Developing Patient-Centered Decision Support for Eosinophilic Esophagitis

开发以患者为中心的嗜酸性食管炎决策支持

基本信息

批准号：
10661102
负责人：
Joy Weiling CHANG
金额：
$ 19.61万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-07-08 至 2027-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10661102
关键词：
Achievement Address Adherence Allergic Area Attitude Automobile Driving Book Chapters Caring Chronic Chronic Disease Clinic Clinical Collaborations Communication Complex Conduct Clinical Trials Counseling Data Decision Making Deglutition Disorders Development Development Plans Diagnosis Diet therapy Disease Disease Management Disease Outcome Education Educational workshop Ensure Eosinophilic Esophagitis Eosinophilic Gastrointestinal Disease Equipoise Esophageal Diseases Esophagus Evaluation Exclusion Face Feedback Fibrosis Focus Groups Food Fostering Functional disorder Funding Gastroenterologist Gastroenterology Goals Grant Guidelines Health Care Costs Health Personnel Healthcare Immune Impaired health Incidence Individual Intervention Intervention Studies Interview Joints Knowledge Left Literature Manuscripts Maryland Mediating Mentors Mentorship Methodology Methods Michigan Outcome Patient Outcomes Assessments Patient Preferences Patients Pattern Peer Review Pharmaceutical Preparations Physicians Prevalence Provider Publishing Qualitative Research Quality of Care Quality of life Randomized Readiness Recommendation Reporting Research Research Methodology Research Personnel Science Scientist Standardization Structure Symptoms Testing Training Treatment Protocols Universities Variant acceptability and feasibility career career development chronic inflammatory disease cost design dietary disorder control efficacy outcomes eosinophilic inflammation experience health related quality of life improved individual patient individualized medicine innovation instructor meetings novel strategies patient engagement patient oriented patient-clinician communication pilot test preference prevent prototype provider factors response satisfaction shared decision making treatment adherence treatment as usual treatment choice usability web based decision aid young adult

项目摘要

PROJECT SUMMARY Candidate’s Long-term Career Goal: To become an independently funded physician-scientist developing and testing patient-centered interventions to support shared decision making (SDM) in chronic esophageal diseases. Research Context: As a chronic disease with rapidly rising prevalence, incidence, healthcare costs, and burdens to patient quality of life, eosinophilic esophagitis (EoE) is an understudied, challenging area of care for both patients and providers that requires support in education, decision making, and communication around complex treatment choices to prevent costly complications. As clinical equipoise exists between medication and dietary therapies, understanding stakeholder drivers of decision making and applying SDM are critical gaps in patient-centered EoE care, and are needed to improve long-term disease outcomes. Candidate Background and Achievements: Dr. Chang is an Instructor in Gastroenterology at the University of Michigan (UM) and an awardee of a Consortium of Eosinophilic Gastrointestinal Disease Researchers grant. She received her MD from the University of Maryland and MS from UM. To date she has published 13 original peer-reviewed manuscripts and one book chapter, 10 of which she is first or senior author. Career Development Plan: Dr. Chang proposes to develop new expertise in mixed methods, advanced qualitative research methods, decision sciences, and clinical trial conduct and evaluation to assess the impact of a decision support intervention on outcomes. Her career development goals are supported by stellar mentorship, advanced didactic coursework, and participation in workshops and professional meetings designed to foster collaboration, ensure successful study completion, and support her seamless transition into a successful independent researcher. Aims: 1) Elicit the multilevel factors that influence decision making for EoE management among patients and providers, 2) Develop a multilevel decision support intervention prototype that supports SDM for selection of EoE therapy, and 3) Pilot test and evaluate feasibility, acceptability, and preliminary patient-reported efficacy outcomes associated with use of the decision support intervention. Research Plan: Dr. Chang will 1) use a mixed methods design to interview patients with EoE to identify factors that drive treatment decision making, 2) conduct qualitative interviews of gastroenterologists and allergists to characterize provider perspectives about EoE management and supported decision making, 3) develop a multilevel decision support intervention to facilitate SDM between patients and providers, and 4) assess decision intervention feasibility, acceptability, and influence on preliminary efficacy outcomes comparing 20 patients receiving decision support to 20 patients receiving control content.

项目概要候选人的长期职业目标：成为一名独立资助的医师科学家，发展并测试以患者为中心的干预措施，以支持慢性食管癌的共同决策（SDM）疾病。研究背景：作为一种慢性病，患病率、发病率、医疗费用和医疗费用迅速上升嗜酸性粒细胞性食管炎（EoE）对患者的生活质量造成负担，是一个尚未得到充分研究且具有挑战性的护理领域需要教育、决策和沟通方面支持的患者和提供者由于药物治疗之间存在临床平衡，因此需要采取复杂的治疗选择来预防昂贵的并发症。和饮食疗法、了解利益相关者决策驱动因素和应用 SDM 至关重要以患者为中心的 EoE 护理方面存在差距，并且需要改善长期疾病结果。候选人背景和成就：张博士是大学胃肠病学讲师密歇根大学 (UM) 和嗜酸粒细胞胃肠病研究人员联盟的获奖者。她获得了马里兰大学的医学博士学位和密歇根大学的硕士学位。迄今为止，她已发表了 13 篇原创文章。经过同行评审的手稿和一本书章节，其中 10 个章节她是第一或高级作者。职业发展计划：张博士建议发展混合方法、先进技术等方面的新专业知识定性研究方法、决策科学以及临床试验的实施和评估以评估影响她的职业发展目标得到了出色的支持。指导、高级教学课程以及参加研讨会和专业会议旨在促进合作，确保成功完成学习，并支持她无缝过渡到一位成功的独立研究员。目标： 1) 找出影响患者和患者 EoE 管理决策的多层次因素 2) 开发一个多级决策支持干预原型，支持 SDM 选择 EoE 疗法，以及 3) 试点测试并评估可行性、可接受性和初步患者报告的疗效与使用决策支持干预相关的结果。研究计划：Chang 博士将 1) 使用混合方法设计采访 EoE 患者以确定因素推动治疗决策，2）对胃肠病学家和过敏症专家进行定性访谈，以描述提供商对 EoE 管理和支持决策的看法，3) 制定多层次决策支持干预，以促进患者和提供者之间的 SDM，以及 4) 评估决策干预的可行性、可接受性以及对初步疗效结果的影响比较 20 接受决策支持的患者与接受控制内容的 20 名患者相比。