Mentoring Researchers in Advance Care Planning and Communication for Vulnerable Older Populations

指导研究人员为弱势老年人群进行预先护理计划和沟通

• 批准号: 9211082
• 负责人: REBECCA L SUDORE
• 金额: $ 18.79万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-02-15 至 2022-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9211082
• 关键词: Adopted; Adoption; Advance Care Planning; Advance Directives; Aging; Americas; Cardiopulmonary Resuscitation; Clinical; Clinical Investigator; Clinical Research; Code; Communication; Complex; County Hospitals; Data; Decision Making; Development; Development Plans; Documentation; Elderly; Environment; Evaluation; Faculty; Feasibility Studies; Fellowship; Funding; Future; Geriatrics; Goals; Guidelines; Health; Health Care Research; Health Communication; Health education; Informed Consent; Institutional Review Boards; Intervention; Knowledge; Leadership; Measures; Medical; Medical Education; Mentors; Minority; Modeling; Older Population; Outcome; Palliative Medicine; Pathway interactions; Patients; Physicians; Population; Positioning Attribute; Primary Health Care; Process; Provider; Public Health; Publications; Publishing; Questionnaires; Randomized; Recruitment Activity; Reporting; Research; Research Infrastructure; Research Personnel; Research Project Grants; Research Support; Research Training; Resources; Scheme; Self Efficacy; Testing; Time; Veterans; Voice; Vulnerable Populations; Work; arm; base; career development; clinical care; design; disenfranchised population; efficacy testing; efficacy trial; empowered; empowerment; health care quality; health disparity; health literacy; improved; innovation; instrument; interest; literacy; novel; patient oriented; patient oriented research; preference; primary care setting; programs; response; skills; student mentoring; web site

ABSTRACT The aims of this proposal are to (1) enable the candidate to further develop her research program focused on improving advance care planning (ACP) and informed medical decision making for vulnerable older adults and (2) use her research program as a platform for mentoring junior investigators interested in patient-oriented aging research, both within Geriatrics and other medical subspecialties. The candidate is a Geriatrician and Palliative Medicine physician who has established a high-impact independent clinical research program that is well funded with an outstanding publication record. In the 10 years since completing her Geriatrics fellowship, she has established herself as a successful mentor of students, fellows, and junior faculty who have published high-impact aging research, become successfully funded, and continue to participate in patient-oriented research in aging. The candidate has developed an extensive research portfolio focused on creating and testing literacy- and culturally appropriate health education materials to improve ACP and medical decision making for older adults. She developed a broader paradigm of ACP that focuses not only on one-time treatment decisions, such as for cardiopulmonary resuscitation (CPR), but also on the process of preparing patients to communicate their wishes and to participate with clinicians in making real-time, complex medical decisions over the course of illness. She operationalized this paradigm into an easy-to-understand, patient- centered website called PREPARE that teaches patients, through videos, how to identify their wishes and communicate with surrogates and clinicians. The candidate received R01 funding from the NIA to test the efficacy of the PREPARE website to engage diverse, vulnerable older adults from an urban, county hospital in ACP using validated patient questionnaires. This K24 proposal will provide the candidate with protected time to expand her research in a new direction focused on direct observation (i.e., audio recording) of patient-clinician communication within primary care encounters in response to the PREPARE intervention. This new research will determine whether a patient-centered ACP website can empower and activate patients to discuss ACP and to facilitate communication with their primary care providers. The candidate will also develop her formal mentoring program with plans for the recruitment, selection, development, and evaluation of mentees who will become leaders in aging research. She will work with each mentee to establish a focused career development plan in which they complete research projects and develop the skills needed to become independent investigators. These plans will make full use of the outstanding clinical research training environment at UCSF. She will leverage her leadership positions at UCSF to recruit more mentees interested in research on ACP and aging in vulnerable populations.

抽象的 该提案的目的是（1）使候选人能够进一步发展她的研究计划，重点关注 改善弱势老年人的预先护理计划 (ACP) 和知情医疗决策 （2）利用她的研究项目作为指导对以患者为中心感兴趣的初级研究人员的平台 老年病学和其他医学亚专业的衰老研究。候选人是一位老年病学家并且 姑息医学医师，建立了一个高影响力的独立临床研究项目， 资金雄厚，出版记录出色。完成老年病学研究金后的 10 年来， 她已成为学生、研究员和初级教师的成功导师，他们发表了 高影响力的老龄化研究，成功获得资助，并继续参与以患者为中心的 老龄化研究。候选人开发了广泛的研究组合，重点关注创造和 测试读写能力和文化上适当的健康教育材料，以改善 ACP 和医疗决策 为老年人制作。她开发了一种更广泛的 ACP 范式，不仅关注一次性 治疗决策，例如心肺复苏 (CPR)，还取决于准备过程 患者可以表达自己的意愿并与临床医生一起制定实时、复杂的医疗 病程中的决定。她将这一范例转化为一种易于理解、耐心的方式 以名为 PREPARE 为中心的网站，通过视频教导患者如何确定自己的意愿并 与代理人和临床医生沟通。候选人获得 NIA 的 R01 资助来测试 PREPARE 网站在吸引来自城市、县医院的多样化、弱势老年人方面的功效 ACP 使用经过验证的患者问卷。此 K24 提案将为候选人提供受保护的时间 将她的研究扩展到一个新的方向，重点是对患者临床医生的直接观察（即录音） 初级保健中针对 PREPARE 干预措施的沟通。这项新研究 将确定以患者为中心的 ACP 网站是否能够授权和激活患者讨论 ACP 和 促进与初级保健提供者的沟通。候选人还将发展她的正式 指导计划，包括招募、选择、发展和评估受训者的计划 成为衰老研究领域的领导者。她将与每位学员合作建立有针对性的职业发展 制定计划，让他们完成研究项目并培养独立所需的技能 调查人员。这些计划将充分利用加州大学旧金山分校优秀的临床研究培训环境。 她将利用她在 UCSF 的领导地位来招募更多对 ACP 和 弱势群体的老龄化。