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Principal Investigator: Junichi Ishigami
Organization: JOHNS HOPKINS UNIVERSITY
Fiscal Year: 2024
Award: $156,551
Funding agency: National Institute of Diabetes and Digestive and Kidney Diseases
ABSTRACT/ PROJECT SUMMARY
Dr. Junichi Ishigami, MD, MPH seeks a Mentored Research Scientist Development Award in order to obtain
essential skills and mentored research experience to become an independent investigator in the field of
implementation research to improve the uptake of influenza vaccination among individuals with chronic kidney
disease (CKD). The research proposal details a five-year plan consisting of implementation research to
improve the uptake of influenza vaccination among individuals with CKD, and advanced coursework at the
Johns Hopkins Bloomberg School of Public Health under the combined mentorship of Dr. Kunihiro Matsushita,
MD, PhD, and Dr. David Dowdy, MD, PhD. Influenza affects 10-35 million individuals annually in the US,
resulting in up to 710,000 hospitalizations and 56,000 deaths. Vaccination against influenza is especially
important for individuals with CKD due to their high risk of influenza complications (e.g., pneumonia,
cardiovascular disease). Yet, we have recently reported that ~40% of adults aged ≥65 years with non-dialysis
dependent CKD in the US did not get an influenza vaccine and the vaccination rate has not improved between
2005 and 2015. This indicates that additional efforts are urgently needed to improve the uptake of influenza
vaccination particularly in this high risk population. However, no evidence-based implementation strategies
exist to improve the uptake of influenza vaccination specifically among individuals with CKD. The proposed
project will address this public health concern. The specific aims of this research proposal are 1) To determine
patient and provider perceptions about influenza vaccination in nephrology care, 2) To design a theory-based
vaccination program and test its feasibility in nephrology care, and 3) To evaluate the cost-effectiveness of a
theory-based vaccination program in nephrology care. To address these issues, we will leverage the Chronic
Renal Insufficiency Cohort (CRIC), an NIDDK-funded, ethnically-diverse, well-documented, contemporary,
longitudinal cohort of 5,499 persons aged 21-74 years at baseline with a variety of CKD stages. This project
will inform implementation strategies to enhance an effective influenza vaccine delivery in CKD, provide proof
of concept of promoting influenza vaccination in nephrology care, and provide information on the cost-
effectiveness of a theory-based vaccination program for decision-making on resource utilization. Together, this
project will pave a theoretical foundation for developing cost-effective and feasible vaccination programs for
individuals with CKD, which can be further extended under other funding mechanisms such as an R01. This
project will make the candidate fully equipped to be an independent investigator and also will provide an
evidence base for improving influenza vaccine uptake in CKD, an understudied and important clinical priority in
nephrology care.
Terms: <21+ years old><65 and older><65 or older><65 years of age and older><65 years of age or more><65 years of age or older><65+ years><65+ years old><> 65 years><Address><Adherence><Adoption><Adult><Adult Human><Affect><Aged 65 and Over><Agreement><Anemia><Awareness><Behavior><Behavioral><Belief><COVID-19><CV-19><Cardiovascular Diseases><Caring><Centers for Disease Control><Centers for Disease Control and Prevention><Centers for Disease Control and Prevention (U.S.)><Cessation of life><Characteristics><Chronic Kidney Failure><Chronic Kidney Insufficiency><Chronic Renal Disease><Chronic Renal Failure><Chronic Renal Insufficiency><Clinic><Clinical><Communicable Diseases><Consolidated Framework for Implementation Research><Consolidated Framework for Implementation Science><Consolidated Framework for Implementing Change><Coronavirus Infectious Disease 2019><Data><Data Systems><Death><Decision Making><Development><Doctor of Philosophy><Education><Educational aspects><Epidemiology><Exposure to><Five-Year Plans><Flu vaccination><Foundations><Funding><Funding Mechanisms><Goals><Grippe><Health Care Costs><Health Costs><Healthcare Costs><Healthy People 2020><Hospital Admission><Hospitalization><IT Systems><Immunization><Immunization Programs><Individual><Infectious Disease Epidemiology><Infectious Disease Pathway><Infectious Diseases><Infectious Disorder><Infectious Epidemiology><Influenza><Influenza Vaccines><Influenza immunization><Influenza vaccination><Information Systems><Information Technology Systems><Intervention><Intervention Strategies><Investigators><K01 Award><K01 Mechanism><K01 Program><Kidney><Kidney Urinary System><Knowledge><Long-term cohort><Longitudinal cohort><Longterm cohort><Mentored Research Scientist Development Award><Mentored Training Award><Mentors><Mentorship><Modeling><NIDDK><NIH><National Institute of Diabetes and Digestive and Kidney Diseases><National Institutes of Health><Nephrology><Patients><Perception><Persons><Ph.D.><PhD><Physicians><Pneumonia><Population><Program Development><Prophylactic vaccination against influenza><Provider><Public Health><Public Health Schools><Questionnaires><Recommendation><Reporting><Research><Research Personnel><Research Proposals><Research Resources><Research Scientist Development Award><Researchers><Resources><Survey Instrument><Surveys><Testing><Trust><United States><United States Centers for Disease Control><United States Centers for Disease Control and Prevention><United States National Institutes of Health><Universities><Vaccination><Vaccination Programs><Vaccines><above age 65><accept vaccination><accept vaccine><adulthood><after age 65><age 65 and greater><age 65 and older><age 65 or older><age > 65><age of 65 years onward><aged><aged 65 and greater><aged 65+><aged ≥65><budget impact><cardiovascular disorder><career><chronic kidney disease><co-morbid><co-morbidity><cohort><comorbidity><comparative cost effectiveness><compare cost effectiveness><coronavirus disease 2019><coronavirus disease-19><coronavirus infectious disease-19><cost effective><cost effectiveness><cost-effectiveness evaluation><death risk><deliver vaccines><design><designing><developmental><disease prevention><disorder prevention><epidemiologic><epidemiological><ethnic diversity><ethnically diverse><evaluate cost-effectiveness><evidence base><experience><feasibility testing><flu immunisation><flu vaccine><flu virus vaccine><health related quality of life><high risk><high risk group><high risk individual><high risk people><high risk population><human old age (65+)><implementation cost><implementation investment><implementation research><implementation strategy><improved><incremental cost-effectiveness><incrementally cost effective><influenza virus vaccination><influenza virus vaccine><interventional strategy><mortality risk><old age><over 65 years><programs><provider barriers><provider-level barriers><renal><skills><strategies for implementation><theories><uptake><vaccination acceptability><vaccination acceptance><vaccination against influenza><vaccination confidence><vaccination uptake><vaccination willingness><vaccine acceptability><vaccine acceptance><vaccine against flu><vaccine against influenza><vaccine confidence><vaccine delivery><vaccine safety><vaccine uptake><vaccine willingness><≥65 years>