGRAMS WERE GIVEN UP TO SIX
WEEKS OF POSTPARTUM CARE.
FORTUNATELY, THAT'S CHANGING
NOW.
I THINK UP TO 38 STATES HAVE NOW
EXTENDED THE COVERAGE OF
MEDICAID TO 12 MONTHS
POSTPARTUM.
THAT'S VERY IMPORTANT IF YOU
LOOK AT THE COUNTIES COLORED IN
RED THESE ARE AREAS WHERE THERE
IS NO OBSTETRICAL CARE.
THERE'S MORE THAN 12 MONTH WOMEN
THAT HAVE NO OBSTETRICAL CARE
AND THIS IS INCREASING.
IT'S ABOUT 7 MILLION WOMEN THAT
LIVE IN.
COUNTIES WITH LOW OBSTETRICAL
CARE ACCESS AND WHERE IT'S
LARGED IS LARGELY MIDDLE OF THE
COUNTRY AND SOUTH AND UPPER
WEST.
THERE WAS A RECENT ARTICLE IN
THE NEW YORK TIMES ABOUT THE
CRISIS AND STATE OF IDAHO WHERE
POLITICAL ISSUES HAVE AFFECTED
THE ABILITY OF OBSTETRICIANS TO
PRACTICE THEIR CARE AND THIS
PARTICULAR ARTICLE STATED FIVE
OF THE NINE MATERNAL FETAL
SPECIALIST HAVE LEFT THE STATE
AND MORE ARE CONTEMPLATING
LEAVING AS WELL.
IT'S GOING TO MAKE THE CRISIS
WORSE AND I'M CONFIDENT THERE
WILL BE AN INCREASE AND WE'LL
SEE THIS MAP NEXT YEAR AND IT
WILL CONTINUE TO GET MORE AND
MORE RED.
WE HAVE INITIATED WITH THE
SUPPORT OF CONGRESS AN NIH WIDE
EFFORT TO REDUCE PREVENTIBLE
CAUSES OF MATERNAL MORBIDITY AND
MORTALITY AND ADDRESS
DISPARITIES IN MATERNAL HEALTH
OUTCOMES.
THE PROBLEM IS THERE'S
DIFFERENCES IN THE PREVENTIBLE
DEATHS BUT CERTAIN POPULATIONS
LIKE BLACK AND AFRICAN AMERICAN
WOMEN HAVE THREE TO FOUR TIMES
HIGHER RATES OF DEATH.
AMERICAN INDIAN AND ALASKAN
NATIVE WOMEN THREE TO THREE
TIMES INCREASE IN MATERNAL
DEATHS.
WE NEED TO DO SOMETHING.
SO OUR APPROACH HAS EMPHASIZED
IMPLEMENTATION RESEARCH AND
COMMUNITY-BASED RESEARCH.
WE WANT TO EXPAND MATERNAL
HEALTH CARE PRACTICES BEFORE AND
DURING THE PRACTICE AND WE'RE
BUILDING RESEARCH CAPACITY IN
COMMUNITY-BASED ORGANIZATIONS.
THE COMMUNITIES KNOW THEIR LOCAL
CULTURE AND WHAT THEY NEED AND
IT WILL BE DIFFERENT IN
DIFFERENT PARTS OF THE COMMUNITY
AND EMPOWERS THE COMMUNITY TO
ASSIST IN AREAS WHERE THERE ARE
NO OBSTETRICIANS AVAILABLE.
WE'RE ALSO ADDRESSING THE
MATERNAL CARE DESERT ISSUE BY
PROMOTING ACCESS TO MATERNAL
HEALTH CARE TECHNOLOGY.
WE'RE ALSO USING ELECTRONIC
HEALTH RECORDS TO DO REAL-WORLD
RESEARCH AND IF YOU WANT TO
LEARN MORE, YOU CAN GO TO THIS
LINK OR JUST TYPE IN NIH IMPROVE
AND GOOGLE.
I'M NOT SURE DR. ZENK SHARED THE
TERM TIN CUPPING BUT IT'S COMMON
WHEN WE ASK FOR SUPPORT FOR
PROGRAMS THAT HAVE NOT REALLY
GOTTEN A SPECIAL APPROPRIATION
FROM CONGRESS.
SO BACK IN DECEMBER, 2019,
BEFORE DR. ZENK GOT HERE, A
NUMBER OF US WENT TO MEET WITH
THE BLACK MATERNAL HEALTH CAUCUS
AND THEY BASICALLY SHAMED US AND
SAID, WHAT ARE YOU DOING?
YOU'RE NOT PAYING ENOUGH
ATTENTION TO THIS PROBLEM.
YOU NEED TO ADDRESS THE RISING
RATES OF MATERNAL MORTALITY.
AT THE TIME DR. COLLINS TURNED
TO US AND SAID, WHAT ARE WE
GOING TO DO ABOUT THIS?
THIS WAS JUST BEFORE THE
PANDEMIC SO WE BEGAN TO ORGANIZE
OUR EFFORTS AROUND WHAT WE KNEW
THEN AS THE PRIMARY CAUSES OF
MATERNAL MORBID AND MORTALITY
INCLUDING CARDIOVASCULAR ISSUE,
RACISM AND POSTPARTUM
DEPRESSION, FOR EXAMPLE AND WITH
TIN CUPPING AND THE SUPPORT FROM
THE OFFICE OF THE DIRECTOR WE
PULLED TOGETHER $7 MILLION TO
SUPPORT 36 PROJECTS MAINLY
SUPPLEMENTS AT THE TIME.
IN THE NEXT FISCAL YEAR WE WERE
ALREADY BEGINNING TO SEE THE
DEVASTATING AFFECT OF PREGNANCY.
ON WOMEN WITH COVID-19 INFECTION
AND PEOPLE INFECTED HAD HIGHER
RATES OF COMPLICATION AS WELL AS
DEATH.
WE THEN DECIDED WE NEEDED TO
FOCUS ON THE EFFECTS OF COVID-19
AND CONTINUE TO EVALUATE THE
IMPACT OF STRUCTURAL RACISM AND
IN THAT YEAR WE WERE ABLE TO
AWARD $13 MILLION.
WHEN I SAY WE, IT'S ACROSS
MULTIPLE INSTITUTES AND CENTERS
FOR 22 PROJECTS.
CONGRESS TOOK NOTICE AND WE'RE
VERY GRATEFUL FOR THEIR SUPPORT.
STARTING IN FISCAL YEAR '22 AND
THE CURRENT FISCAL YEAR THEY
GAVE US TARGETED APPROPRIATION
OF $30 MILLION FOR THE IMPROVE
INITIATIVE.
SO OVER THAT TIME WE'VE LOOKED
AT AN INTEGRATED PROGRAM WITH
SIX COMPONENT PARTS INCLUDING
THE CONNECTATHON.
THE REAL WORLD ELECTRONIC HEALTH
RECORD RESEARCH WHERE WE KCAN
WHERE WE CAN LOOK AT THE WAY
MEDICATIONS WERE GIVEN AND BEGIN
TO DETERMINE STANDARDS FOR
TREATMENT AND DISSEMINATION AND
IMPLEMENTATION NOTICES OF
SPECIAL INTEREST AND WE'RE
FUNDING THE CREATIVE FUNDING
OPPORTUNITIES FOR IMPLEMENTATION
SCIENCE SO WE CAN TAKE PRACTICES
THAT IMPROVE CARE AND LOOK AT
THEM IN LARGER POPULATIONS, FOR
EXAMPLE.
THE RADDEX TECH FOR MATERNAL
HEALTH USING THE SHARK TANK
APPROACH AND LOOKING AT
TECHNOLOGY FOR COVID AND HAVING
A GROUP OF JUDGE EVALUATE THE
TECHNOLOGY FOR THEIR
IMPLEMENTATION PARTICULARLY IN
MATERNAL CARE DESERTS.
WE HAD A CHALLENGE CALLED
CONNECTING THE COMMUNITY FOR
MATERNAL HEALTH.
THIS IS A PROGRAM TO BUILD
CAPACITY COMMUNITIES AND
INFRASTRUCTURE AND ANOTHER
CALLED THE COMMUNITY
IMPLEMENTATION PROGRAM WHICH
ENABLES ADOPTION AND INTEGRATION
OF INTERVENTIONS EFFECTIVE IN
COMMUNITY SETTINGS.
THIS IS BASED ON THE PRIOR
RELATIONSHIPS IN THOSE
COMMUNITIES.
AND WE'VE ANNOUNCED THE CENTERS
OF EXCELLENCE.
THIS IS A NATIONAL NETWORK I'LL
DESCRIBE IN MORE DETAIL.
SO VERY BRIEFLY GOING THROUGH
AND HOW DO WE REACH THE WOMAN
OUT THERE IN SOUTH DAKOTA WHO
HAS A PROBLEM WITH NOWHERE TO GO
AND HAS A THREE-HOUR DRIVE TO
REACH A CENTER CAPABLE OF TAKING
CARE OF HER?
THE CHALLENGE IS BRINGING IN
COMPANIES THAT MAY NOT HAVE BEEN
ACTIVE IN THIS SPACE AND ASKING
THEM TO WEAR POINT OF CARE
TECHNOLOGIES TO FOCUS ON A
PROBLEM.
HERE WE FOCUS ON THE POSTPARTUM
PERIOD FOR TWO PERIODS.
ONE IS BECAUSE THAT'S WHERE THE
MAJORITY OF DEATHS ARE OCCURRING
BUT IT'S ALSO MUCH EASIER TO
COMMERCIALIZE TECHNOLOGIES THAT
ARE GIVEN TO POSTPARTUM PEOPLE
RATHER THAN TO PREGNANT PEOPLE
WHERE THE TECHNOLOGIES WOULD
UNDER GO MORE SCRUTINY.
WE'VE AWARDED UP TO $8 MILLION
IN PRIZES.
THERE'S DIFFERENT PHASES.
WE'RE NOW DOWN TO THE TOP 10.
AND JUST TO GIVE YOU AN EXAMPLE
AND THERE'LL AND MONITOR AND
THERE ARE MENTAL HEALTH CHECKS,
FOR EXAMPLE, WHERE PARTICIPANTS
ARE NOW ANSWERING QUESTIONNAIRES
ON THEIR SMARTPHONE AND THERE'S
ARTIFICIAL INTELLIGENCE THAT IS
GOING TO DETERMINE WHETHER
THEY'RE AT RISK OR NOT FOR
SUICIDE AND POSTPARTUM
DEPRESSION, ETCETERA.
WITH THE COMMUNITY FOR MATERNAL
HEALTH CHALLENGE, SO WE THOUGHT
ABOUT THIS BECAUSE PRIOR TO THE
IMPROVE INITIATIVE WE MET WITH A
NUMBER OF THE LOCAL MATERNAL
HEALTH ORGANIZATIONS SHOWN IN
THE PHOTOGRAPH THERE.
THE IDEA WAS HOW DO WE SUPPORT
THE COMMUNITY-BASED
ORGANIZATIONS THAT HAVE NEVER
GET -- WRITTEN A GRANT
APPLICATION AND PART OF THE
SUPPORT WAS NOT ONLY GIVING
MONEY TO THESE ORGANIZATIONS AND
PROVIDING MENTORING AND
ASSISTANCE WITH WRITING
PROPOSALS.
WE'RE NOW IN THE FINAL RESEARCH
PHASE AND THEY'RE CONDUCTING
THEIR PROPOSED RESEARCH AND WILL
REPORT BACK THEIR RESULTS AND
HAVE A YEAR TO DO THAT SO WE
WILL REPORT BACK THE WINNERS
NEXT SEPTEMBER.
HERE TAY ARE FOCUSSING ON
NUTRITION AND FOCUSSING ON
SEVERAL OF THE GRANTS LOOKING AT
DOULA AND NON-PHYSICIAN CARE IN
THE COMMUNITY.
LOOKING AT POSTPARTUM,
DEPRESSION, ETCETERA.
THEN THERE'S THE IMPROVE SIP
LOOKING AT COMMUNITY-INFORMED
AND COMMUNITY-ENGAGED
IMPLEMENTATION STRATEGIES.
THOSE AWARDEES INCLUDE THESE
THREE INSTITUTIONS ALSO LOOKING
AT DOULAs WITH UNDER REPRESENTED
COMMUNITIES.
THERE'S A WINNEBAGO TRIBE IN
NEBRASKA LOOKING AT AND IT'S
FOCUSSED MORE ON CARDIOVASCULAR
COMPLICATIONS.
THE CENTERS OF EXCELLENCE WE
JUST ANNOUNCED LAST MONTH AND
THESE ARE ESSENTIALLY HUBS THAT
ARE BEING TESTED IN PARTS OF THE
IMPROVE.
WE HAVE 10 INSTITUTIONS YOU CAN
SEE HERE.
THERE ARE TWO NERVE CENTERS ONE
IS AT JOHNS HOPKINS A DATA
INNOVATION AND COORDINATING HUB
AND ONE IS THE UNIVERSITY OF
PENNSYLVANIA THAT IS IN
IMPLEMENTATION SCIENCE HUB.
THE VISION IS ANY OF THE PARTS
OF IMPROVE CAN WORK WITH THE
HUBS USE THE RESOURCES OF THE
HUBS TO MAKE THE SUM GREATER
THAN ITS INDIVIDUAL PARTS.
AND THE INTENT HAS BEEN TO
STRETCH OUT TO AS MANY
POPULATIONS AND MANY PARTS OF
THE COUNTRY.
AND DIFFERENT TIME POINTS AND
LOOK AT POPULATIONS.
WE'RE LOOKING AT COMMUNITY
HEALTH WORKERS HOME VISITING
PROGRAMS INTEGRATED CARE MODELS,
ETCETERA AND ON THE LOWER RIGHT
WE'RE LOOKING AT SOCIAL
DETERMINATES OF HEALTH.
WHAT IS THE AFFECT OF HOUSING
STABILITY ON PREGNANCY OUTCOMES
AND INTIMATE PARTNER VIOLENCE,
ACCESS TO CARE AND WE HEARD WITH
THE NAVAJO POPULATION IN ARIZONA
WE'RE TALKING WITH THEM ABOUT
WHAT ARE YOUR BIGGEST CONCERNS.
I'VE NEVER BEEN ON A NAVAJO
RESERVATION.
I WOULD HAVE OUT THE IT'S BEEN
ACCESS TO CARE BUT IT'S BEEN
ACCESS TO FRESH FOOD.
THEY HAVE TO TRAVEL MULTIPLE
HOURS TO GET TO A GROCERY STORE
THAT HAS FRESH FRUITS AND
VEGETABLES.
SO NUTRITION IS EXTREMELY
IMPORTANT.
HERE WE SHOW YOU THIS WAS DONE
AN INTENTIONAL AND INTEGRATED
WAY PUTTING THE PROGRAMS
TOGETHER.
IT'S SPREAD OUT TO THE EXTEND
POSSIBLE SOME OF THE BIGGEST
AREAS OF NEED ARE IN THE
SOUTHEAST BUT UNFORTUNATELY WE
DID NOT GET A LOT OF
APPLICATIONS FROM THAT AREA.
WE COULD NOT ADDRESS AS MANY
ISSUES AS WE WOULD ARE LIKED TO
BUT GO ACROSS GEOGRAPHY AND
APPLICATIONS.
IN MY REMAINING TIME WILL GO
OVER SOME RESEARCH PROGRAM
HIGHLIGHTS.
NOW WE'LL SWITCH OVER TO NICHD.
WE HAVE OUR NAMESAKE, EUNICE
KENNEDY SCHRIVER AND THIS IS A
WONDERFUL BOOK.
WE DID A BOOK SESSION WITH THE
AUTHOR.
SHE TELLS INCREDIBLE STORIES AND
THE SUB TITLE OF THE BOOK IS THE
KENNEDY WHO CHANGED THE WORLD
BECAUSE SHE NOT ONLY ESSENTIALLY
FOUNDED NICHD BUT FOUNDED THE
SPECIAL OLYMPICS.
IN LOOKING AT OUR PORTFOLIO AS
WE IMPLIED, 55% IS PEDIATRICS
AND 35% IS REPRODUCTIVE HEALTH
AND THE REST IS INTELLECTUAL AND
DEVELOPMENTAL DISABILITIES.
I THOUGHT YOU'D BE INTERESTED IN
THE OUTCOME OF THE HEAL
INITIATIVE THAT WE PARTICIPATED
IN.
SO THE HEAL INITIATIVE IS
HELPING TO END ADDICTION LONG
TERM A LONG INITIATIVE
CONSIDERABLE MORE FUNDS THAN
IMPROVE.
BABIES BORN TO MOTHERS USING S
REQUIRED EXTENSIVE INPUT TO
SCORE THEM.
THERE'S SOMETHING CALLED THE
SCORING SYSTEM IN WHICH EVERY
THREE TO FOUR HOURS A NURSE AT
THE BEDSIDE WOULD BE EVALUATING
A BABY FOR OVER 20 DIFFERENT
SYMPTOMS.
IT TAKES AN ENORMOUS AMOUNT OF
TIME AND BASED ON THE SCORE THE
BABY GETS, THE DECISION IS MADE
WHETHER OR NOT TO GIVE THAT BABY
SOME MEDICATION TO ADDRESS HIS
OR HER WITHDRAWAL SYMPTOMS.
AND THERE'S EAT, SLEEP AND
CONSOLE.
IT'S FAMILY ORIENTED.
IT GETS THE OPIOID USING BIRTH
PARENT INVOLVED AND AS PART OF
THE HEAL INITIATIVE WE COMBINE
THE NEONATAL RESEARCH NETWORK
WHICH IS BASED IN NICHD AND ECHO
WHICH IS BASED IN THE OFFICE OF
THE DIRECTOR.
THIS WAS DONE DURING THE
PANDEMIC.
IT WAS A WHOLE OF PRACTICE
CHANGE AND AMAZINGLY, DURING THE
PANDEMIC THEY WERE ABLE TO TRAIN
OVER 5,000 CARE PROVIDERS.
MANY OF WHOM WERE NURSES AND
PHYSICIANS AND OTHER SUPPORT
STAFF IN NEWBORN NURSERIES.
BASICALLY FOR EACH NURSERY THERE
WERE I THINK 26 DIFFERENT
NURSERIES INVOLVED.
EACH NURSERY HAD ITS OWN WAY OF
TREATING THESE BABIES WHICH
TURNS OUT IS DIFFERENT IN ALL
THESE 26 DIFFERENT NURSERIES.
THEY WOULD GO FROM THEIR USUAL
CARE THEN GET TRAINED AND THEN
THEY WENT TO EAT, SLEEP AND
CONSOLE.
THE RESULTS WERE VERY
CONCLUSIVE.
THE HOSPITALIZATION STAY FOR THE
BABIES WAS REDUCED BY A WEEK.
AND SIGNIFICANT REDUCTION IN THE
BABY'S NEEDING ANY MEDICATION AT
ALL.
THE BABIES WERE FOLLOWED UP TO
THREE MONTHS POST BIRTH.
THERE WAS NO DIFFERENCE IN TERMS
OF ADVERSE OUTCOMES SO IT'S
CONSIDERED TO BE SAFE.
THE BABIES ARE BEING FOLLOWED UP
TO TWO YEARS TO LOOK AT THE
DEVELOPMENT AFFECTS BUT A VERY
SUCCESSFUL STUDY, MASSIVE EFFORT
DURING THE PANDEMIC AND JUST
PUBLISHED IN THE NEW ENGLAND
JOURNAL OF MEDICINE THIS MAY.
WE ALSO SUPPORT THE MATERNAL
FETAL SERVICES NETWORK FOUNDED
IN 1986.
IT CURRENTLY HAS 14 SITES.
THESE ARE COLLABORATIVE
MULTI-SITE CLINICAL TRIALS AND
OBSERVATIONAL STUDIES.
IT'S A CORE NETWORK AT NICHD.
IT'S LOOKING AT ALL KINDS OF
THINGS RELATED TO PREGNANCY,
LABOR, RECOVERY, REDUCING
PREMATURE DELIVERIES.
ETCETERA.
THE INTERESTING THING IS THE
MFMU ARE INTERESTED IN THE
APPROACHES COMING OUT OF IMPROVE
AND THERE'S THE POSSIBILITY OF
CROSS-FERTILIZING MORE AND
LASTLY THE ENFORCE ON RESEARCH
SPECIFIC TO PREGNANT WOMEN AND
LACTATING WOMEN THIS WAS SIGNED
BY PRESIDENT OBAMA.
THE THE TIME IT WAS ALREADY
RECOGNIZED THAT THERE WAS A
TREMENDOUS GAP IN HOW
MEDICATIONS ARE USED IN BOTH
PREGNANT PEOPLE AND CHILDREN AS
WELL BUT FOR THIS THE FOCUS WAS
ON PREGNANT AND LACTATING WOMEN.
I CHAIRED THE TASK FORCE WHICH
INCLUDED PARTICIPANTS FROM ALL
SECTORS INCLUDING OTHER NIH
INSTITUTES, OTHER FEDERAL
AGENCIES, PROFESSIONAL
SOCIETIES, INDUSTRY, WE HAD
PHARMACEUTICAL REPRESENTATIVE
ARE HELPFUL AND WE DELIVERED
RECOMMENDATIONS AND SECRETARY OF
HEALTH AND HUMAN SERVICES AT THE
TIME AZAR LIKED IT SO MUCH HE
SAID, HE WANTED TO EXTEND IT AND
NEEDED TO COME BACK WITH
IMPLEMENTATION PLAN.
THE KEY RECOMMENDATIONS INCLUDED
CHANGING THE EXISTING CULTURE
FROM PROTECTING PEOPLE THROUGH
RESEARCH SORRY, TYPICALLY,
PREGNANT PEOPLE ARE PROTECTED
FROM RESEARCH.
WE NEEDED TO COMMUNITY TO
PROTECT THEM THROUGH RESEARCH.
ANDYY AND REALLY CHANGE THE
EXISTING CULTURE THAT EXCEPT
PEOPLE WHO WANTED TO PARTS SPATE
IN THESE STUDIES.
WE WERE ABLE TO REMOVE PREGNANT
WOMEN AS A VULNERABLE POPULATION
THROUGH THE COMMON RULE.
ANOTHER PART OF THE
RECOMMENDATIONS WHICH WE ALREADY
IMPLEMENTED WAS TO EXPAND
WORKFORCE OF CLINICIANS AND
RESEARCHERS WITH LACTATION
PHARMACOLOGY AND WE'RE WORKING
ON REMOVING OTHER REGULATORY
BARRIERS.
IF YOU'RE INTERESTED IN FINDING
OUT MORE, YOU CAN GO TO NIH
PRGLAC AND FINALLY ONE OF OUR
MAJOR INVESTMENTS HAS BEEN IN
MATERNAL AND PEDIATRIC PRECISION
IN THERAPEUTICS HUB.
SO THIS IS ANOTHER NATIONAL
RESOURCE TO REALLY EXPAND THE
KNOWLEDGE AS WELL AS PROVIDE
WAYS OF STUDYING PHARMACO K
KINETICS IN PREGNANT AND
LACTATING PEOPLE TAKING
MEDICATIONS THEY NEED TO TAKE
FOR THEIR OWN HEALTH
IT'S A DISSERVICE TO NOT USE
THEIR INHALERS OR OTHER
MEDICATIONS.
SO THIS IS AN AREA THAT IS
GROWING FOR US.
SO I'M A LITTLE BIT OVER TIME
BUT I'M HAPPY TO ANSWER ANY
QUESTIONS AND WE'RE VERY
GRATEFUL FOR OUR COLLABORATION
WITH THE NATIONAL INSTITUTE OF
NURSING RESEARCH.
THANK YOU.
>>THANK YOU, DR. BIANCHI.
DR. FITZPATRICK.
>>I'M FROM THE STATE OF GEORGIA
AND WE HAVE THE HONOR OF HAVING
ONE OF THE WORSE MATERNAL
MORBIDITY OUTCOMES IN THE NATION
AND THE SAD THING IS I HAVEN'T
HEARD ABOUT IT UNTIL RECENT
YEARS.
I THINK THE WORK TO YOU'RE DOING
IS NOT ONLY IMPORTANT BUT
PERHAPS STARTING TO GET OUT
THERE.
I HEARD DISCUSSIONS ABOUT IT
FROM THE NCATS PERSPECTIVE AND
OTHER GROUPS.
IT'S TIMELY AND IMPORTANT AND I
THINK THE FACT YOU'RE GOING IN
THE COMMUNITIES IS REALLY VERY
APPROPRIATE BECAUSE MY
UNDERSTANDING OF THE DATA IS YOU
CAN HAVE TWO POPULATIONS THAT
OTHERWISE LOOK SIMILAR AND ON
THE SURFACE THEY LOOK SIMILAR
BUT THE DIVIDING LINE IS WHERE
THEY LIVE AND IT STARTS TO GET
INTO THINGS LIKE RED LINING
PRACTICES HISTORICALLY.
SO I LOVE THERE'S A COMMUNITY
FOCUS TO THIS.
I THINK THAT'S VERY IMPORTANT.
MY QUESTION IS RELATED TO THE
PORTFOLIO AS A WHOLE.
HAS THERE BEEN ANY THOUGHT ABOUT
COMMON DATA ELEMENTS YOU'RE
TRYING TO GATHER BECAUSE I THINK
THERE'S GOING TO BE THE
DELIVERABLES FROM THE SCIENCE
AND PERHAPS DELIVERABLES THAT
COME LATER AS THE DATA BECOME
PUBLICLY AVAILABLE.
HAS THERE BEEN THOUGHT TO THAT?
>>YES.
SO IT STARTED WITH THE PANDEMIC.
THE DATA HUB AS PART OF INCLUDE
WILL BE TO INCLUDE COMMON DATA
ELEMENTS.
BECAUSE WE REALLY EMPHASIZED IN
OUR KICKOFF SESSION JUST A
COUPLE WEEKS AGO HOW IMPORTANT
IT WILL BE FOR THESE UNITS TO
ALL COLLABORATE WITH EACH OTHER
AND TO DO THAT THEY HAVE TO BE
SPEAKING THE SAME LANGUAGE
THROUGH COMMON DATA ELEMENTS.
THEY SEEM TO ALL RECOGNIZE THAT
AND I THINK IT'S VERY IMPORTANT
TO SET IT UP FROM THE VERY
BEGINNING.
AND IN THE VARIOUS STATEMENTS
AND PRESENTATIONS THAT THE 10
GROUPS MADE, THEY SEEM TO
REAFFIRM THE FACT THAT THEY WERE
VERY INTERESTED IN COLLABORATION
AND WE WILL BE REQUIRING THEM TO
SHARE THEIR DATA.
SO I TOTALLY AGREE WITH YOU.
I BELIEVE ONE OF THE HUBS IS IF
IT'S NOT LISTED IN THE CIRCLE IT
HAS A PARTNERSHIP IN GEORGIA.
GEORGIA'S ONE OF OUR
COLLABORATING -- ACTUALLY AT
MOREHOUSE WITH EMORY.
I GOT UP AT 4:30 IN THE MORNING
SO I'M NOT FIRING AS QUICKLY AS
I NORMALLY DID.
>>THE MATERNAL MORBIDITY CRISIS
AT LEAST FROM MY PERSPECTIVE WAS
NOT ON THE RADAR UNTIL RECENTLY
AND IT MAKES ME THINK WHAT ELSE
WE'RE MISSING.
WHAT ABOUT THE OFFSPRING OF
THESE MOTHERS AND WHAT HAPPENS
WHEN THE MORBIDITY RATE
INCREASES LIKE THIS.
IS THERE ATTEMPTS THROUGH THE
PROGRAMS TO ALSO FOLLOW THE
CHILDREN?
WE DON'T NECESSARILY HAVE IT
WITH IMPROVE.
IT'S FUNDED TO BE SCHEDULED FOR
SEVEN YEARS AND WE HAVE OTHER
PROGRAMS IN NICHD WHERE WE'RE
LOOKING AT TRANS GENERATIONAL
HEALTH AND LOOKING AT EPIGENETIC
FACTORS, FOR EXAMPLE.
WE'RE LOOKING AT WHERE YOU LIVE
AND HOW THAT TRANSLATES INTO THE
NEXT GENERATION'S HEALTH, FOR
EXAMPLE.
SO YES, MY WHOLE LIFE HAS BEEN
DEVOTED TO ING THE FACT THAT
CHILDREN ARE THE FUTURE OF
AMERICA AND YOU CAN EITHER BE
PROACTIVE OR YOU CAN PAY FOR IT
AT THE END WHEN THERE'S SO MANY
COMPLICATIONS THAT COULD HAVE
BEEN ADDRESSED EARLIER ON.
SO YES, WE ARE LOOKING AT THAT.
>>OTHER QUESTIONS OR COMMENTS
FOR DR. BIANCHI.
>>I KNOW I'M AT THE END OF A
VERY RICH PROGRAM.
DO ANY OF YOU HAVE CENTERS YOU
KNOW OF IN YOUR STATE?
I GUESS NOT.
PART OF THAT IS THERE'S MORE
WOMEN IN CONGRESS AND I THINK
SOME OF THE TRAGIC COMPLICATIONS
WITH FEEL ATHLETES WHO HAD
PREVENTIBLE DEATHS RECEIVED A
LOT OF ATTENTION.
IT'S RISING IN THE CONSCIOUSNESS
BUT WE HAVE TO DO MORE SO THANK
YOU.
>>THANK YOU, DR. BIANCHI.
IT'S A NICE OVERVIEW OF THE
INITIATIVES AT NICHD AND IMPROVE
AND WE'RE COMMITTED TO
CONTINUING THE COLLABORATION
WITH YOU SO THANKS FOR COMING.
I FORGOT OR LOST TRACK OF A VERY
IMPORTANT PART OF OUR AGENDA
WHICH WE'LL MOVE TO NOW WHICH IS
ON CONCEPTS.
SO AS YOU KNOW IN OUR ADVISORY
ROLE TO THE NINR DIRECTOR YOU'RE
THE SOURCE OF NON-GOVERNMENT
ADVICE ON DIRECTION AND NINR
SEEKS COUNCIL'S ADVICE FOR
LONG-TERM PLANNING BY PRESENTING
CONCEPTS FOR CLEARANCE.
A CONCEPT IS THE EARLIEST
PLANNING STAGE OF INITIATIVE
BEFORE RELEASING AN RFA OR
PROGRAM ANNOUNCEMENT WITH SET
ASIDE FUNDS OR CONTRACT.
A CONCEPT DESCRIBES THE
BACKGROUND OBJECTIVES AND
POTENTIAL MECHANISMS FOR THE
INITIATIVE.
ANY APPROVED CONCEPTS MAY OR MAY
NOT TURN INTO A FUNDING
INITIATIVE BASED ON A NUMBER OF
FACTORS INCLUDING FUND'S
AVAILABILITY.
TODAY NINR DIRECTOR WILL PRESENT
A CONCEPT ON INTERSECTIONALITY
AND NURSING RESEARCH, A SUMMARY
OF THE CONCEPT WAS MADE
AVAILABLE IN THE ELECTRONIC
COUNCIL BOOK FOR YOUR REVIEW IN
ADVANCE OF THIS MEETING.
SO FOLLOWING DR. BYNUM'S
PRESENTATION, COUNCIL MEMBER
DR. ROBERT ATKINS WILL OFFER
COMMENTS TO OPEN THE DISCUSSION.
DR. DINE BYNUM
DR. BYNUM TAKE IT AWAY.
>>MY PRESENTATION WAS FORGOTTEN
AND I'M ACTUALLY THE LAST
PRESENTATION OF THE DAY SO
HOPEFULLY I'LL KEEP IT
INTERESTING.
MY ANDRY EXCITED TO HAVE THE
OPPORTUNITY TO PRESENTATION THE
AXES INITIATIVE THIS AAFTERNOON
AND TELL YOU WHY
INTERSECTIONALITY IS ESPECIALLY
IMPORTANT TO THE FIELD OF
NURSING SCIENCE.
THE CONCEPT OF INTERSECTIONALITY
HAS ORIGINS IN BLACK MEM NIFT
SCHOLARSHIP AND REFERS TO THE
NOTION YOU CAN'T
COMPARTMENTALIZE PEOPLE AND WE
ARE WHO WE ARE IN OUR FULLNESS
AND THAT REQUIRE SUSTAINED
RECOGNITION.
AT THE INTERSECTIONS AT SELF AND
GENDER IDENTITY AND SEXUAL
ORIENTATION, THE EXPERIENCES OF
PEOPLE INTERSECT PROVIDING
AFFECTS OTHERWISE OB SECURED IF
VIEWED INDEPENDENTLY.
A BLACK LATINA WOMEN DOES NOT
ONLY WALK IN HER BLACKNESS ONE
DAY AND WOMAN HEAD THE NEXT DAY
AND HISPANIC HERITAGE THE
SUBSEQUENT DAY.
THE IS ALL THOSE THINGS
SIMULTANEOUSLY AND BEARS THE
CONDITION, CIRCUMSTANCES AND
SOCIAL DISADVANTAGES THAT
ACCOMPANY THEM.
SO INTERSECTIONALITY PERSISTS AT
SOME INTERSECTIONS OF SOCIAL
STATUSES, SOCIO ADVANTAGE AND
PRIVILEGE IS CREATED AND
EMBEDDED WHILE AT OTHER
INTERSECTIONS SOCIO DISADVANTAGE
AND OPPRESSION IS EMBEDDED AND
CREATED.
ANOTHER CONCEPT THAT WE THINK IS
REALLY IMPORTANT TO
OPERATIONALIZE AS WE MOVE
THROUGH THE PRESENTATION IS
SDOH.
WE'RE LEVERAGING THE NIH
CONCEPTUALIZATION DR. ZENK
MENTIONED AND MORE DETAIL
EARLIER TODAY.
SO I'LL JUST MENTION THAT HERE
FOR THIS CONCEPT WE ARE
CONSIDERING THE CONDITIONS OF
DAILY LIVING AS WELL AS THE
WIDER SET OF STRUCTURES THAT
SHAPE THEM.
SO THE STATE OF THE PROBLEM IS
SDOH PLAYS A KEY ROLE IN
DETERMINING HEALTH TRAJECTORIES
IN A POSITIVE FORMS OR
TRAJECTORIES OF ILLNESS AND ITS
NEGATIVE FORMS.
BELONGING TO DOMINANT OR
MAJORITY GROUPS BASED ON
INTERSECTIONS OF SOCIAL
STATUSES, ACCESS TO SYSTEMS OF
PRIVILEGE WHILE BELONGING TO
GROUPS THAT SOCIETY HAS
MARGINALIZED CONTENDING WITH
SYSTEMS OF OPPRESSION SUCH AS
RACISM, SEXISM, HOMOPHOBIA,
CLASSISM, ABLISM AND XENOPHOBIA
AN UNFORTUNATELY THE LIST
CONTINUES.
WE KNOW SDOH IS IMPORTANT IN THE
CONTEXT OF HEALTH AND HOPEFULLY
I'VE COMMUNICATED EFFECTIVELY
THE IMPORTANCE OF
INTERSECTIONALITY AND YOU HEARD
SECTIONALITY BROUGHT IN BY
DR. ZENK.
WHAT DO WE NEED TO KNOW TO MOVE
THE FIELD FORWARD?
MOST INTERSECTIONAL RESEARCH
DOCUMENT THE HEALTH DISPARITIES
EXIST AT INTERSECTIONS OF SOCIAL
STATUSES.
WE KNOW FAR LESS ABOUT THE
MECHANISMS AND PATHWAYS THROUGH
WHICH THIS OCCURS ESPECIALLY AT
THE STRUCTURAL LEVEL.
IN THE DOCUMENTATION OF HEALTH
DISPARITIES AND SOCIAL STATUSES
THE LITERATURE HAS FOCUSSED ON A
MORE BROADLY ON A NARROW SET OF
STATUSES.
THE LARGEST PROPORTION BEING
RACE, ETHNICITY AND GENDER.
THIS PRESENTS AN OPPORTUNITY TO
EXPAND INTERSECTIONALITY
RESEARCH TO BE MORE INCLUSIVE OF
OTHER MARGINALIZED POPULATIONS
EITHER PRESENT DAY OR
HISTORICALLY.
COOPERATION OF INTERSECTIONALITY
IS LIMITED TO DATE WHICH REDUCE
THE OPPORTUNITY TO CONSIDER
PEOPLE IN THE CONTEXT OF THE
WHOLE PERSON OR THEIR LIVES AND
LIVING CONDITIONS.
LASTLY, PROGRESS AND
INTERSECTIONALITY RESEARCH WILL
REQUIRE METHODS SUITED TO
IDENTIFYING COMPLEX PATHWAYS
THROUGH WHICH SDOH DETERMINES
INDIVIDUAL AND POPULATION HEALTH
AND THAT TIES BACK INTO THE
FIRST POINT I DISCUSSED.
CUMULATIVELY THE UNDERSTANDING
OF INTERSECTIONALITY MUST BE
CLOSED TO ADVANCE THE FEEL OF
INTERSECTIONALITY AND ADVANCE
HEALTH EQUITY.
SO WE ARE PROPOSING HERE THE
AXES INITIATIVE WHICH FOCUSES ON
ADVANCING RESEARCH TO UNDERSTAND
AND ADDRESS THE IMPACT OF SDOH
AT INTERSECTIONS OF SOCIO STATUS
SUCH AS RACE, ETHNICITY, GENDER
IDENTITY, MIGRATION AND OTHER
STATUSES MARGINALIZED.
THERE ARE THREE POTENTIAL
INITIATIVES THAT MAY FALL UNDER
THE CONCEPT.
ONE BEING OBSERVATIONAL RESEARCH
TO ELUCIDATE THE HEALTH IMPACT
ACROSS CRIMINAL LEGAL AND SOW
SOCIO COMMUNITY AND OTHERS
HEALTH INEQUITIES AND TRAINING
PROGRAMS TO BUILD SCIENTIFIC
CAPACITY TO BUILD RIGOROUS
RESEARCH.
SO WHAT DOES INTERSECTIONALITY
HAVE TO DO WITH NURSING SCIENCE?
WELL, WE BELIEVE THE AXES
INITIATIVE ALIGNS WELL WITH THE
NINR STRATEGIC PLAN AND NURSING
SCIENCE PERSPECTIVE OF
CONSIDERING PEOPLE IN THE
CONTEXT OF THE WHOLE PERSON.
SO EVOKING A HOLISTIC APPROACH
TO OPTIMIZING HEALTH AND
FOSTERING COMPLEX EXPERIENCES OB
SECURED WHEN ASSESSED
INDEPENDENTLY.
EXPANDING CONSIDERATIONS OF
PEOPLE'S LIVES AND LIVING
CONDITIONS AS HEALTH
DETERMINATES AND STRUCTURAL
INEQUITIES THAT PLACE SOME AT AN
UNFAIR AND UNJUST HEALTH
DISADVANTAGE.
WE RECOGNIZE WE HAVE A WAYS TO
GO TO GET TO THE POINT OF
LIBERATION WHERE SYSTEMS FORCES
AND POLICIES OF OPPRESSION NO
LONGER EXIST.
WE DO BELIEVE UNDERSTANDING
PEOPLE AT THEIR INTERSECTIONS
AND HOW THEY OPERATE IN SOCIETY
IS AN IMPORTANT STEP IN THIS
PROCESS.
THANK YOU FOR LISTENING.
>>THANK YOU, DR. BYNUM.
DR. ATKINS?
>>THANK YOU, DR. DINE UM.
-- DR. BYNUM.
I'M DELIGHTED WE ARE STARTING TO
CONTEMPLATE AND THE IDEA OF HOW
DO WE START TO THINK ABOUT THE
PLACE ARE GETTING -- WE'VE SEEN
A LOT OF MAPS TODAY AND THESE
MAPS HAVE SOME REAL COMMON
THEMES IN TERMS OF PLACES THAT
ARE BEING SEEN, PLACES THAT
WE'RE BLIND TO AND I THINK
THERE'S SOMETHING AROUND
INTERSECTIONALITY AND THESE
COMMUNITIES OF INVESTMENT THAT
ARE AGAIN PLACES THAT ARE
APPALACHIA, TRIBAL LANDS, THE
RUST BELT, THESE PLACES THAT WE
ARE NOT PUTTING RESOURCES
TOWARDS AND CONTINUE THAT
DISINVESTMENT.
I WONDER IF THERE'S ANY THOUGHTS
AS YOU START TO CONTEMPLATE THE
IDEA OF STRUCTURAL DETERMINATES
OF HEALTH AND HOW DO WE BRING
THAT INTO THAT CONVERSATION
THINKING ABOUT THE PLACES WE'RE
INVESTING.
>>WHEN YOU THINK ABOUT PLACES
WE THINK ABOUT PEOPLE AND I
THINK IT'S REALLY IMPORTANT AS
MENTIONED EARLIER THAT THE
MAJORITY OF INTERSECTION
LITERATURE TO DATE DOCUMENTS THE
PROBLEM.
WE KNOW AT DIFFERENT
INTERSECTIONS DISPARITIES EXIST.
WE DON'T KNOW THE PATHWAYS AND
PROCESSES THROUGH WHICH THAT
OCCURS.
AND THE MAJORITY OF THE
LITERATURE HAS FOCUSSED ON A
NARROW SET OF INTERSECTION.
AND IF YOU DRILL THAT DOWN EVEN
MORE, RACE IS ONE THAT IS THE
MAJORITY OF FOCUS HAS BEEN ON
RACE BUT IF YOU DRILL IT DOWN
ANYMORE EVEN FURTHER I'M SURE
YOU'LL FIND SOME POPULATIONS
STILL ARE UNDER REPRESENTED.
SO IF YOU THINK OF PLACES YOU
THINK OF POPULATIONS AND HOW
INTERSECTIONALITY RESEARCH
REALLY DOES HAVE THE CAPACITY TO
EXPAND SCOPE AND UNDERSTANDING
THE PROBLEMS SO THE PROBLEMS CAN
BE ADDRESSED IN THESE PLACES AND
THAT COMPRISE PEOPLE.
>>YES.
I THINK YOU'RE RIGHT.
TO DRILL DOWN AND THINK ONE OF
THE PIECES AS YOU DRILL DOWN
WE'RE GOING TO GET TO SOME
POINTS THAT SEEM SALIENT EVERY
TIME I LOOK AT THE NEW YORK
TIMES THEY'RE TALKING ABOUT THIS
WAY THAT PRIVILEGE AND WAYS
AROUND HIGHER EDUCATION AND WHO
IS GETTING ACCESS TO THESE
PLACES WE KNOW GIVE ADVANTAGE
AND WHEN YOU LOOK AT THE WORK
AROUND SOCIAL MOBILITY AND HOW
ZIP CODES PROBABLY MATTER MORE
THAN GENETIC CODES IN TERMS OF
HOW THAT ALSO -- PART OF MY
INTEREST IN AND TALKING ABOUT
HOW WE START TO THINK ABOUT
THESE PLACES AND THE SOCIAL
MOBILITY THAT COMES FROM THESE
PLACES AND THE CONNECTIONS WITH
AFFLUENCE OR OTHER KINDS OF
OPPORTUNITY PIECES THAT WRAP
AROUND THAT.
THIS IDEA AS YOU DRILL DOWN TO
LOOK AT OPPORTUNITY AND THE WAY
OPPORTUNITY ASK CONFERRED
THROUGH PLACE AND -- IS
CONFERRED THROUGH PLACE AND SOME
OF THE STRENGTHS OF WEAK TIES
AND WHO YOU KNOW AND WHO IS IN
YOUR NETWORK.
THERE'S SOME PLACES THAT HAVE
THINGS WE DON'T NECESSARILY TALK
ABOUT.
THERE ARE COMMUNITIES POSTALLY
BLACK AND BROWN COMMUNITIES THAT
TEND TO BE YOUTHFUL AND CHILD
DENSE AND HOW DOES THAT AFFECT
ADVANTAGE AND OPPORTUNITY AND
RESOURCES.
42 FLIP SIDE IS ADVANTAGE AND
TRYING TO UNDERSTAND HOW THE
SYSTEMS AND FORCES AND
STRUCTURES ADVANTAGE SOME WHILE
SIMULTANEOUSLY DISADVANTAGING
OTHERS.
TRYING TO UNDERSTAND ADVANTAGE
AS WELL AS DISADVANTAGE IS
IMPORTANT IN THE CONTEXT OF
INTERSECTIONALITY.
THANK YOU FOR THAT.
>>THANK YOU FOR YOUR
PRESENTATION.
SORRY YOU WERE FORGOT.
>>WELL, NOW I KNOW I'M NOT.
IT SEEMS SO IMPORTANT.
IT'S RELATED TO DR. ATKINS'
COMMENT BECAUSE WE TRY TO TALK
ABOUT INTERSECTIONALITY FROM AN
ASSET AND WHEN THERE'S HIGH
DEGREES OF LATINOS, HIGH
CONCENTRATIONS THERE'S MORE
CAPITAL AND MORE SHARING OF
RESOURCES SO THINKING ABOUT THAT
INTERSECTION WITHIN THAT CONTEXT
TO IDENTIFY ASSET IN THE
COMMUNITY OR IN FAMILIES OR EVEN
WITHIN AN INDIVIDUAL THEY COPE
WITH WHATEVER THE SITUATION
MIGHT BE.
I LOVED READING ABOUT THIS
BECAUSE AS WE MOVE INTO
INTERVENTION RESEARCH TO
CAPITALIZE AND BUILD ON THE
ASSETS.
I DON'T KNOW WHERE WE'RE GOING
TO LAND WITH THIS.
>>THAT'S AN IMPORTANT POINT.
COMMUNITIES DO HAVE ASSETS THAT
CAN SERVE AS BUFFERS OR SERVE TO
MITIGATE THE EXPERIENCES THAT
PEOPLE ENCOUNTER ON A DAILY
BASIS.
I THINK THAT WILL BE AN
IMPORTANT CONSIDERATION IN THE
CONCEPT.
THANK YOU GUYS FOR LISTENING AND
THANK YOU FOR YOUR DISCUSSION.
>>ALL RIGHT.
THANK YOU.
SO HEY, IT'S BEEN A LONG DAY BUT
AN EXCITING DAY.
THANK YOU FOR YOUR ENGAGEMENT
AND YOUR PARTICIPATION SO I WANT
TO JUST PAUSE AND OPEN IT UP FOR
ANY COMMENTS OR ANY GENERAL
DISCUSSION AMONG COUNCIL.
ALL RIGHT, WE'RE GOOD?
ALL RIGHT.
SO THEN WE'LL CONSIDER OPEN
SESSION CLOSED SO IT'S NOW 2:38.
SO HOW MUCH TIME DO WE NEED?
IS 12 MINUTES ENOUGH BEFORE WE
RECONVENE FOR CLOSED SESSION?
DOES THAT SOUND OKAY BALANCING
ALL THINGS HERE?
OKAY.
SO COUNCIL WILL CONVENE AT 2:50
EASTERN FOR CLOSED SESSION.