# Teens on TB Treatment:  Predicting Adherence through Clinical Decision Analysis

> **NIH NIH K01** · RHODE ISLAND HOSPITAL · 2021 · $94,438

## Abstract

This International Research Scientist Development Award (IRSDA) from Rhode Island Hospital and
Partners In Health-Peru will serve as a vehicle for the candidate, a pediatrician with advanced training in
tuberculosis (TB), to become an independent physician-scientist in global health research. The candidate’s
long-term goal is to improve outcomes for adolescents with TB by building an adolescent TB clinical research
program in Peru. Of note, TB is one of Peru’s six national priority areas for biomedical research. This IRSDA
will address the lack of evidence on adolescent-specific risk factors for poor TB treatment adherence. The
three specific aims of this study will culminate in the derivation and validation of a clinically applicable
prediction rule that identifies adolescents at risk for poor adherence to therapy for drug-susceptible pulmonary
TB. Poor adherence will be defined as failure to complete the six-month regimen within nine months. The two
parts of Aim 1 will lead to the development of a data collection tool to capture predictors of adherence. In Aim
1a, the research team will conduct 70 in-depth interviews with adolescents, parents, and health providers to
explore perspectives on barriers and facilitators to adolescent adherence to TB treatment. In Aim 1b, the
candidate, informed by these interviews, will develop a two-part data collection tool—consisting of a 20-
minute structured survey and a brief chart abstraction from—that captures predictors of adherence. In Aim 2,
the research team will administer the data collection tool to 400 adolescents who recently completed or
defaulted from TB therapy. Using these data, the candidate will apply regression analysis to derive a clinical
prediction rule for poor adherence, and then derive a second prediction rule using recursive partitioning. In
Aim 3, these prediction rules will be externally validated in a prospective cohort of 400 newly diagnosed
adolescents. The area under the receiver operator curve for each model will be measured against the
outcome of poor adherence, which will be assessed at the end of therapy. The more accurate rule will be
selected as the final model and will be incorporated into the candidate’s R01 proposal—which she will
prepare in Years 4 and 5 of this IRSDA—to develop novel approaches to optimize adolescent adherence to
therapy for TB disease.
 In parallel with this research plan, the candidate will take courses in epidemiology, biostatistics, clinical
prediction modeling, adolescent health, advanced qualitative analysis, the conduct of international clinical
translational research, and grant writing. She will also receive instruction in these areas from an experienced
mentorship team. Dr. Jennifer Friedman (primary mentor) has 20 years’ experience conducting NIH-funded
international pediatric infectious disease studies and has successfully mentored previous K recipients. Drs.
Leonid Lecca (overseas mentor) and Mercedes Becerra (co-mentor) have a combined 35 ...

## Key facts

- **NIH application ID:** 10453071
- **Project number:** 3K01TW010829-05S1
- **Recipient organization:** RHODE ISLAND HOSPITAL
- **Principal Investigator:** Silvia Shinpei Chiang
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $94,438
- **Award type:** 3
- **Project period:** 2017-09-25 → 2022-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10453071

## Citation

> US National Institutes of Health, RePORTER application 10453071, Teens on TB Treatment:  Predicting Adherence through Clinical Decision Analysis (3K01TW010829-05S1). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10453071. Licensed CC0.

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