FACE-PC: Family-Centered Care for Older Adults with Multiple Chronic Conditions in Primary Care

FACE-PC：在初级保健中为患有多种慢性病的老年人提供以家庭为中心的护理

• 批准号: 8890968
• 负责人: Mijung Park
• 金额: $ 9.38万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-04-09 至 2018-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8890968
• 关键词: Acute; Address; Adherence; Aging; Area; Behavioral; Caregiver Burden; Caregivers; Caring; Categories; Chronic; Chronic Care; Chronic Disease; Clinic; Clinic Visits; Clinical Trials; Clinical Trials Design; Communities; Comorbidity; Comprehensive Health Care; Data; Discipline of Nursing; Disease; Disease Management; Education; Elderly; Expenditure; Face; Family; Family Caregiver; Goals; Health; Health Insurance Portability and Accountability Act; Health Services; Health Services Research; Healthcare; Individual; Institutes; Intervention; Interview; K-Series Research Career Programs; Lead; Learning; Life; Link; Medical; Mental Depression; Mental disorders; Mentors; Methodology; Methods; Mission; Modeling; National Institute of Mental Health; Online Systems; Outcome; Outcome Measure; Participant; Patients; Persons; Pharmaceutical Preparations; Phase; Population; Prevalence; Primary Health Care; Protocols documentation; Psychiatry; Public Health; Quality of Care; Quality of life; Randomized; Research; Research Methodology; Research Personnel; Research Priority; Sampling; School Nursing; Scientist; Self Management; Services; Strategic Planning; System; Targeted Research; Technology; Testing; Time; Training; Treatment Effectiveness; Universities; World Health; base; burden of illness; care delivery; career; caregiving; chronic care model; chronic depression; comparative effectiveness; cost effectiveness; disability; effectiveness trial; evidence base; experience; follow-up; geriatric depression; health care model; implementation science; improved; medical complication; medication compliance; meetings; multiple chronic conditions; professor; programs; psychosocial; ranpirnase; screening; symptom management; theories; tool; treatment adherence; treatment as usual

DESCRIPTION (provided by applicant): This is a revised application for a Mentored Research Scientist Career Development Award (K01) entitled "FACE-PC: Family-Centered Care for Older Adults with Depression and Chronic Medical Conditions in Primary Care." Dr. Mijung Park, the candidate, is a tenure-track Assistant Professor at the University of Pittsburgh, School of Nursing. Her career goals are to (1) improve the quality of care for older adults with multiple medical and psychosocial comorbidities and (2) become an independent researcher with expertise in comparative effectiveness trials conducted in "real-world" health care settings. Comorbid depression and multiple medical conditions in older adults are a serious public health problem. As an important facilitator of health-related activities, families are already involved in various aspects of self-management of chronic disease in older adults. Despite the benefits they provide, informal caregiving activities currently are organized outside the medical system, which potentially creates redundant or misaligned efforts. Dr. Park's research targets patient- family dyads to optimize patients and their families' collective ability to self-manage chronic disease. Family is defined as kin and non-kin informal caregivers. Her mentors are Dr. Charles F. Reynolds III (primary mentor), Professor of Psychiatry, and the director of the NIMH-sponsored Advanced Center for Interventions and Services Research for Late-life Depression (ACISR) (P30 MH090333) and the Aging Institute of UPMC Senior Services and University of Pittsburgh and Dr. Kathryn R. Puskar (co-mentor), Professor of Nursing and an expert in dissemination and implementation of evidence-based psychosocial intervention. This K01 features two training objectives. Objective 1 is to attain expertise in developing and testing family-centered care program in the context of "real-world" health care settings. To meet this objective, Dr. Park plans on gaining hands-on training in quality improvement approaches as a method for intervention refinement (Objective 1a) and in conducting pragmatic clinical trials (Objective 1b). Objective 2 is to learn about approaches in dissemination and implementation sciences, with specific emphasis on implementing intervention. The purpose of the mentored research is to examine the feasibility and acceptability of the FACE-PC, a theory-driven, multi- component, technology-assisted interdisciplinary team-based care model that systematically involves family in chronic disease management. It aims to optimize the patient and family's collective ability to self-manage chronic disease. We will first refine the study protocol, using rapid cycle quality improvement approaches (Aim 1). We will then pilot test FACE-PC using mixed-methods of pragmatic clinical trial design and qualitative methodology (Aim 2). The three sub-Aims are to examine the feasibility and acceptability (Aim 2a); determine if there is evidence of the hypothesized directional effect (Aim 2b); and elicit participants' experience with FACE- PC via face-to-face exit interviews (Aim 2c). Concurrently, we will explore the feasibility of the researc methods for the subsequent R01 (Aim 3).

描述（由申请人提供）：这是指导研究科学家职业发展奖 (K01) 的修订申请，题为“FACE-PC：初级保健中针对患有抑郁症和慢性病的老年人的以家庭为中心的护理”。候选人 Mijung Park 博士是匹兹堡大学护理学院的终身教授助理教授。她的职业目标是 (1) 提高患有多种医学和心理社会合并症的老年人的护理质量；(2) 成为一名独立研究人员，拥有在“现实世界”医疗保健环境中进行的比较有效性试验的专业知识。老年人共病抑郁症和多种疾病是一个严重的公共卫生问题。作为健康相关活动的重要推动者，家庭已经参与其中 老年人慢性病自我管理的各个方面。尽管它们提供了好处，但目前非正式护理活动是在医疗系统之外组织的，这可能会造成冗余或失调的工作。 Park 博士的研究针对患者与家庭二人组，以优化患者及其家庭自我管理慢性病的集体能力。家庭被定义为亲属和非亲属非正式照顾者。她的导师是精神病学教授 Charles F. Reynolds III 博士（主要导师），也是 NIMH 资助的晚年抑郁症干预和服务研究高级中心 (ACISR) (P30 MH090333) 和老龄化研究所的主任匹兹堡大学 UPMC 高级服务部主任和护理学教授兼专家 Kathryn R. Puskar 博士（共同导师）传播和实施循证心理社会干预措施。 K01 具有两个训练目标。目标 1 是获得在“现实世界”医疗保健环境中开发和测试以家庭为中心的护理计划的专业知识。为了实现这一目标，Park 博士计划 获得质量改进方法的实践培训，作为干预细化的方法（目标 1a）和进行务实的临床试验（目标 1b）。目标 2 是了解传播和实施科学的方法，特别强调实施干预。指导研究的目的是检验 FACE-PC 的可行性和可接受性，FACE-PC 是一种理论驱动、多组成部分、技术辅助的跨学科团队护理模式，系统地让家庭参与慢性病管理。它旨在优化患者和家庭自我管理慢性病的集体能力。我们将首先使用快速循环质量改进方法完善研究方案（目标 1）。然后，我们将使用实用临床试验设计和定性方法的混合方法对 FACE-PC 进行试点测试（目标 2）。三个分目标是审查可行性和可接受性（目标 2a）；确定是否有证据表明假设的方向效应（目标 2b）；并通过面对面的退出访谈获取参与者使用 FACE-PC 的体验（目标 2c）。同时，我们还将探索后续R01（目标3）研究方法的可行性。