Application of the Delphi method to the development of common data elements for social drivers of health: A systematic scoping review.

Collaborative data science requires standardized, harmonized, interoperable, and ethically sourced data. Developing an agreed-upon set of elements requires capturing different perspectives on the importance and feasibility of the data elements through a consensus development approach. This study reports on the systematic scoping review of literature that examined the inclusion of diverse stakeholder groups and sources of social drivers of health variables in consensus-based common data element (CDE) sets. This systematic scoping review included sources from PubMed, Embase, CINAHL, WoS MEDLINE, and PsycINFO databases. Extracted data included the stakeholder groups engaged in the Delphi process, sources of CDE sets, and inclusion of social drivers data across 11 individual and 6 social domains. Of the 384 studies matching the search string, 22 were included in the final review. All studies involved experts with healthcare expertise directly relevant to the developed CDE set, and only six (27%) studies engaged health consumers. Literature reviews and expert input were the most frequent sources of CDE sets. Seven studies (32%) did not report the inclusion of any demographic variables in the CDE sets, and each demographic SDoH domain was included in at least one study with age and sex assigned at birth included in all studies, and social driver domains included only in four studies (18%). The Delphi technique engages diverse expert groups around the development of SDoH data elements. Future studies can benefit by involving health consumers as experts.

Collecting and capturing social factors that affect individuals' health is imperative. Social drivers of health data allow researchers to understand health disparities to make healthcare available, accessible, and affordable. However, collecting common health data elements has challenged researchers due to limited resources to facilitate change. Incorporating various stakeholders, such as individuals and patient advocacy groups, can effectively contribute to the research process as community advisors. This article reviews the studies that used the Delphi method and brings together experts to agree on guidelines for collecting common data elements. The article's findings reveal that experts are healthcare professionals and researchers, leaving out the crucial input from patients and caregivers. This article emphasized that developing a standard set of data elements can improve the standardization of social drivers of health. Common data elements provide the opportunity to improve patients' and social circumstances and their efforts toward health outcomes.

Trends in publication and levels of social determinants of health reporting in Journal of Clinical and Translational Science from 2017 to 2023.

Social determinants of health affect clinical and translational research processes and outcomes but remain underreported in empirical studies. This scoping review examined the rate and types of social determinants of health (SDoH) variables included in the JCTS translational research studies published between 2017 and 2023 and included 129 studies. Most papers (91.7%) reported at least one SDoH variable with age, race and ethnicity, and sex included most often. Future studies to inform the role of SDoH data in translational research and science are recommended, and a draft SDoH data checklist is provided.

Pilot implementation of a co-mentoring circles program for the clinical research professionals: Evidence for formative evaluation and logic model.

Clinical research professionals (CRPs) are essential contributors to clinical and translational research endeavors, encompassing roles such as research nurses, research coordinators, data managers, and regulatory affairs specialists. This paper reports on the implementation of a novel training program for the CRPs, the Co-mentoring Circles Program, developed by the University of Florida Health Clinical Research Professionals Consortium, and proposes an initial logic model of CRP workforce development informed by the observations, participant feedback, and the established Translational Workforce Logic Model. The co-mentoring program was delivered through an online didactic curriculum and bi-monthly meetings over nine months, from January to September 2022. The formative evaluation identified the factors that support CRP workforce development through knowledge acquisition and professional relationship building. Finally, this paper proposes a logic model of CRP workforce development, including financial and human inputs, didactic and co-mentoring activities, workforce outputs, outputs related to workforce and clinical research study progress, and resulting impacts of increased national capacity for translational research and increased rate of research translation.

Peer review of GPT-4 technical report and systems card.

The study provides a comprehensive review of OpenAI's Generative Pre-trained Transformer 4 (GPT-4) technical report, with an emphasis on applications in high-risk settings like healthcare. A diverse team, including experts in artificial intelligence (AI), natural language processing, public health, law, policy, social science, healthcare research, and bioethics, analyzed the report against established peer review guidelines. The GPT-4 report shows a significant commitment to transparent AI research, particularly in creating a systems card for risk assessment and mitigation. However, it reveals limitations such as restricted access to training data, inadequate confidence and uncertainty estimations, and concerns over privacy and intellectual property rights. Key strengths identified include the considerable time and economic investment in transparent AI research and the creation of a comprehensive systems card. On the other hand, the lack of clarity in training processes and data raises concerns about encoded biases and interests in GPT-4. The report also lacks confidence and uncertainty estimations, crucial in high-risk areas like healthcare, and fails to address potential privacy and intellectual property issues. Furthermore, this study emphasizes the need for diverse, global involvement in developing and evaluating large language models (LLMs) to ensure broad societal benefits and mitigate risks. The paper presents recommendations such as improving data transparency, developing accountability frameworks, establishing confidence standards for LLM outputs in high-risk settings, and enhancing industry research review processes. It concludes that while GPT-4's report is a step towards open discussions on LLMs, more extensive interdisciplinary reviews are essential for addressing bias, harm, and risk concerns, especially in high-risk domains. The review aims to expand the understanding of LLMs in general and highlights the need for new reflection forms on how LLMs are reviewed, the data required for effective evaluation, and addressing critical issues like bias and risk.

Expectations and perspectives of cognitive behavioural therapy for childhood anxiety and related disorders.

BACKGROUND: Anxiety disorders are the most frequently diagnosed psychiatric conditions in children and adolescents. Cognitive behavioural therapy (CBT) is a well-established and effective treatment for anxiety and related disorders across the lifespan. Expectations of psychotherapy have been demonstrated to affect outcomes, yet there is sparse existing literature on adolescent patient and parent perspectives of CBT prior to engagement with treatment. AIMS: This study aimed to qualitatively explore the expectations and perceptions of CBT for anxiety and related disorders among adolescent patients and parents. METHOD: Fourteen adolescent patients and 16 parents participated in semi-structured individual interviews or focus groups consisting of 2-3 participants. Interview transcripts were analysed using inductive analysis. RESULTS: Three themes were identified: worries about CBT, expectations and knowledge of the CBT process, and the role of parents and families. Overall, we found that adolescents and parents had generally positive views of CBT. The outset of CBT saw adolescents and parents express concern about stigma as well as the ambiguity of CBT. Parents continued to express a lack of understanding of what CBT entailed during their child's treatment course. CONCLUSION: These results suggest that both adolescents and parents would benefit from early discussion and reinforcement of expectations for CBT treatment. Further research efforts are warranted and should be directed towards determining appropriate expectations for parental involvement in a child's CBT course and effective communication of treatment expectations to both adolescents and parents.

Erratum: 89 Bridging Cell Biology and Engineering Sciences: Interdisciplinary Team-based Training in Computational Pathology - ERRATUM.

[This corrects the article DOI: 10.1017/cts.2023.172.].

Individual and Institutional Factors Contribute to Research Capacity Building for Early-Stage Investigators from Groups Underrepresented in Biomedical Research: A Qualitative Comparative Analysis.

BACKGROUND: Enhancement of diversity within the U.S. research workforce is a recognized need and priority at a national level. Existing comprehensive programs, such as the National Research Mentoring Network (NRMN) and Research Centers in Minority Institutions (RCMI), have the dual focus of building institutional research capacity and promoting investigator self-efficacy through mentoring and training. METHODS: A qualitative comparative analysis was used to identify the combination of factors that explain the success and failure to submit a grant proposal by investigators underrepresented in biomedical research from the RCMI and non-RCMI institutions. The records of 211 participants enrolled in the NRMN Strategic Empowerment Tailored for Health Equity Investigators (NRMN-SETH) program were reviewed, and data for 79 early-stage, underrepresented faculty investigators from RCMI (n = 23) and non-RCMI (n = 56) institutions were included. RESULTS: Institutional membership (RCMI vs. non-RCMI) was used as a possible predictive factor and emerged as a contributing factor for all of the analyses. Access to local mentors was predictive of a successful grant submission for RCMI investigators, while underrepresented investigators at non-RCMI institutions who succeeded with submitting grants still lacked access to local mentors. CONCLUSION: Institutional contexts contribute to the grant writing experiences of investigators underrepresented in biomedical research.

Strategic Team Science Promotes Collaboration and Practice-Based Research at the Research Centers in Minority Institutions.

BACKGROUND: This paper reports on the implementation and evaluation of a strategy to promote collaborations and team science among investigators at the Research Centers in Minority Institutions (RCMI). The strategy presented in this paper was a hands-on workshop that allowed the application of strategic team science through structured dialogue, asset sharing, and systematic exploration of opportunities for collaboration. METHODS: The workshop was attended by more than 100 participants, including RCMI and non-RCMI investigators, practice-based research network (PBRN) supplement program directors, and an NIH Institute on Minority Health and Health Disparities Program Officer. RESULTS: A post-workshop survey was administered to collect participant feedback, assess the relevance of the workshop to the participants' professional development goals, and gauge the applicability of the tool as a support strategy to promote collaborative research. Most of the participants acknowledged that the session met the conference objectives (95.8%), and 93.7% noted that the workshop, to a high degree, met their personal goals and objectives. During the workshop, participants shared 35 resources they were willing and able to offer for prospective collaborative projects. CONCLUSION: The experience reported and evaluated in this paper paves the way to understanding methods for disseminating effective strategies for inter-institutional collaborations for the sustainable growth and operation of PBRNs.

Communicating risk to promote colorectal cancer screening: a multi-method study to test tailored versus targeted message strategies.

Colorectal cancer (CRC) screening rates are suboptimal, partly due to poor communication about CRC risk. More effective methods are needed to educate patients, but little research has examined best practices for communicating CRC risk. This multi-method study tests whether tailoring CRC risk information increases screening intentions. Participants (N = 738) were randomized with a 2:2:1 allocation to tailored, targeted, and control message conditions. The primary outcome was intention to screen for CRC (yes/no). Additional variables include perceived message relevance, perceived susceptibility to CRC, and free-text comments evaluating the intervention. A chi-square test determined differences in the proportion of participants who intended to complete CRC screening by condition. A logistic-based path analysis explored mediation. Free-text comments were analyzed using advanced topic modeling analysis. CRC screening intentions were highest in the tailored intervention and significantly greater than control (P = 0.006). The tailored message condition significantly increased message relevance compared with control (P = 0.027) and targeted conditions (P = 0.002). The tailored condition also increased susceptibility (P < 0.001) compared with control, which mediated the relationship between the tailored condition and intention to screen (b = 0.04, SE = 0.02, 95% confidence interval = 0.02, 0.09). The qualitative data reflect similar trends. The theoretical mechanisms and practical implications of tailoring health education materials about CRC risk are discussed.

Culture of Interdisciplinary Collaboration in Nursing Research Training.

BACKGROUND: Establishing and maintaining collaborative scientific environments that can cultivate and benefit from a full range of talents is essential for the quality and influence of science. Inclusion of research training and career development interventions to expose nursing PhD students, postdocs, and junior faculty to team science stands to prepare graduates to effectively engage with interdisciplinary colleagues to conduct cutting-edge nursing research and compete successfully for precious research resources. To be effective, nursing research workforce development programs need to recognize and share a culture of interdisciplinarity. OBJECTIVES: This project aims to develop, validate, and disseminate a theoretically grounded and methodologically rigorous tool for a cultural consensus analysis (CCA) of the culture of interdisciplinary collaboration in nursing research. METHODS: Culture can be defined as shared cognitive structures and consensus around culturally correct values, attitudes, and normative behaviors. This mixed-methods study employs CCA to assess construct validity and empirically determine a set of underlying socially learned and shared notions about the cultural domain of interdisciplinary collaboration in nursing research. The study will include three phases: (a) qualitative data collection and analysis to define the cultural domain of interdisciplinary collaborations in nursing research; (b) validation of the CCA tool with the use of cultural knowledge statements; and (c) application of the CCA tool to assess cultural differences among nursing trainees, junior faculty, and training directors. The study participant pool consists of National Institutes of Health-National Institute of Nursing Research awardees, including training directors of institutional training grants, pre- and postdoctoral trainees with individual fellowship training grants, and junior faculty with career development awards. Qualitative data will be analyzed to formulate cultural statements about the values and behaviors that promote interdisciplinary collaboration in nursing research. Subsequent survey data will be assessed using matrix algebra, principal component analysis, and the Stuart-Maxwell Marginal Homogeneity Test. DISCUSSION: The development and validation of a CCA tool is a novel approach to assess, support, and systematically examine interdisciplinary collaboration and team science in nursing research and training. However, the investigation of culture needs to remain value neutral, refrain from being prescriptive, and be sensitive to the emergence and dominance of one "right" culture.

Strategic Team Science: Scaffolded training for research self-efficacy, interdisciplinarity, diversity, equity, and inclusive excellence in biomedical research.

Research collaboration is an essential research skill that promotes diversity and inclusion in research and requires comprehensive curriculum and instructional methods to provide early-stage trainees with low-risk, scaffolded experiences of collaborative research practice. Strategic Team Science is an instructional method that introduces biomedical science trainees to an inclusive way of thinking, capitalizes on the diversity of individual capabilities, and provides scaffolded experience of cross-disciplinary collaboration. Pilot results show that guided dialogues around Strategic Team Science increase research self-efficacy and interdisciplinary research orientation. Scaffolded collaboration dialogues allow students from diverse disciplines to engage actively and share ideas equitably.

CTS teams: a new model for translational team training and team science intervention.

INTRODUCTION: Clinical/translational science (CTS) is team-based, requiring effective collaboration and communication across many disciplines involving a variety of stakeholders. We implemented a pre-doctoral team-based training model with didactic and experiential curricular interventions to support the development of CTS research skills in a cross-disciplinary team environment. We assessed the potential impact of this new training model as a team science intervention that can catalyze new cross-disciplinary collaborations across the institution. METHODS: Between 2016 and 2020, 32 pre-doctoral students and 26 co-mentors participated in the assessment of the CTS Team program over a two-year period of TL1 training grant support. Data collection and analyses followed a program logic model and used a variety of metrics for clinical and translational scientist career success. RESULTS: CTS training in the context of CTS Teams supported improved self-efficacy for clinical research skills and resulted in a significant increase in the frequency of participation in cross-disciplinary collaborative activities by both trainees and mentors. Most CTS Team co-mentor pairs had not previously collaborated. Two-thirds of the co-mentors plan to continue collaborating, and most (85%) currently use or plan to use collaboration tools, for example, written collaboration plans, authorship agreements. CONCLUSIONS: The CTS Team training model provides a unique clinical and translational science team training experience that embeds authentic cross-disciplinary research collaboration into PhD research projects. It establishes trainee cohorts that are diverse in terms of scientific disciplines and translational research phases, and creates a new cross-disciplinary community of practice across faculty members and research groups in multiple colleges.

Randomized Controlled Study to Test the Effectiveness of Developmental Network Coaching in the Career Advancement of Diverse Early-Stage Investigators (ESIs): Implementation Challenges and Lessons Learned.

Introduction: Adding developmental networks (DN) to grant-writing coaching can significantly enhance ESIs' research careers. Herein, we present study design, ESIs' characteristics and encountered challenges/lessons learned and their resolutions when deploying/implementing (a) NCR algorithm(s), (b) recruitment/retention and (c) implementing DN intervention. Methods: Nested Cluster Randomization (NCR) design governs this study implementation. The sample size is 220 ESIs intending to submit an NIH K, R, U, and/or Minority Supplement application(s). Primary outcome: intensity/sustainability of grant submission(s)/funding(s), measured by time to/between application(s). Outcome(s) analyses modes: summaries, Kaplan Meir and Cox proportional hazard models as a function of randomization groups and other predictors of outcomes. Results: In the present study, we recruited two cohorts of ESIs (N = 85): 39% African Americans, 18% Latinx, 18% Whites, 20% Asians and 6% Hawaiian/Pacific Islander/other ethnicities; 65% are women; 73% are assistant professors, 4% are Associate Professors and 23% are instructors/scientists/post-doctoral. Participants' disciplines: 32% basic/biomedical, 36% clinical/translational and 32% social/behavioral. Proposal(s) mechanisms: 61% research grants (R series), 31% career development (K series), 7% support of competitive research (SCORE) and 1% National Science Foundation applications. NCR did produce balance in the distribution of ESIs' demographics, sex at birth, ethnicity, professional appointments, background disciplines, and mechanism of sought funding. Lessons learned/challenges: NCR implementation was methodologically challenged during implementation by added constraints (e.g., assigning coaches to the same randomization arm of their participants as well as blinding them to ESIs' randomization group). Recruitment and retention were hampered by the COVID-19 pandemic and more progressive and innovative strategies were needed to heighten the visibility and outreach of this program. DN delivery was also affected by the pandemic and monitoring of ESIs' engagement and facilitation of communications interventions were needed. Resolution of these challenges effectively reconfigured NCR algorithms, recruitment/retention plans, and DN intervention delivery. We intend to recruit an additional 135 ESIs focusing on underrepresented scholars from RCMIs, CTSAs, and other programs. COVID-19 rendered this program 100% virtual, with recruitment/retention challenges and substantial disruption of ESIs' research. We may extend the grant writing period, coaching, and Mock Study Section support.

State of the Practice of Team Science in Speech-Language Pathology and Audiology.

Purpose The purpose of this study was to investigate engagement in collaborative research (team science) and perceptions of related knowledge and skills to inform personnel preparation and workforce development efforts. Method A questionnaire was used to solicit information about the team science-related experiences of 220 doctoral students, faculty, and research scientists in speech-pathology and audiology. Additionally, the questionnaire surveyed participants' perceptions of readiness, benefits, and challenges to team science. Results Results demonstrated low percentages of respondents had received training in collaborative research (17%), and those with training were more likely to engage in cross-disciplinary collaborative research. Group differences were found with female researchers reporting lower psychological safety than male researchers. The most frequently cited advantages of team science included diverse perspectives, collective expertise, innovative ideas, and productivity. Conversely, common challenges included time constraints, finding collaborators, and differing expectations. Implications Because this study yielded group difference in psychological safety between groups that differed in gender and position, results suggest additional efforts may be necessary to ensure that imbalances in the power structure of members are not allowed to dissuade members from actively contributing to team activities. Additional training opportunities in team science could support the degree to which professionals in communication science and disorders engage in collaborative research. Supplemental Material https://doi.org/10.23641/asha.15506034.

The Black Voices in Research curriculum to promote diversity and inclusive excellence in biomedical research.

Underrepresentation of Black biomedical researchers demonstrates continued racial inequity and lack of diversity in the field. The Black Voices in Research curriculum was designed to provide effective instructional materials that showcase inclusive excellence, facilitate the dialog about diversity and inclusion in biomedical research, enhance critical thinking and reflection, integrate diverse visions and worldviews, and ignite action. Instructional materials consist of short videos and discussion prompts featuring Black biomedical research faculty and professionals. Pilot evaluation of instructional content showed that individual stories promoted information relevance, increased knowledge, and created behavioral intention to promote diversity and inclusive excellence in biomedical research.

Gender differences in the expression and cognition of empathy among nursing students: An educational assessment study.

BACKGROUND: In the medical context, previous studies found that female care providers present more empathy with patients than their male counterparts. Yet, the explanatory mechanisms for such a difference are not fully explored. PURPOSE: Guided by the message design logics, this study looked to assess the differences in the expression of empathy by male and female nursing students. METHODS: The data included transcripts of conversations between 343 undergraduate nursing students and a virtual patient. RESULTS: Study hypothesis, which was supported, predicted that when presented with opportunities to express empathy female students will use such opportunities more frequently than male students. RQ1 assessed the level of empathic responses and showed no differences between male and female students. RQ2 focused on the cognitive models of empathy and showed that female students had more complex maps that included a larger number and levels of empathy-related concepts. CLINICAL RELEVANCE: While both male and female students could benefit from education and support in effective expression of empathy, tailored education could promote the recognition of opportunities to be empathic among male students. Clinical communication skill training programs should consider gender-sensitive interventions to support and promote male nurse empathy skills.

Electronic health record use among cancer patients: Insights from the Health Information National Trends Survey.

Over 90% of US hospitals provide patients with access to e-copy of their health records, but the utilization of electronic health records by the US consumers remains low. Guided by the comprehensive information-seeking model, this study used data from the National Cancer Institute's Health Information National Trends Survey 4 (Cycle 4) and examined the factors that explain the level of electronic health record use by cancer patients. Consistent with the model, individual information-seeking factors and perceptions of security and utility were associated with the frequency of electronic health record access. Specifically, higher income, prior online information seeking, interest in accessing health information online, and normative beliefs were predictive of electronic health record access. Conversely, poorer general health status and lack of health care provider encouragement to use electronic health records were associated with lower utilization rates. The current findings provide theory-based evidence that contributes to the understanding of the explanatory factors of electronic health record use and suggest future directions for research and practice.

Using social media to assess care coordination goals and plans for leukemia patients and survivors.

Care coordination has been shown to have a positive effect on the management of chronic disease. Specific to the management of leukemia, coordination may occur between primary care physician, medical and radiation oncologists, surgeons, cardiologists, and genetics specialists. Experiencing gaps in communication and care coordination, many health consumers seek instrumental support in their social circles, including online forums and networks. The goal of this theory-guided study was to provide an in-depth assessment of how individuals use online forums to deliberate about their goals and plans for leukemia care coordination. Guided by the planning theory of communication, the data were collected from the American Cancer Society Cancer Survivors Network and included 125 original posts and 1,248 responses. Thematic analysis and axial coding were applied to analyze the data. Goal-related themes included overcoming the diffusion of care coordination and achieving health management cohesion. Planning themes included social health management, communication self-efficacy, and role deliberation. Online patient forums provide an interactive platform for patients and caregivers to engage in active conversations, which in turn can serve as identifiers of care coordination needs. Communication with those who share similar experiences allows cancer patients and survivors to accumulate functional health literacy, gain communication self-efficacy, and articulate a care coordination role acceptable to them.