Implementation speed and scale-up of personalized tobacco use treatment

About This Grant

PROJECT SUMMARY/ABSTRACT Tobacco use treatment remains limited as only 1 in 5 patients who would benefit receive a prescription from their doctor, only 1 in 3 patients who receive a prescription use the medication, and only 1 in 3 patients who use the medication successfully quit smoking. These gaps require solutions on multiple fronts: precision medicine to improve the personal efficacy of the treatments, and implementation science to ensure that personalized approaches are leading to evidence-based tobacco use treatment being prescribed and used. Still, it remains unknown whether personalized approaches, particularly those that use genetics and other biological markers to inform specific patient risks and recommend specific treatments, are accelerating progress toward more widespread use of effective treatment. This K02 proposes to address two important yet understudied areas, implementation speed and scale-up, to understand how we can bring, with less delay, personalized guidance for tobacco use treatment to more people who would benefit. I am a recently tenured investigator making important contributions in bringing genetics-informed behavioral interventions into real- world settings to improve uptake and engagement with tobacco use treatment. Through my two active NIH R01 trials (R01 CA268030 and R01 DA056050), there are data available to address a novel question: “How fast and how far can innovations in personalized tobacco use treatment spread to improve population health?” While important, the areas of focus on speed and scale-up are not in scope with these R01s. Instead, this K02 proposal is uniquely situated to advance my scientific leadership in these areas of high priority for the fields of substance use and implementation science. In pursuit of this goal, I will lead the following integrated Research and Career Development aims: (1) investigate factors influencing the speed of implementation of personalized tobacco use treatment; (2) determine the potential for implementation scale-up of personalized tobacco use treatment; and (3) maximize growth in mentorship of early-stage investigators to become the next generation of scientists focused on implementation of tobacco and substance use prevention and treatment interventions. I will collaborate closely with a purposefully selected group of investigators at Washington University and external experts who will contribute to my learning in genomic discovery, behavioral intervention development, precision medicine in the clinic and community, electronic health record integration, and implementation science. These collaborations will help me gain new content and methodological skills, including abilities to synthesize datasets across multiple trials and collaborative projects. In summary, this Independent Scientist Award is essential to advancing my career development and trajectory so that I can have greater impact on the field and its understanding of how to speed and scale-up personalized tobacco use treatment to more individuals who could benefit.