Department of Epidemiology and Biostatistics – One Big Idea

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A Little Big Idea: Intensive Scientific Retreats

Submitted by Steven Cummings on April 25, 2019 - 8:06pm Last revised by Open Proposals Admin on September 6, 2019 - 5:17pm.
Big Idea Status: 
Awarded

 Phase 2 Proposal

 Co-sponsors:  Steve Cummings and Mark Pletcher

Other sponsors and supporters:  Maria Glymour, Jacquelyn Torres, Tom Newman, Lydia Zablotska, Mike Nevitt, June Chan, and Isabel Allen

Background

Our academic time is fragmented, interrupted and often conducted in silos.  We make more progress, and generate good ideas, when we have long blocks of protected time to focus on a shared project, or a new area of collaborative research with other faculty.  Many organizations successfully use targeted retreats to create collaborative new directions.  Epi and Biostat should, too.

Proposal

Establish a fund for Intensive Scientific Retreats. Retreats would be proposed and conducted by groups of Epi and Biostat faculty. They would submit a proposal for support of a retreat that would be evaluated by the Chair and a small faculty committee.

The team proposing the retreat would submit a 1 or 2-page proposal describing 1) background and areas of focus, 2) goals and products (e.g. a strategic plan for a new research direction, new projects leading to grant proposals, detailed plans for a new Division, or learning a new area or skill, such as machine learning, that may be valuable to creating new research proposals), 3) description of the participants, involving at least 4 Epi and Biostat faculty, and potentially including others and UCSF and expert(s) / scientist(s) outside of UCSF, 4) duration (1/2 to 2 days), location, and plans for protecting the time and attention of attendees (e.g. no mobile devices), and 5) requested support for space rental (if needed), food during the retreat, reimbursement of external scientist/expert(s), materials or other anticipated expenses.

Examples (provided by co-sponsors and supporters of the Idea)

These retreats could be integrated into other Big Ideas, such as Diabetes, as a way to start or accelerate development of those projects.

Here are examples from faculty who support and co-sponsor this Big Idea:

  • Planning a Center for Public Health (Kirsten's idea) that would work with local communities to provide accurate information on effects of environmental exposures and, potentially, initiate new studies.  The retreat would develop a comprehensive plan, resources needed, team, and timeline.  A goal would be to strengthen Environmental and Occupational Epidemiology in the Department.
  • Introduce Epi Biostat faculty to “How to Use Actual UC-wide EHR data.”  Participants would bring or develop a project, and execute the beginning of that project - with code, table shells, and manuscript outlines done by the end of the retreat.  They would also establish a timeline for completion of the project.
  • Plan the new Life-course Division, with its faculty mapping out the conditions, methodologies, collaborations and organization. Within this area, there are several potential topics that might benefit from retreats to map out research, teams, and proposals on social determinants of healthy aging; biological mechanisms of social inequalities in aging; life-course epidemiologic methods, and aging; social policies to reduce the population burden of Alzheimer's disease.
  • A disease-oriented project on shortness of breath could start with a retreat to map out several causes -  age-related, environment-related, disease-related, economically-related.  Then develop a plan of research for each potential cause and methodologies to address it.
  • A retreat could address a broad topic that would lead to more specific proposals for research and funding, for example (from Tom Newman): How to use epidemiologic methods to improve healthcare value or (from June Chan): novel uses of mobile technologies for epidemiologic and health research.

Costs

We propose that $20,000 be set aside for initially funding 3 retreats. Potential budgets would be included in proposals for Retreats.

Evaluation

A “Retreats Committee” (or Epi-Biostat leadership) would review the reports of the results of the retreat and subsequent accomplishment and products from the 1st 3 retreats. and make recommendations about whether to continue and how to improve the Scientific Retreats program.  

This Big Idea meets the review criteria

1) It would engage a very broad and diverse group of Epi and Biostat faculty; essentially, any individual could propose or may participate in a retreat pertinent to their area of interest. 2) An essential goal of a retreat would be to plan future grant proposals and/or outreach to potential donors. 3) Successful retreats would lead to new projects and new collaborations that would, by nature, increase the visibility of the Department within UCSF and/or external communities. 4) This is essentially a pilot program of 3 retreats that would be evaluated based on their products.

 

Comments

Kirsten Bibbins-Domingo - April 28, 2019 - 2:19pm

Dear Steve - Thanks for getting us started with an outstanding idea!

Dear everyone else in DEB. - What do you think of Steve’s idea?  Give him some feedback to help improve this concept.

Here’s my question to everyone - What would make you attend or not attend such retreats?  The science?  The location?  The people?  The food?  the prospect of specific f/u after the retreat?   How do we lower the barriers to participation and keep the quality high?

Isabel Allen - April 28, 2019 - 9:38pm

Love this idea and I don't need a faraway place just slightly remote from MH.  Probably half a day - maybe include breakfast but end before lunch.  Not sure how to start this, though, would be good to have a proposal for the funding but then have specific assignments to some participants to fertilize the ideas before the retreats.

Thomas Newman - May 8, 2019 - 5:23pm

To me, to really be a retreat it would need to be more than 1/2 or even1 day.  Really getting away and having down time for free-ranging conversations (perhaps during walks along the beach or in the trees) would make this different enough from usual day-to-day work to be appealing to me.  But it would need to be organized by some one good at such things.

Maria Glymour - May 8, 2019 - 8:04pm

I agree that focused time is invaluable to difficult, serious work.  I also suspect Tom is right - we will need more than a day to do anything notable.  If it's <4 hours, the advantages of short commute time and reliable wifi in MH2500 probably offset the disadvantages of being too close to all the normal demands.  Ideally if we were doing a grant, we could get substantial writing and thinking about prelim studies done together during such a retreat.  This might be especially valuable for program projects or that kind of sprawling project that needs integration of a lot of disparate parts. 

Lydia Zablotska - May 10, 2019 - 5:33pm

Great idea. I also agree with Tom and Maria's comments. What about a DEB competion of teams who have an idea they want to work on and a list of people they want to invite to brainstorm? Winners will go on a 3-4 day retreat to flash the project out and submit an application for funding.

Charles Mcculloch - May 13, 2019 - 5:25pm

We'll need some electronic device police to confiscate them as you walk in ;-)

Jacqueline Torres - May 14, 2019 - 10:41am

Perhaps the other big ideas that seem to be pointing towards eventual program or center grants (e.g. PUMA, the global diabetes program) might adopt this mini-retreat idea as a strategy for accelerating applications for sustainable funding sources within the one-year timeline. The junior faculty/new collaborations idea could also incorporate the mini-retreat idea.

John Witte - May 17, 2019 - 10:04am

Great idea Steve! And some good suggestions about how to implement this. I agree that some of the other Big Ideas could benefit from such a retreat to help accelerate proposals, etc. Designing this in a novel way to focus and engage participants would be great.  

June Chan - May 17, 2019 - 4:13pm

Nice idea. I would be interested in attending one on digital/mHealth... which then makes the collection of devices at the door kind of hard... ! ;) 

To Chuck's point  - I observed at a high school recently that before class, the teacher collected all phones/devices in cubby containers, then returned them 5 min before the end of class.

What would attract me to attend one? the people, the topic, the location, and food. I understand John's lab does something like this annually...?? Maybe he has further tips on how to make it fun and productive?

I think the last line, about having to report back in is key, and we should have some structure or plans on what tangible product will come out of the retreat.  While I like the part about getting away and brainstorming, I think it's important to have some a priori planned HW that will be turned in and reported back. I think some of us work better when there is something to turn in...

 

 

Joan Hilton - May 17, 2019 - 5:39pm

To answer KBD, I very much enjoyed last year's DEB retreat so am content to entrust you with the format. For me, once a year is enough for these oppotunities to connect, brainstorm, and relax together.

I am more interested in collaborations that jump-start super-productive research. Check out my proposal of "platform studies." I'd love your good ideas.

Thomas Hoffmann - May 17, 2019 - 10:39pm

Great idea! Could take a quick survey for those interested in each retreat or overall as to specifics that would increase attendance.

Bob Hiatt - May 18, 2019 - 12:23pm

I like the idea of a faculty retreat as well. For me, it would be better as a whole day (and perhaps overnight if we could afford it) experience to really get people relaxed and focused on each other. I agree that we need some sort of draconian measure to get people away from their screens. Key point for me, however, is that over the years I have noticed that there is not much interdepartmental collaboration on research projects. We tend to work with colleagues outside the DEB and even outside UCSF. If the retreat could be organized to stimulate more intradepartmental collaborations (e.g., program projects perhaps), I think it would be great for scientific as well as social reasons.

Bob Hiatt - July 8, 2019 - 7:24pm

Still like this one. My only additional comment is that even with an overnight or day and a half it would be important to select ONE topic to focus on. Time will pass quickly and having enough of it to produce a good product would be important. KBD's questions about operations and process still are important considerations.

 

Bob

Laura Jelliffe - July 14, 2019 - 10:35am

Love the idea of retreats. Similarly to a few of the other proposals, I get a bit stuck on funding a proposal to fund other proposals. I do wonder if this might be a target of its own big idea open proposal or say a "Retreats" open proposal where folks could pitch their ideas? Feels like this should be something we are just planning to do yearly as a department.

Commenting is closed.

Funding the future

Submitted by Nadia Diamond-Smith on May 1, 2019 - 4:30pm Last revised by Open Proposals Admin on September 6, 2019 - 5:17pm.
Big Idea Status: 
Review Complete

Phase 2 Proposal

Submitted by: Nadia Diamond-Smith, Jackie Torres, Patience Afulani

 Many faculty in our department, especially junior faculty, have differing streams of research but overlapping interests or complimentary skill sets and areas of expertise and would like to start working on projects together. However, setting time aside to write a new proposal or do a preliminary analysis on a topic not directly stemming from a current project can be impossible, since we are all funded on specific other grants. Supporting new proposals or projects that bring together faculty who have not previously received funding to work together will not only expand the innovation and breadth of topics that our department is contributing to scientifically and known for, but it will help bring in more funding, which has long lasting impacts on the careers of faculty, staff and students in the department, the latter of which would be involved in the resulting projects in various roles. These types of collaborations will also build community among members of the department, helping to ensure that the department can retain its faculty, especially junior faculty laying the foundation of a career in the department.

 We propose a fund that groups of faculty (at least 2) who have not previously been funded to work together can apply to. Groups can include non-faculty members, such as post-docs, students, and research assistants at various levels, however, some of the funds must be used to cover faculty time (in other words, trainees cannot do all the work). Funds will be prioritized for groups that have at least 1 junior faculty member (assistant level) participant. Funds will also be prioritized for proposals that involve members from other departments in order to create more collaboration between UCSF departments. Funds can be used to support a small portion of faculty salary for a limited time to write grant proposals for funding research projects they are interested in pursuing together. The funds can also be used for such groups to do a secondary data analysis project together that is envisioned to directly lay the foundation for a grant proposal (and ideally publications as well).

 

Proposals to the fund would be short (1-2 pages) and describe the research idea that the faculty would like to write a grant/do the analysis for, the innovation of the partnership, and why the request salary time and amount are necessary. This would include how their funds would be distributed and among whom. For grants, the funding mechanism to be pursued should be stated clearly, as well as a timeline towards reaching that goal. For data analysis projects, the longer-term vision (eventual funding or publication) and target funding source or journal should be stated, as well as timeline. Proposals would also discuss why this groups cannot do this without the support of this extra salary coverage and how this will expand their current work, build collaborations, and develop new areas of focus for the department as a whole.  

 Total budget requested: $100,000

 Structure: Groups can apply for support of up to $20,000 (total) to support their time/effort to write proposals/do analysis together. We anticipate that this will fund at least 5 groups (or more if some groups request smaller amounts). Groups can be of any size and money/time can be allocated in the way that the group see fit, and within any time frame the group sees fit. For example, the funds could be spread evenly (or not) among at least 2, but up to a larger group, of members, and it could be used within 1 month or spread over the course of a few months.

 We envision that there could be 2 funding cycles. Cycle dates are proposed to align roughly with NIH cycles (although not all proposals need to be grant proposals), so funding would be available about 4 months before the next submission cycle. Proposals will be reviewed by a committee of department members and 2-3 groups will be selected at each cycle. Midway through the process, the selection committee will review the success of the proposal submissions. Success would be measured by 1) submission of grants, 2) time to grant submission, 3) completion and dissemination of any secondary analyses that served as preliminary data for grant proposals. This will help us quantify the amount of new interactions that the funded faculty members had that they would not have had otherwise AND/OR any interactions beyond the DEB that were generated from the funds.  If modifications to the process are needed, it will be adjusted before Round 2.

 Milestones:

 Round 1: Call for proposals (August 15), proposals submissions (Sept 15), selections announced (Oct 1)

 Review Round 1: March 2020: review progress of Round 1 grants

 Round 2: Call for proposals (April 15), proposals submissions (May 15), selections announced (June 1)

Comments

Nadia Diamond-Smith - May 1, 2019 - 4:33pm

Co-written by Patience Afulani and Jackie Torres

Thomas Newman - May 8, 2019 - 5:18pm

I agree that this is a problem and the potential solution seems viable. Worth considering even if it is not selected as the Big Idea.

Bob Hiatt - May 8, 2019 - 5:57pm

I like the idea of encouraging interdisciplinary collaboration within the department, so Yeah. But not clear if faculty really need salary support to do this. There could be some other sort of recognition to highlight such novel collaborations.

Maria Glymour - May 8, 2019 - 7:59pm

Preferentially funding department members who have not previously collaborated to develop their work together -- especially if at least one of the people involved is a junior faculty member -- sends a powerful message about our priorities.  Bob is probably right that funding might not be strictly necessary, but I've participated in this type of pilot funding project before, and the money definitely made a difference at least for me (call me shallow). It just helped me get through those first awkward conversations when we were trying to figure out how to communicate and if the idea had legs.  Also, if there's even a little bit of money you can list it on your CV which may help get more money. 

Ali Mirzazadeh - May 16, 2019 - 1:02pm

Great idea - I do agree that small money for pilot study, a secondary analysis of existing data or writing up a key paper lead to bigger grants. The department will benefit form making these opportunities (salary and time) to faculty and students. 

John Witte - May 17, 2019 - 9:58am

Great idea! Many years ago the Cancer Epi Division (and maybe others) had a small grant program for pilot projects for faculty. Maybe worth re-launching that as this program. 

Joan Hilton - May 17, 2019 - 5:35pm

Hi Nadia, I agree with you that working as partners can reap large benefits. My proposal also would require collaboration among colleagues. That and deeping immersing in a topic can make work all the more rewarding. I'd love to team up to bring about both our ideas.

P.S. You might find this interesting, I do!  https://en.wikipedia.org/wiki/Pair_programming

Thomas Hoffmann - May 17, 2019 - 10:39pm

Great idea! Agree providing a touch of funding sets priorities / incentives.

Bob Hiatt - May 18, 2019 - 12:13pm

OK. OK. So funding helps. I understand. In fact for a number of years now I have supported purposefully transdisciplinary small grants/pilots under the 3T's rubric (Team, Transdisciplinary & Translational Science) to stimulate bringing people together with different perspectives on a common problem. So, all for it. Maybe the thing that struck me earlier was that money may not be needed to bring people together per se, but if there is a focus on a pilot project that could lead to a larger proposal (e.g., R-type grant) then I think it makes more sense. Cancer Center T3 pilots have been around $50K for one year.

Steven Cummings - July 8, 2019 - 3:15pm

Am I correct that, in essence, this would provide a little support for several faculty to work together on a proposal for research in a new area?  Perhaps a shorter more intensive day together would quickly reveal whether a new collaboration would have an excellent chance at external support.  Seems like it should be open to experts outside Epi if that would maximize the chance of success of a proposal.

Bob Hiatt - July 8, 2019 - 7:10pm

Nadia,

I still like the idea of bringing people together internally to take advantage of the great diversity of expertise and subdisciplines within our department. But not clear how this differs from funding for small pilots to generate findings for larger R-type projects (e.g., the T3 proposals I mention above.

Bob

Laura Jelliffe - July 14, 2019 - 10:29am

I do think this is very cool and needed. The idea of funding a proposal to fund other proposals is what has me a bit stuck. I wonder if there might be a way for this idea to be its own kind of "Big Idea" call but specific to the grops you outline?

Commenting is closed.

The UCSF Epi/Center Lectureship

Submitted by Robert A. Hiatt on May 3, 2019 - 9:42am Last revised by Open Proposals Admin on September 6, 2019 - 5:17pm.
Big Idea Status: 
Review Complete

Phase 2 Proposal

 

Submitted by Bob Hiatt, John Witte, and Maria Glymour

Background

The Department of Epidemiology and Biostatistics is virtually unique on campus in not being well defined as either a basic science or a clinical department, but rather in the center of campus academic research and teaching. In many ways are (and could be more) supportive of progress across all UCSF departments and centers. Being the EpiCenter is a way of expressing our mission in research and training that is at the center of biomedical research because the disciplines of epidemiology and biostatistics are key to understanding and solving challenges in health and disease at all levels of biologic organization from “cells to society”.

Proposal

This proposal (Big Idea) is to sponsor an annual named lecture (The EpiCenter Lectureship) on topics that illustrate how epidemiologic and biostatistical methods and perspectives are central in solving important problems (e.g., dementia and cognitive decline, the control of HIV/AIDs and emerging infections, health inequities, climate change and health). This would draw attention to the department in a really intellectually stimulated way. The proposal is ‘outward facing’ and intended to educate and inform a broad audience across UCSF and related stakeholders. Other noteworthy Big Ideas are ‘inward facing’ and designed to strengthen the work we do in the department. These approaches might be considered together as complementary in advancing the interests of the DEB.

The idea of establishing a formally named EpiCenter Lectureship within the DEB is that it would specifically call out the disciplines of epidemiology & biostatistics as the core to successfully addressing complex contemporary problems that would benefit patients and populations. It does not duplicate the annual Population Health Colloquium because it will be focused on epidemiologic methods and solutions.

Examples of high-profile outside speaker who would meet this challenge might be:

            Miguel Hernan – Causal Inference and Population Health Problem Solving

            Michael Marmot - Social Justice and the Determinants of Health

            Sherman James – John Henryism, stress and illness

            David Hunter – Genomics and the Future of Epidemiology

            Lisa Berkman or Ichiro Kawachi – Social support, social capital

            John Ioannidis – “Evidence”-based medicine and Epidemiology

            Valarie Beral – Largescale meta-analyses and women’s cancers.

            Muin Khoury – Precision population health and population genomics

Approach

A small committee would be formed to nominate and select speakers to invite based on the criteria that they represent forward thinking in the field and applications to the improvement of the health of populations and communities. We would also want them to be engaging speakers and to represent the gender and race/ethnic diversity of our discipline. The committee could distribute suggestions for nominees to the whole department to build broad support and involvement.

In coordinating with  speaker confirmation, full-scale planning for the event of the EpiCenter Lectureship would be operationalized. Anticipated attendance might be 150-250 people. It could be open to the broader academic community in the Bay Area and the public with proper planning.

The visit of the named Lecturer would be planned for at least two days and include smaller seminars open to all faculty and students as well as one-on-one meetings to pursue ideas and projects of joint interest.

We would heavily advertise the event through departmental means and School of Medicine and Campus public relation offices.

Financial Support

On an annual basis $20,000 would go towards the support of the annual lecture from and an outside institution and associated activities. This would cover airfare, hotel (2 nights), ground transportation,  and honorarium (~$1500-2000) and incidentals. Sustained support for such an undertaking could be a naming opportunity for a donor that could endow the EpiCenter Lectureship.

Evaluation

Success of the EpiCenter Lectureship would be based on attendance and feedback solicited at the time from attendees. Other means of evaluation could include social media recognition (e.g. Tweets) and recognition by campus leaders outside the DEB. The EpiCenter Lectureship should be considered a pilot to be assessed after one and two years to determine whether they should be continued.

Comments

Maria Glymour - May 8, 2019 - 7:50pm

The idea of bringing high profile speakers to talk about methods applied to urgent contemporary issues is very appealing.  There's some overlap w/ the proposal from the Soc Pop consortium.  For $50K, is this going to be multiple lectures or are we going to have one annual speaker + an awesome party?  

Or do you imagine people coming as "in residence" for a while to prompt more dialogue and collaboration?

Lydia Zablotska - May 10, 2019 - 5:28pm

Great idea. What about using the funds not only for a lecture but also to support a short residency/ subbatical for eminent epidemiologists to visit our department. This would enrich our educational programs, and, potentially, spark some extramural collaborations for our faculty.

John Witte - May 17, 2019 - 9:54am

Great idea! It seems like we should could even do this more than once a year. What would the $50k go toward? I think the honor and travel might suffice for many of our colleagues.  

June Chan - May 17, 2019 - 4:32pm

similar question as John/Maria... $50K seems like alot, unless the person is staying for a while, or you were suggesting we pay them? I agree with John, a lot of folks would do it for the honor (to put on one's CV), travel, and a nice meal maybe...

May I suggest that we combine this idea/theme with an effort to invite or feature women scientists or other under-represented groups in medicine/public health; or highlight folks who do research in eliminating public health disparities  That would distinguish it from other Dept of epid "speakerships" out there, and sync up with UCSF's leading role in promoting diversity in medicine/science/STEM. 

Bob Hiatt - May 18, 2019 - 12:50pm

Thanks for the supportive comments. Seems like most concern is about the $50K proposed as being too high. I have to admit that I didn't try to be too specific on the budget, so here is another try: Flight ($500-1000), hotel ($200-300), ground transport ($200), honorarium (usually expected I think - $1500), incidentals ($300)...so maybe $3000 for the speaker. Then I was thinking of perhaps the need to rent a venue if we are going big for the campus and public and reception catering (~$10-15,000) depending on size of attendance. So that brings it down under $20K. Better? We could decide on increasing the length of the visit or having more than one a year, if initially successful.

I am, of course, fully behind iniviting women and emphasizing health inequities as well as the discipinary tools of epidemiology and that is why Valarie Beral and Michael Marmot were suggested. I have a longer list that includes suggestions like Alice Whittemore, Sonia Hernandez-Diaz, and Lisa Berkman, but think that if we like this idea enough, we should have a group process to select speakers for the EpiCenter Lectureship

 

Laura Jelliffe - July 14, 2019 - 10:27am

Love this and my gut reaction was -- "well of course we should be doing this" and given we are not, might we make this say a 5 year $25,000 thing to cover 5 years?

Commenting is closed.

Hunters Point Shipyard epidemiological study

Submitted by Lydia Zablotska on May 7, 2019 - 1:56pm Last revised by Open Proposals Admin on September 6, 2019 - 5:17pm.
Big Idea Status: 
Review Complete

Hunters Point Shipyard has a legacy of ground contamination by particulate radiation. While the politicians are arguing who is responsible for the cleanup, wether the previous cleanup was done correctly or not, and what should be done about it, epidemiologists have a role to play to provide the local community and the larger Bay Area community with solid data to develop evidence-based solutions. UCSF and UC Berkeley are already working together to analyze the quality of procedures which were used to test for radiation contamination. The next step would be for epidemiologists and biostatisticisns to put their heads together to quickly analyze the data on population health in Hunters Point which coul be easily accessed. For example, among those who have lived at Hunters Point for at least five years, is there any evidence of increased risks of lung cancer or bone cancer (cancers we would expect to increase with this particular type of radiation)? Or, has there been any increase in respiratory problems in children?

The 1990 NCI report of populations living near nuclear facilities concluded that cancer mortality rates were the same whether a reactor was nearby or not. While this was a negative finding, it proved to be extremely effective in discussions with local communities. As the institution literally next-door to this community, we should provide residents of Hunters Point with the evidence on potential risks to their health.

Comments

Maria Glymour - May 8, 2019 - 7:42pm

I realy love the vision for local public health relevance, especially for topics potentially affecting health inequalities.

John Witte - May 17, 2019 - 9:49am

Very exciting opportunity for the DEB to be involved with a local public health issue, in an underserved population. Is there concern about having sufficient power to detect an association (and having confidence in a negative finding)? Who else would you envision being involved with such a study?

Bob Hiatt - July 8, 2019 - 7:18pm

Dear Lydia,

I think this is a really important application of the expertise we have in the DEB and UCSF. But you should know that we have been working on such a detailed epidemiologic analysis of cancer rates (expected/observed) using GBACR data in Scarlett's group. Lung cancer has popped up as site with possible excess occurence and further studies have been suggested to the SFDPH. Other proposals have introduced the idea of sampling tumor blocks from residents to determine of any mutation signatures (USCF 500) can be identified that might be back linked to environmental exposures.  So you may already be aware of these efforts, but make sure to make existing intradepartmental connections on this topic stronger if your Big Idea goes forward.

Bob

Joan Hilton - July 9, 2019 - 12:11pm

Hi Lydia,

I think this is a worthy idea. How can I help you pursue it?

Paul Wesson - July 14, 2019 - 9:42pm

I really like the idea of locally relevant public health research. Would this initiative also include a formal mechanism to communicate findings back to the community (e.g. community forum, town halls, newsletter, etc.)?

Lydia Zablotska - July 14, 2019 - 10:33pm

Thank you very much for your interst in this proposal and for your comments. I wanted to let everyone know that we are not proceeding with this proposal because recently our colleagues from the Greater Bay Area Cancer Registry (GBACR) (Drs. Scarlett Gomez and Iona Cheng) completed a study of cancer incidence of Bayview-Hunters Point residents (https://www.sfdph.org/dph/files/listenshareconnect/3-7-19_BVHP_Cancer_In...).

Thank you, Scarlett and Iona!

 

Commenting is closed.

Establish a Population and Maternal-Child Health Accelerator (PUMA) program

Submitted by Laura Jelliffe on May 8, 2019 - 6:39am Last revised by Open Proposals Admin on September 6, 2019 - 5:17pm.
Big Idea Status: 
Review Complete

Phase 2 Proposal

Advisors/ Partners: Jacquelyn Torres, Patience Afulani, Brittany Chambers, Nadia Diamond-Smith, Deb Karasek, Dilys Walker, Maria Glymour   

While a great deal of research related to maternal and child health is being conducted within the Department of Epidemiology & Biostatistics (DEB), no DEB mechanism exists for connecting the work of these groups. In addition, while many of these groups work closely with clinical and other UCSF programs to leverage data related to maternal and child health currently held by DEB faculty for subanalyses and targeted products (manuscripts, grants), no formal mechanism exists for connecting clinical researchers and trainees with DEB faculty and data or for supporting associated analytic and investigative efforts. If such a program existed it would serve not only to connect faculty, staff and trainees within and outside of the department but it would also aid in accelerating discovery and translation focused on maternal and child health.

We propose to establish a PopUlation and Maternal-Child Health Accelerator program within the department that would work in concert with other clinical and academic programs to investigate critical maternal and child health problems with translation of innovative findings into clinical and public health settings. Our hope is that eventually, PUMA will become a nested center within DEB that serves as a hub for interdisciplinary maternal and child-health focused research wherein intense intellectual engagement, debate and progress is fostered.

PUMA would serve a critical need within the department in that it would link the multiple teams currently doing research in maternal and child health and it would allow for the creation of a virtual core of experts and data sources that could be applied to a broader scope of outcomes and health inequities than are currently being addressed by individual projects. PUMA would also provide a critical bridge to other clinical and academic programs, faculty, and trainees who often want to gain access to data but have neither the time, resources, or expertise to secure and utilize them. Examples of data that could be leveraged for this effort includes State and National birth certificate, environmental and census data, state hospital discharge data, and data related to health care, pregnancy, birth and other outcomes collected in Africa, India and in other developing settings. Through PUMA, programs and trainees could gain access to data and to department experts. As such, we believe that PUMA would lead to new and productive partnerships and ultimately to accelerated translation from data and discovery to clinical and public health interventions.

PUMA would be a multi-year effort. The first year of the program would focus on establishing the program and on creating a resource and sustainability plan. Specifically, in year one we would: 1) Convene a cross-department summit to a) learn about data that is currently in use across the department that could be leveraged towards this focus; And, b) learn about within department programs and project teams working in maternal and child health; 2) Meet with chairs and faculty from other departments to assess their data and collaboration needs for faculty and trainees and to explore co-funding opportunities (starting with Obstetrics, Gynecology and Reproductive Sciences, Pediatrics, and Psychiatry); 3) Develop a department page for PUMA that provides information on department resources and projects and personnel doing work in maternal and child health that includes an engagement tool for facilitating connections between our department and other clinical and academic programs; 4) Create a sustainability plan for funding in year two and beyond that includes outreach and potential trainings across the university depending on other clinical and academic program needs; 5) Initiate at least three demonstration projects (at least one of which will be focused on data from a developing setting; And, 6) Draft an NICHD R21/R33 phased infrastructure development grant (submission Fall 2020) to support PUMA (with an eventual eye on an R24 for obtaining further support, a T32 training grant, and nested topic-specific R21, R01, and philanthropic grants). Evaluation of PUMA in FY1 will be focused specifically on completion of activities 1-6.

Total request for the first year of the program is $100,000 which includes: $15,000 for a Program Coordinator at 15% time; $40,000 for faculty support at 5% maximum time for demonstration project leads (with a focus on junior faculty); $7,000 for a faculty retreat; $8,000 for website development and launch and for nested RedCap/ Qualtrics survey; $30,000 for analytic support for demonstration projects.

Of note is the strength of this project with respect to the DEB BIG IDEA review criteria. The proposed project meets and excels with respect to all criteria in that it: 1) Engages a broad group of faculty within the department (via outreach to individuals and via the proposed retreat); 2) It has the potential to attract future funding through university and clinical funding and through grants, contracts and philanthropy that would support specific nested projects and PUMA infrastructure; 3) It has the potential to dramatically increase the visibility of DEB within UCSF and elsewhere in that it will increase awareness around existing resources, will provide access to data and experts, and will lead to the acceleration of research on maternal and child health; 4) It will be able to show significant project within one year across multiple fronts based on targeted and time-specific deliverables; 5) It includes a focused sustainability plan that will require no or minimal departmental funds after the first year.

 

Comments

Thomas Newman - May 8, 2019 - 5:26pm

Sounds good!  I would be interested in contributing to this.

 

Laura Jelliffe - May 9, 2019 - 7:35am

Tom that would be FANTASTIC!

Maria Glymour - May 8, 2019 - 7:40pm

Terrific domain: how does this integrate/overlap with the larger population health data initiatives?  Is the emphasis data access or substantive expertise or facilitating access to technical skills? 

Laura Jelliffe - May 9, 2019 - 7:34am

I think there is a HUGE overlap with the other health data initiatives -- at least that would be the hope. The idea is to really come together around maternal and child health where this is less about getting data and technical skills to those that need and want them (although that is certainly part of the mix) but more about partnering towards solutions where we don't just provide methodological expertise but we also provide content expertise and participate in solutions. Our department is incredibly unique in that there is an incredible depth of methodologic, clinical and public health expertise. I am suggesting that we are UNIQUELY positioned to LEAD in this space.

Deb Karasek - May 10, 2019 - 1:45pm

This is a great idea, especially given the expertise within Epi and potential to coordinate this work across departments. I assume PUMA would include population health topics that are specifically related to MCH? What about a lifecourse approach?

Laura Jelliffe - May 10, 2019 - 4:42pm

Thanks Deb. Yes, I think work on Developmental Origins might fit in here as well re: Lifecourse.

John Witte - May 10, 2019 - 5:50pm

Very interesting and exciting idea! I especially like the bridge to other people and groups who have not yet had an opportunity to work in this area.

Laura Jelliffe - May 11, 2019 - 6:13am

Thank you Brittany Chambers for suggesting we use "inequities" rather than "disparities" -- I have made those changes.

George Rutherford - May 11, 2019 - 6:55am

This is a timely idea that would help organize MCH epidemiology activities within the department and across department. This might also serve as a hub for ACES and trauma-informed care both for children and women.

Laura Jelliffe - May 14, 2019 - 4:38pm

Thanks George. Agreed, I think this would be a good place to center ACES work and also other develeopmental origins work. Perhaps most importantly to create a place where this expertise is certralized and shared.

Jaime Sepulveda - May 12, 2019 - 1:44pm

I really like the idea of focusing on MNCH. Hope the MNCH Cooperative, led by Dilys Walker at IGHS, can be an active partner on this. And i like the PUMA acronym!

Laura Jelliffe - May 14, 2019 - 4:41pm

Thanks Jaime.. If this goes forward we will need to connect with Dilys for sure.

Nadia Diamond-Smith - June 20, 2019 - 10:51am

I agree, this seems like a great group to overlap with (as someone part of it!), and like it would make sense given the new division of lifecourse epi!

Brittany Chambers - May 14, 2019 - 9:59am

This is a great idea! I would recommend also adding a component to talk with "clinical and academic programs, faculty, and trainees who often want to gain access to population-based data but have neither the time, resources, or expertise to secure and utilize them;" to explore what data, access, and supports they may want and need.

Laura Jelliffe - May 14, 2019 - 4:40pm

Thanks Brittany. Agreed, this should be a real dialogue with the other departments to explore what would be needed for them to support such an effort -- a key component for sustainability.

Jacqueline Torres - May 14, 2019 - 11:10am

Agree that this is a great idea. I'm wondering if there are specific opportunities for program or center grants through the NIH (or other funding sources) that might serve as sustainability targets. One the one hand, it would be nice to dream big, beyond the boundaries of what is fundable based on NIH priorities -- but identifying future opportunities might help facilitate very concrete discussions about necessary data sources and resources. 

Laura Jelliffe - May 14, 2019 - 4:49pm

Totally agree. The idea is to create a home base for this kind of work so we can respond rapidly to these kind of big program and center grants that my be generated out of our department or others. I think sustainability requires a eye towards the NIH, foundations and clinical programs within UCSF -- maybe even UCOP if for example our reach went beyond just UCSF (dream big right). I think this can be done if the focus is not just on creating the accelerator rather on creating a structure that can accelerate work tackling critical health and developmental challenges that contain within them deep inequities and social determinants.

Patience Afulani - May 14, 2019 - 5:33pm

I think this is a great idea too. But perhaps it will be useful to leave it open as "to investigate critical maternal and child health problems with translation of promising findings into clinical and public health settings" i.e is take out "using big datasets" from that sentence. Big datasets is a key approach, but it will be great to not only focus on that and allow for diversity in methodologies

Laura Jelliffe - May 14, 2019 - 6:23pm

Great point. I made this change.

Joan Hilton - May 17, 2019 - 5:25pm

Hi Laura, I believe that this is another example, like Jaime's, of a broad research program that could benefit from the structure of a "platform study." It's a means of chipping away at the broad goal via a series of related studies, conducted in the sequence that builds knowledge while using participant resources efficiently.  I'd be happy to discuss the specifics any time.

Commenting is closed.

Investing in human capital to enhance collaboration, expertise and establish DEB as knowledge hub for modern sampling methods for health disparities research.

Submitted by Meghan Morris on May 10, 2019 - 10:27am Last revised by Open Proposals Admin on September 6, 2019 - 5:17pm.
Big Idea Status: 
Awarded

 

Phase 2 Propsal

 Leadership: Paul Wesson, Meghan Morris, Thomas Hoffmann, Maria Glymour and YOU!

 1. Rationale. Sampling is a cross-cutting challenge in multiple research domains (including health disparities, genomics, disease-specific research, health care, and precision medicine), and a foundational epidemiologic topic. This initiative will have a broad appeal to departmental and university research and training efforts.

 2. The Idea. This year-long - four-quarter block - initiative will establish DEB as a knowledge hub for sampling methods to improve population science and health disparities research. Each block will cover a pressing challenge as it relates to sampling and population science, and methodological approaches to address those challenges. Month 1 of each block will include a 2-4 hour themed workshop led by a topic expert (e.g., external academic or industry, DEB member) paired with a DEB faculty expert; with the goal of establishing foundational knowledge and encourage intra/extra-departmental collaboration. Two ninety-minute monthly sessions complete the block; held in a journal club format with a DEB facilitator (paid) with the goal of applied methods/theory connecting public health implications of the topic introduced during the workshop. We envision this culminating in a workgroup forming with a core group of DEB members engaged in collaborative implication (e.g., theoretical papers, applied research projects, commentary/op-ed articles, department courses, grants). The year-long series will increase all attendee’s overall knowledge of sampling methods and strengthen expertise necessary to establish our department as a hub for modern sampling methods for population research. The tentative curriculum is as follows: (Block 1) complex sampling designs for representative samples, (Block 2) sampling for hard-to-reach populations, (Block 3) techniques to estimate the “dark figure”, i.e., assessing the magnitude of unreported data points (selection bias) for hard to reach populations, including estimating population size, and (Block 4) internal and external validity concerns as they relate to pooled data sources, including tools to address inconsistent sampling strategies fielded for different population subgroups such as racial/ethnic minorities.

 3. Importance. Sampling is a core study design component and the origins of the analytic sample shape analytic decisions, interpretation, and public health relevance of our research. Many of the technical concepts that arise in sampling relate directly to broader analytic ideas (e.g., the Horvitz Thompson estimator as the basis for inverse probability weighting and marginal structural models). Notwithstanding debates about the importance of representative sampling1, substantial evidence documents the difference between individuals who participate in health studies and the general population about whom we often hope to draw inferences.2,4,5,6,7  At the same time, systematic approaches to transporting effect estimates from one sample to another are being popularized8,9. Many of the statistical tools we use are built from the foundational assumption that our data set comes from a simple random sample. An important contribution from this series will be to highlight and explore this foundational assumption so that we are all better informed on when it is appropriate (and inappropriate) to use certain statistical tools. As far as we know there is not another “hub” focused on sampling let alone cutting edge sampling methods with a methodological and conceptual focus.

 4. General Approach. 4 domains/blocks, each 3-months, will include multiple activities allowing for varying participation levels/types, to enhance the value of the initiative for people across DEB. Proposed activities include journal clubs, case studies from diverse areas of research, workgroup participation for new methods/conceptual application, and workshop attendance and problem sets.

   Each block will launch with a kickoff in-depth training led by a visiting speaker (either academic or non-academic), paired with a DEB faculty member (if desired) with expertise in that domain. These kickoff workshops will be accessible to DEB trainees, faculty, and staff, and the greater UCSF community, regardless of population research area. The next two months will be 90-min journal-club sessions led by a DEB member. Sessions will have food and the session leader will be paid for facilitating. The journal club sessions will focus on applying the sampling challenge (or workshop topic) for public health research and health disparities research, along with applications of the sampling methodology. In addition to a journal article, participants will be encouraged to submit an issue from their own research. The facilitator can group these issues to inform a set of discussion questions/prompts for the journal club session. We hope this will allow attendees to deepen content area knowledge and apply learnings quickly to their work. These journal club sessions can foster collaboration and provide a platform for members to form workgroups leading to subsequent projects (e.g., manuscripts, commentaries, grants, courses, seminars). Each block will conclude with a meeting to discuss potential spin-off ideas to pursue. The project RA will be charged with compiling the readings (the official journal articles and others raised during discussions), slides and presentations used in discussions, and summary of key ideas from each journal club to feed into the teaching modules (see section 3b). The four blocks are:

(1) Complex sampling designs for representative samples will address design and analysis considerations related to clustering and stratification. We begin with this because it is broadly relevant to nearly everyone in health research, as nearly all major surveillance data sets (e.g., NHANES) use a complex sample design and methods such as inverse probability weighting draw on the same ideas. These designs are especially relevant for disparities research since moving beyond simple random sampling is typically essential to support research on smaller population size groups. This block will address statistical issues when analyzing clustered data. 

(2) Sampling for hard-to-reach populations, such as Time-Location Sampling (TLS) and Respondent-Driven Sampling (RDS). Traditional sampling methods rely on an existing sampling frame to draw a representative sample of the target population to generate generalizable knowledge. Many populations of public health importance are socially marginalized (and criminalized) to the extent that an existing sampling frame is infeasible (if not also unethical), e.g., sexual and gender minorities, people who inject drugs, and (in some contexts) women seeking abortion services. This block will discuss recent developments in sampling approaches for hard-to-reach populations, debates concerning the representativeness of these samples, and statistical approaches to derive inference to the underlying target population. We will also discuss how applications of these modern sampling approaches have contributed to health disparities. 

(3) Techniques to estimate the dark figure, i.e. selection bias, refers to data points missing from our analyses that, when incorporated, could change our understanding of the situation. In this block, we will examine methods to quantify this figure, particularly in reference to the “denominator problem”, i.e., what is the size of the population at risk (an essential quantity in order to estimate the burden of disease in any population). We will discuss the strengths and limitations of these methods (e.g. capture-recapture/multiple systems estimation), common applications (e.g. addressing undercounts), and analytic options.

(4) Internal and external validity concerns as they relate to pooled data sources, including tools to address inconsistent sampling strategies fielded for different population subgroups such as racial/ethnic minorities. This will include statistical tools for transporting effect estimates to new populations.

 5. Anticipated Outcomes.

5.a. Participant Learning objectives include: (1) Understand the purpose of sampling tools (e.g., stratified/ clustered designs, capture/recapture methods, time-location sampling) in population health research. (2) Understand how sample designs affect data utility and generalizability for population research. (3) Evaluate the pros and cons of different types of sampling methods used in population research for various research topics. (4) Learn how sampling should guide analytic decisions and statistical analysis appropriate for responding to select sampling challenges (e.g., transporting effect estimates to new populations). (5) Gain insights about health disparities research and opportunities to overcome sampling challenges through collegial discussions

 Table 1. Short-term goals inform the structure, content, and operation of the initiative.

Short-Term Goal

Evaluation Metric(s)

1. Strengthen relationships with experts outside DEB; increase professional network

Number of outside department

speakers and attendees; Number of workgroups formed and number of members/workgroup

2. Provide resources to help DEB members address sampling challenges in scholarly activities (e.g. grants, manuscripts)

Create, circulate and post citable resources, by topic block

3. Strengthen the department’s expertise in modern sampling methods for population research

Number of attendees (by workshop, seminar, workgroup)

4. Increase research rigor

Number of scholarly products (e.g., papers, grants) that apply sampling methods resources

 

5.b. Anticipated subsequent outcomes include grants, education/training, core services.

By investing in this “One Big Idea” our department can enhance the quality of future external grants, develop new future training opportunities, and increase the visibility and marketability of our department.

   (1) Expertise in sampling methods and approaches to overcome sampling challenges can strengthen any grant application. Examples of funding domains include: (a) understanding disparities in Alzheimer’s disease and related disorders (ADRD) given these studies are often based on highly selected samples from clinical populations leading to a biased picture of the biological processes culminating in ADRD and the drivers of racial disparities in ADRD; (b) Scaling successful interventions to communities with high representation by URM. Methods of transportability are an area of active development and hold promise for solving the well documented problems with the gap between efficacy and effectiveness and non-replication of successful interventions. (c) Grants to increase recruitment/participation in clinical trials and cohort studies to improve the representation of communities traditionally under-sampled. (d) Precision medicine/precision public health initiatives would be strengthened by the incorporation of expertise in sampling methodology to address the premise that individuals have heterogeneous treatment responses.

   (2) Training in modern sampling methods is a current gap across UCSF’s educational curriculum. The expertise and content generated by this initiative could efficiently translate to a course, potentially offered online, to fill this gap. Our minimum training goals are to develop teaching modules corresponding with each of the four blocks, generate a list of readings, a recording of the workshop, and problem sets. These resources could be directly applicable to existing courses, e.g., Epi265 (epi methods 3 / chronic disease epi, where sampling is introduced), in the PhD seminar, Bio202 (Intro to Big Data, where public data sets with complex sample designs, such as NHANES, are commonly used), and in BIO215 (where concepts such as IPW, central to classical survey sampling, are used extensively). Other courses may also find these useful. If there is substantial demand, this could be developed into a stand-alone short course offered as part of core epi methods or the Data Science track.

   (3) The combination of increasing all member’s knowledge in modern sampling methods, investing existing expert faculty, and providing a set of free educational seminars to the UCSF community will increase the visibility of our department’s valuable skills. Doing so may allow: new consulting services, co-investigator roles on grants, and core services in sampling to complement existing services focused on recruitment.

   (4) Our proposal is strategically aligned with DEB’s educational mission. First, it will provide a series of lectures and workshops to further develop expertise in this research area. Second, it will support our goals to recruit excellent junior faculty by providing a resource and center of expertise for those who wish to take advantage of it, e.g., those writing independent grants.

 

6. Budget. Our $94,800 budget is detailed below. This increase from our initial submission includes additional support from a trainee, and compensation for meeting facilitation to ensure the project proceeds smoothly.

Budget item

Item Amount

Total

Faculty salary support for Morris, Wesson, and Hoffmann (Glymour in-kind)

$5,000x3

$15,000

Faculty compensation for leading each content block

$10,000x4 blocks

$40,000

Journal club facilitation

$500x10

$5,000

External workshop speakers for workshop honorarium

$1,000x4

$4,000

Workshop leaders travel/hotel (assuming one is local)

$2,000x3

$6,000

Food for workshops and journal clubs

$400x12

$4,800

PhD or Postdoc to direct to support content development and organization

Half stipend

$20,000

Total

 

$94,800

 

7. Timeline. We will organize speakers in 9/19, offer blocks 1/20-12/20, and intense grant-writing starting 6/20.

 8. References available here: https://docs.google.com/document/d/1pgqhjGAht5jKOEciAwAPAjV_lHu5KKxR80IYE_xbSag/edit?usp=sharing

 

 

 

                                                                                                      

Comments

Laura Jelliffe - May 10, 2019 - 4:47pm

Super interesting. This feels like a great suggestion for a new course or course series -- is that where you think this might eventually land?

Paul Wesson - May 16, 2019 - 10:43am

Yes! We envision (as one outcome) using the knowledge and materials generated by this initiative to develop a course on sampling methods/challenges/novel approaches and applications/etc. for the DEB.

Lydia Zablotska - May 10, 2019 - 5:23pm

I think this is a great idea. We have a lot of strong researchers in this area and if they band together, they could achieve a number of things: become a go-to place on methods for disparities research, facilitate inclusion of disparities research in other areas of epi investigations, develop a comprehensive training curriculum for various levels of trainees.

Ali - May 16, 2019 - 12:51pm

This is super interesting idea which is addressing the most challenge in reaching and study most hard-to-reach vulnerable populations. I would also suggest adding block five -> population size estimation methods.

John Witte - May 17, 2019 - 9:42am

Great idea, and hooray for more epi methods in the Dept! I especially like the idea of leveraging our expertise to support University-wide research effots. I wonder if we might eventually want to have an Epi Methods 'core' the could provide expertise in study design, sampling, etc. to other invesigators. Sort of like what the Biostat consulting services do, but focused specifically on epi topics such as sampling. 

June Chan - May 17, 2019 - 4:23pm

I'm intrigued and it sounds promising. I'd like more info...

Can you clarify - does this include the challenges of recruitment, enrollment, retention in studies?  I would be very interested to understand how this could synergize with other campus wide efforts to increase diversity in research. What are techniques that work? What are strategies or existing community networks that can be leveraged to increase URM in our research studies. Even if one samples or identifies groups.. it is another challenge to actually enroll people and have them participate. Is that under the scope of this proposal? If not, perhaps consider it?  thanks!

 

Steven Cummings - July 8, 2019 - 3:06pm

It depends on whether this program would be unique to UCSF Epi or uniquely strong to be a magnet for trainees, faculty, and funding.  I don't know the field well enough to know.  As raised by another comment, for novel sampling concepts and methods to be relevant to our research, it would need to include practical consderations of costs and recruitment.

Mohsen Malekinejad - July 12, 2019 - 3:45pm

great work! like many others commented above,  I also like the idea... certainly speaks to an important and cross-cutting method areas that almost all researcher would benefit from it one way or another.., I am less clear about the proposed format... maybe that is the intention but it apears to me that maybe if we identify a small group of faculties with expertise in propsed areas and they collaboratively put together resources and develop a course, that would be a way to better ssutain this work over time than fragmented activities such as journal clubs, case studies, etc.  I am happy to discuss further about sampling of hard-to-reach popualtions and also topic of external validity with you guys!

Paul Wesson - July 14, 2019 - 9:54pm

Thank you, Mohsen! Yes, it is our vision that one outcome of this Big Idea is to use the information shared and resources developed from this year-long initiative to develop a course on sampling for health disparities research to include in the DEB curriculum. We would love to take you up on your offer to further discuss your thoughts on sampling hard-to-reach populations and external validity.

Ali Mirzazadeh - July 13, 2019 - 9:33am

I am super excited about this idea and the proposal to advanced our knowledge and skills for modern sampling methods. Happy to contribute as much as needed. I think there are materials and courses out there for Block 1, that can be used/adopted quickly. However, for Block 2 to 3, there is no formal courses as I know and mostly covered in short-term workshops. The goal of making a formal course for Block 2 and 3 is really valid and important. I highly suggest to divide each block into two areas, IMPLEMENTATION and STATISTICAL METHODS. Block 4 as explained covers so many different things and not clear what is the focus. Thanks for the idea and nice proposal!

Paul Wesson - July 14, 2019 - 9:58pm

Thanks, Ali! I think your suggestion to include an "implementation" component and a "statistical methods" component for each block is a great one. I think it also ties in nicely with Steven Cummings' comment about including practical guidelines related to cost and recruitment (this would fall under the "implementation" piece).

Laura Jelliffe - July 14, 2019 - 10:19am

This is super well-thought out. Feels like this is a candidate for establishing a new DEB PhD/ clinical/ TICR program focus of some sort. Sounds like at the end the most tangible thing is increased participant knowledge. I wonder if you might also identify a goal training grant to be submitted at the end of the funding period? Seems something like that might be useful.

Paul Wesson - July 14, 2019 - 10:02pm

Thank you, Laura. I love that idea. Do you have any initial thoughts on training grants that might be appropriate for this initiative?

Patience Afulani - July 15, 2019 - 2:08pm

This is a great idea and well thought out. Developing a course out of this and highlighting faculty with expertise in various sampling techniques who could provide consulting services will be very useful.

Commenting is closed.

UCSF Global Diabetes Initiative

Submitted by Jaime Sepulveda on May 10, 2019 - 12:57pm Last revised by Open Proposals Admin on September 6, 2019 - 5:17pm.
Big Idea Status: 
Review Complete

Phase 2 Proposal

 Co-sponsors: Jaime Sepúlveda, George Rutherford, Dean Schillinger

Other sponsors: [ALL THE FOLLOWING FACULTY WILL BE INVITED TO PARTICIPATE] Justin White, Alicia Fernandez, Kirsten Bibbins-Domingo, Laura Schmidt, June Chan , Jacqueline Torres, Nadia Diamond-Smith

UCSF Students: Andrea Pedroza, Lucia Abascal, Luis Rodriguez

International collaborators: Simon Barquera (INSP, Mexico), Carlos Aguilar-Salinas (INCMNSZ, Mexico), Cesar Hernandez (PhD Student, INSP)

Our One Big Idea: To develop a UCSF Global Diabetes Initiative (GDI), an impact-oriented, multi-level and strategic program to confront and reverse the diabetes epidemic locally and globally through collaborative, transdisciplinary and scalable methods

The burden of diabetes is increasing locally and globally | Type 2 diabetes (T2D) has emerged as a driver of premature death and disability worldwide. In California, 1 in 7 adults (~4 million) have T2D, a 30% increase in the last decade. Across the globe, 1 in 11 adults over age 20 has diabetes, and by 2040, this is projected to increase to 1 in 10. In all these settings, T2D disproportionately impacts the poor and disenfranchised, and it is rapidly expanding into young adult and youth populations. Today, three-quarters of all adults with diabetes live in low and middle-income countries, where there is a large unmet need for diabetes diagnosis and care. There is an urgent need for leadership to harness communal resources – financial, intellectual, political and social – to "bend the inexorable diabetes curve" and transform and even reverse the current T2D trajectory, both locally and internationally. It requires that strategies for diabetes focus on four main goals: surveillance, prevention, early diagnosis, and control. Thus, a transdisciplinary approach that considers the study of biological and sociodemographic determinants, health policies, health systems, and implementation sciences is imperative.

UCSF has the potential to develop a multi-level strategic program to confront and reverse the diabetes epidemic | While many universities host centers for diabetes research, no major university has developed a global diabetes initiative whose purpose is to collaborate with a broad range of local and global partners to rapidly reduce the health and economic burdens of T2D. UCSF boasts prominent, interdisciplinary and T2D-focused research, public health, educational and clinical faculty. While many of these individuals are developing essential and impactful programs locally, and in a small set of specific countries, to date there has been no university-wide effort to initiate and sustain what would be an unprecedented, multi-level and strategic program to confront and reverse the diabetes epidemic.

Diabetes needs to be tackled from multiple approaches | We propose to develop a UCSF Global Diabetes Initiative that will serve as a catalyst and thought leader to (1) better understand, confront and reverse the T2D epidemic; (2) communicate about T2D to activate policy-makers and increase public awareness with respect to preventing and controlling T2D; (3) convene and strategize with relevant multi-sector stakeholders to leverage prevention efforts; (4) build local and global capacity by preparing and training the primary care workforce; and (5) discover, innovate and disseminate scalable models for the prevention and control of T2D. We propose building on our firmly established collaborations in safety net health systems and health departments across California and Mexico, as well as expanding nascent UCSF initiatives to collaborate with two additional countries with the largest numbers of people with T2D: China and India. To reach these objectives, we propose the following approaches:

  1. Develop and structure the work of the UCSF Global Diabetes Initiative to reflect its complexity and interdisciplinarity. The structure of the work can be envisioned as a Rubick’s Cube (Figure 1) that uses the "STEPS-to-Impact" domains (Science, Technology, Economics, Policy, and Society) enabled by cross-cutting approaches involving Communication, Collaboration, and Capacity-building through training and other investments in the critical geographies described above. We plan to take advantage of the existing research focused on implementation science of other chronic diseases to design and implement successful strategies for diabetes prevention and diabetes management adherence. 
  2. The GDI will be a mission-oriented initiative that is described with the knowledge triangle framework (Figure 2):

a) Knowledge generation: Creating evidence of cost-effective interventions to tackle the diabetes epidemic, from prevention to early diagnosis to control.

 b) Knowledge transfer: Disseminating the evidence through seminars, presentations in international congress and high-level meetings, as well as training the next generation of leaders on T2D research through academic exchanges between students from UCSF and collaborating institutions worldwide.

c) Knowledge implementation: Working closely with stakeholders and policymakers to transfer the evidence into health policies.

To be successful, people from different fields and backgrounds must work together |The GDI will coordinate efforts between researchers and synergize current studies, as well as create comprehensive and transdisciplinary studies. The initiative would strengthen collaboration within DEB faculty across different areas of concentration in which diabetes intersects, such as biostatistics, clinical epidemiology, epidemiology of aging, epidemiology of cardiovascular and neurological disorders (ie. the cardiovascular disease policy model and the PCORnet Blood Pressure Control), genetic epidemiology, implementation sciences, research methods in epidemiology, social epidemiology, and global health.

Within the broader UCSF campus, the initiative would bring together key actors from different departments including DEB, IGHS, the Center for Vulnerable Populations at ZSFGH, the School of Nursing, and the Diabetes Center, Asian American Research Center on Health (AARCH) and the Latinx Center of Excellence.

We also plan to engage external players nationally such as Stanford, and the Biotech industry; other UC campuses and various departments of Public Health. Internationally we will collaborate with institutions in Mexico (National Institute of Public Health, Ministry of Health, National Institute of Nutrition), China (China Medical Board (CMB) and the Peking Union Medical College (PUMC)), India (Public Health Foundation of India, PHFI), and potential collaboration with African countries in which UCSF already has partnerships (KEMRI, Makerere University, Muhimbili University and others).

The GDI will increase the visibility of DEB faculty locally and internationally |We plan to have open sessions, available online, including seminars and global diabetes grand rounds, which would  increase visibility, allow us to receive feedback, and strategically identify people interested in collaborating with our work. We strive to develop rigorous scientific research and find evidence-based solutions to the global diabetes epidemic and disseminate our findings nationally and internationally by publishing and presenting at high-level conferences.

The UCSF Global Diabetes Initiative has the potential to be a major grant recipient | Leveraging our existing portfolio, we have many opportunities to continue to attract new major donors.

Current grants We have begun to develop a successful model for the UCSF Global Diabetes Initiative through our collaborative work in Mexico, with the National Institute of Public Health and the National Institute of Nutrition. We received grants from the World Diabetes Foundation and Fundación Rio Arronte to develop a program in which we screened 12,000 patients for diabetes and 2,500 patients for diabetic retinopathy; the plan is to follow-up these patients. 

We have also received a grant from UC-MEXICO Initiative to develop PRUDENTE study (Prevention of Diabetes through Exercise, Nutrition, and Medication Therapy) in 49 public primary care clinics in Mexico City, where we are also planning to evaluate metabolomic markers of diabetes incidence and renal function.

Grant submissionsWe have formally submitted a $500K grant proposal toFundacion Rio Arronte. Dr. Schillinger has applied for funding to the Clinton Health Access initiative (CHAI), which has recently prioritized T2D in low-resource settings. CHAI has expressed deep interest in Dr. Schillinger’s idea of a holistic diabetes strategy.

Potential donors.The GDI has the potential to receive funding from other donors such as NIH, the World Diabetes Foundation, and Bloomberg Philanthropies.

Expected outcomes | The GDI will become a leader for T2D research, creating evidence for actionable policy changes and scalable interventions for diabetes prevention and control in vulnerable populations.

 Budget

Projects Incubation                          $30,000

Academic Exchanges                      $15,000

Dissemination                                  $10,000

Administrative Support                    $15,000

PhD Dissertation Fund                    $30,000

Total                                                $100,000

Comments

Laura Jelliffe - May 10, 2019 - 4:44pm

Such a cool idea. I wonder if some government/ public funds might be leveraged to move this as well?

John Witte - May 17, 2019 - 9:38am

Exciting idea! Do you have specific examples of how DEB faculty could engage in this program? Especially those not presently working in Diabetes or Global Health?

June Chan - May 17, 2019 - 4:01pm

Have you considered collaborating with AARCH (Asian American Research Center on Health), given the high occurence of T2D among Asians, and the screen at 23 campaign etc? I think this is a strong idea, and pulls in complementary interests from several in the Dept, including those of us interested in diet/exercise interventions, obesity prevention, behavioral change, and health disparities. It would be great to learn more about how others in the Dept. could get involved.

Joan Hilton - May 17, 2019 - 5:13pm

Hi Jaime, I don't see an item "(2)" in your notes. I believe that my proposal to conduct "platform studies" could be inserted there!  I'd be happy to discuss the specifics any time.

Dennis Black - May 27, 2019 - 8:14pm

The theme of T2D has potential to serve as a unifying theme for a number of groups in DEB.  Not only from the global perspective, but also since the implications are so diverse, it would provide a focus for collaborations and growth in areas where DEB is already strong such as OA, heart disease, aging, etc. as well as areas where the campus is already strong such as neurology.

Jaime Sepulveda - June 5, 2019 - 3:13pm

I would like to thank Laura, John, June, Joan and Dennis for their kind and useful comments. I believe there is a huge potential to bring DEB faculty and students together to focus on a major local and global health problem. We already have a T2D retinopathy prevention program in California with Mexican migrants, and also a large T2D prevention program in a prediabetic and obese adult cohort in Mexico City. I agree with Dennis we could build collaboration bridges with other campus teams.

Many thanks to KBB for inviting us to submit a proposal for a second round. I'd like to invite all interested DEB faculty to join me in submitting a proposal for a second round Two PhD student--Luis Rodriguez and Andrea Pedroza--have already expressed interest in the idea, as part of their PhD thesis.

Steven Cummings - July 8, 2019 - 3:21pm

I like the idea because it brings so many groups and expertise together re: a major global health problem. Are there other large Diabetes research programs/institutes of this type in the US or elsewhere?   If so, what would be unique about this one that, for instance, would draw philanthropy to this rather than other Diabetes institutes.

Jaime Sepulveda - July 8, 2019 - 3:42pm

Thanks for your comments, Steven. There are 16 diabetes research centers funded by the NIDDK--one of which is at UCSF, and founded by Jeff Bluestone. These are basic sciences research centers; the one at UCSF is mostly focused on Type 1 Diabetes (T1D). To my knowledge, none of those centers work on the epidemiology of T2D at the global level, with an emphasis on vulnerable populations. Thus, those centers would not compete with our initiative for philanthropic resources.

Bob Hiatt - July 8, 2019 - 7:03pm

Jaime,

This is a great idea and well presented. The aspects I like are the magnitude of the problem, the existing expertises and interest at UCSF, the US-Mexico link, the transdisciplinary approach, the knowledge transfer-implementation frame, and the potential magnet it represents for philanthropy. Concerns are what can be accomplished in one year of modest funding, what would be the benefits to the DEB as opposed to the entire university (not a bad thing to benefit the entire university), what would be the actual substance of the research envisioned, and the complex organizational structure. On balance, however, I view your Big Idea positively.

Bob

Jaime Sepulveda - July 8, 2019 - 8:40pm

Bob,

Many thanks for your thoughtful and positive comments. I think your concerns are all valid, and I might not have all the answers. Clearly, $100K is only seed money, allowing a core group of faculty to go after the big money. The UC-Mexico initiative has taught us lessons about this approach--both from successes and failures. The potential benefit of DEB is to be the owner of the initiative, raising its visibility. But frankly, I think the real benefit is the impact we could have on creating, disseminating and implementing knowledge, thus improving people's lives. the actual substance of the research envisioned will hopefully emanate from the core DEB faculty interested in joining this initiative. We already have some projects ongoing in Mexico City and in California, and some new ideas to put on the table for consideration of DEB colleagues.

Laura Jelliffe - July 14, 2019 - 10:24am

I think this is a great idea and would attractive to a number of funders including a NIH program grant etc... . I also suspect ministries in a number of developing countries might be interested in investing -- I think the global nature of this is really a novel characteristic. I wonder if you might want to have an organizational structure that has both a domestic and global arm so as to attract specific funding into each arm? Of course (and no surprise), I also think calling out pregnancy mighty be useful given such strong links to poor pregnancy outcomes.

Jaime Sepulveda - July 15, 2019 - 3:42pm

Thanks for your comments, Laura. Indeed, the whole idea is to work locally in California and globally in some selected countries. Through the UC-Mexico initiative, we have recently funded work on T2D retinopathy prevention in the Central Valley.

I very much like your idea on incorporating diabetes in pregnancy as part of this initiative.

Commenting is closed.

Platform Studies

Submitted by Joan Hilton on May 13, 2019 - 12:10am Last revised by Open Proposals Admin on September 6, 2019 - 5:17pm.
Big Idea Status: 
Review Complete

Phase 2 Proposal

Phase II, new thoughts.  The strengths of platform studies, exemplified by the STAMPEDE trial, are (1) the presence of a vision at the outset of a long-term research agenda that has the capacity to adapt during its conduct, and (2) a breadth of research questions that could be addressed by a cohesive research group working together to achieve a broad goal. Among the 8 “Big Ideas” applications, 3 target research topics (diabetes, PUMA, radiation health) that could be candidates for this approach and the other applications propose infrastructure that could facilitate it. This effort would benefit from all of the Big Ideas submitted!  

Steve Cummings’ proposal mentions Kirsten's interest in “planning a Center for Public Health (PH) that would work with local communities to provide accurate information on effects of environmental exposures and, potentially, initiate new studies.” Along these lines, I found inspiration at the U of Wisconsin-Madison website describing their “Institute for Research on Poverty,” https://www.irp.wisc.edu/. At the home page, we see their focus is on Wisconsin and on rural poverty; we could provide complementary focus on urban poverty. Under the “people” link, we see that they team with representatives of foundations and the private sector as well as with academics from other institutions -- including UC Davis, UCLA, UCSD, and Stanford; surely they need insights from UCSF biostatisticians and epidemiologists to round out their approaches. Under the “training” link, their 2018 ‘Teaching Poverty 101 Workshop’ provides a lot of valuable background information – indeed, the whole website is valuable.

It would like to see DEB not only conduct research that explains underpinnings of our selected problem – say, Kirsten’s idea – but also studies best approaches to preventing and reducing the problem and works with community partners to implement effective strategies in a sustainable way.

Objectives for Year 1:

  1. Reach out to the UWM IRP group to see if we can join them and benefit from their infrastructure and organizational approaches.
  2. Establish a working group of interested DEB members to refine target topics, and weigh their feasibility and interest to members, and select a final topic. Identify relevant readings, podcasts, and experts; meet regularly to review and discuss these.
  3. Outline a strategic plan for the coming years, identifying many side options (to allow adaptation). Identify personnel needs and emerging leaders within DEB. Identify resources that could provide support.    

Budget:

My initial thought is that at least 3-4 faculty members would have 5%-10% of their time covered to launch this effort.   

Your thoughts on this agenda are most welcome.

~ ~ ~

Phase-I submission. While teaching Biostat 226 this year, I was reminded of STAMPEDE, a multi-arm multi-stage randomized controlled trial cancer protocol that was selected as 1 of 2 RCTs of the year by the Society for Clinical Trials. Per doi:10.1093/annonc/mdx410: "...opening to recruitment with five research questions in 2005 and adding in a further five questions over the past 6 years, it has reported survival data on 6 of these 10 RCT questions over the past 2 years [1–3]. Some of these results have been of practice-changing magnitude [4, 5]." It appears that STAMPEDE also caught the eye of HDFCCC leadership, who sent this solicitation on May 10: "As part of a strategic planning process, the Cancer Center is conducting a broad scientific strategic review termed Cancer Research in 2030. Essentially, we are asking each of you to predict what cancer research will look like in 2030, and accordingly, what we will need to do to get there. [...This is] an effort to present scientific gap analyses and white papers to help Center leadership plan resource allocation and program design. I would like to meet with the leadership and members of your Site Committee at an appropriate time..."

Although STAMPEDE is tailored to research questions relevant to cancer that call for randomized assignments, I believe that whether randomization is employed or not, (i) a strategic visionary research plan that encompasses a range of linked individually led studies could move every clinical field forward very effectively, and (ii) DEB faculty could be valuable partners -- for example, with epidemiologists contributing expertise in behavioral measures and interventions and biostatisticians contributing expertise in study design, conduct, and analysis methods (as in STAMPEDE). Matching budgets from partner departments could cover time of faculty developing such an umbrella protocol. 

As we collectively gain experience in developing strategic plans, we also will identify specific areas of our own fields that need further development. Clinical research is moving toward use of Common Data Elements and PROMIS measures (doi: 10.1037/hea0000752); similarly, there is a need for standardization of many behavioral measures and methods to analyze them and need for implementation studies to optimally operationalize the platform protocols (Campbell MK et al, Health Technol Assess. 2007 Nov;11(48):iii, ix-105).

I foresee a potentially wide application of this visionary approach, with DEB faculty partnering with clinical colleagues to accomplish the goals.  

Comments

Charles Mcculloch - May 13, 2019 - 5:21pm

Nice suggestion.  But what would you achieve in the one year and how would it be self-sustaining after the first year?  Is there an infrastructure you can put in place to make it easier in the future?

Joan Hilton - May 17, 2019 - 4:55pm

Hi Chuck, I'd welcome your thoughts on the points you raise. 

I imagine that in the first year, participants within a given clinical area could hone in on their forest and enough of the trees to write at least one grant together and map out plans for others. Infrastructure might be developed in collaboration with existing coordinating centers / patient networks in order to tap their participant resources.   

John Witte - May 17, 2019 - 9:35am

Very interesting idea. STAMPEDE is indeed an exciting and promising approach; in fact, right now I'm involved with a project that's using design. As to Chuck's point, would you consider having a STAMPEDE expert / point person in the Dept that could help others integrate this design into their trials?

Joan Hilton - May 17, 2019 - 5:05pm

Hi John, I believe STAMPEDE is succeeding thanks to intensive interdisciplinary collaboration, rather than through the advice & expertise of a single point person. In terms of time commitment of participants focusing on a specific topic, a starting model could be the amount of time and regularity and deadlines associated a 2-3 hr course. Your point person / my instructor could be someone who could map out topics that need to be addressed, a sequence and timeline, etc.

I hope we can brainstorm further. I'd love to hear about the study you're designing !

June Chan - May 17, 2019 - 3:56pm

I am intrigued, but also remain a bit foggy on what exactly is being developed here and where the fund are going. 

Joan Hilton - May 17, 2019 - 5:08pm

Hi June, I'd be glad to share more about this anytime.  As I mentioned in my reply to John, intensive dedicated time would be needed and funds to support that could enable it to happen.  Thanks!  

Steven Cummings - July 8, 2019 - 3:01pm

The concept is attractive. Does the Dept wan't to join a project led by a different university? Seems like Aim 2 needs to be addressed in order to determine whether this would be worth an investment Epi resources.

Joan Hilton - July 9, 2019 - 10:51am

Hi, Steve. Thanks for your comment. 

I believe we hope to aim very high, establishing a research agenda for DEB that many of us would like to spend energy on for a long time. The ISP initiative at UWM could serve as a great model for us. I also think our initiative would benefit of having one/more faculty join theirs because they are well established, they welcome partners from multiple institutions, and we could learn from them as we begin and proceed. Since I haven't reached out to them yet, I don't want to project too far how this would play out. Their large number of high profile partners suggests this is a viable opportunity.

NOTE TO ALL:  I HAVE HOUSEGUESTS COMING FRI-MON (JUL 12-JUL 15). I EXPECT MY TIME TO BE VERY LIMITED THOSE DAYS. 

Jaime Sepulveda - July 8, 2019 - 3:57pm

Thanks to Joan Hilton. I would be very interested to learn more about Platform Studies (exemplified by the STAMPEDE trial) and how that approach could benefit our global diabetes initiative--and other big ideas as well.

 

Joan Hilton - July 9, 2019 - 11:20am

Hi, Jaime. Thanks for reaching out.

I would love to meet with you to brainstorm on how to specifically integrate our Big Ideas. In general, one way I look at the platform approach is this:  The ~5 year funding cycle tends to drives the time-frames of our research aims. I believe it would be more efficient and effective to carefully characterize our long-term agendas. Further, because research questions roll in over time, adaptable agendas are needed. Such an approach may identify infrastructure that should be established to enable efficient achievement of longer-term goals. One of many pillars of STAMPEDE is use of one control arm (with on-going enrollment so that comparisons are always concurrent) against which several others (some initiated later than others; some discontinued early) are compared. Examples of integration with other Big Ideas could include: selected faculty learning and developing Modern Sampling Methods, engaging with one another through Intensive Scientific Retreats tied in with an Epi-Stat Lectureship, providing mentoring & funding for junior faculty in order to Fund the Future. 

Bob Hiatt - July 8, 2019 - 6:48pm

Dear Joan. I like the way you are thinking, crossing disciplines, sectors and institutions. This is essentially what we have been doing over the last 3 years with the San Francisco Cancer Initiative (SF CAN). From leading that initiative I can say that although the creation of the 'platform' has been ground breaking and productive in moving toward the goal of reducing cancer mortality in San Franciso, it continues to take a huge amount of effort on the organizational side that is not research and also costs a lot of money. So a large cautionary note on your suggested Big Idea if implementation is an eventual goal, but I do like (and have published on) the concept of epidemiologists and biostatisticians being at the center of "pulling together a cohesive group of (multidisciplinary) investigators" to work on a "long term agenda" for a particular research topic.

Joan Hilton - July 9, 2019 - 11:50am

Hi, Bob. Thanks for your feedback.

Based on your thoughts, it seems we should identify at the outset feasibility characteristics of Selected Topic versus SF CAN versus ISP (and other models?). Your input will be very valuable in thinking this through.

I hope we will jointly select a topic that would engage the minds & hearts of interested faculty members and provide them funding to enable investment in the research. Like you (and Kirsten, Laura, Lydia, and others), I lean toward an important public health problem, influenced by Bay Area experience.

Joan Hilton - July 9, 2019 - 12:03pm

P.S. Here is the start of a list of candidate topics that coulld be submitted to faculty for their vote, along with requests for other topics: 

Laura Jelliffe - July 14, 2019 - 10:12am

Interesting and super useful idea. I agree that this project idea has links to the other Big Ideas submitted. Some additional key, tangible deliverables might be useful as well as specific next steps re: grants for sustainability.

Commenting is closed.