Mentoring Researchers in Advance Care Planning for Underrepresented Older Adults at Risk for Alzheimer’s Disease and Related Dementias and Their Caregivers

指导研究人员为面临阿尔茨海默病和相关痴呆症风险的代表性不足的老年人及其护理人员进行预先护理计划

• 批准号: 10587383
• 负责人: REBECCA L SUDORE
• 金额: $ 18.46万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-02-15 至 2028-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10587383
• 关键词: Address; Adult; Advance Care Planning; Advance Directives; Aging; Alzheimer' s disease related dementia; Alzheimer' s disease risk; California; Cardiopulmonary Resuscitation; Caregiver Burden; Caregiver support; Caregivers; Caring; Chinese; Church; Clinical Investigator; Clinical Research; Communication; Companions; Complex; Decision Making; Development; Development Plans; Discipline; Disparity; Educational Materials; Educational process of instructing; Elderly; Environment; Evaluation; Exclusion; Exercise; Face; Faculty; Feedback; Funding; Future; Geriatrics; Goals; Health education; Home; Impaired cognition; Individual; Intervention; Interview; Leadership; Learning; Libraries; Link; Medical; Mentors; Mid-Career Clinical Scientist Award (K24); Modeling; Nephrology; Older Population; Oncology; Operative Surgical Procedures; Palliative Care; Palliative Medicine; Participant; Patient Care Planning; Patients; Persons; Physicians; Positioning Attribute; Preparation; Procedures; Process; Public Health; Publications; Publishing; Reduce health disparities; Reporting; Research; Research Personnel; Research Project Grants; Research Training; San Francisco; Service delivery model; Structure; Suggestion; Testing; Time; Trust; United States National Institutes of Health; Universities; Visit; Work; career; career development; community engaged research; coronavirus pandemic; decision-making capacity; design; digital; efficacy testing; end stage disease; evidence base; experience; health literacy; implementation framework; implementation science; improved; interest; literacy; live stream; marginalization; marginalized community; marginalized population; mild cognitive impairment; novel strategies; patient oriented; patient oriented research; person centered; preference; primary care setting; programs; recruit; satisfaction; skills; student mentoring; theories; therapy development; virtual; virtual group; virtual healthcare

PROJECT 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 medical decision making for older adults, particularly historically marginalized individuals and persons with limited health literacy; (2) expand her research to older persons with mild cognitive impairment (PMCI) at risk for Alzheimer's Disease and Related Dementias (ADRD) and caregivers of PMCI or ADRD; and (3) use her research platform to mentor junior investigators interested in patient-oriented aging research, both within Geriatrics and other subspecialties. The candidate is a Geriatrician and Palliative Medicine physician who has established a well-funded, high-impact, independent clinical research program with an outstanding publication and mentoring record. In the past decade she has established herself as a successful mentor of students, residents, 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 also 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 marginalized older adults. She developed an expanded ACP paradigm that focuses not only on one-time treatment decisions, such as for cardiopulmonary resuscitation (CPR), but also on the process of preparing patients and caregivers to communicate their wishes and to participate with clinicians in making complex, in-the-moment medical decisions over time. She operationalized this expanded paradigm into easy-to-understand, person-centered programs (i.e., PREPARE for YOUR Care for patients and PREPARE for THEIR Care for caregivers) that use video stories to teach people how to identify and communicate their medical preferences and to make informed medical decisions. The candidate has received ongoing R01 and other funding to test the efficacy of these programs in primary care settings. This K24 proposal will provide the candidate with protected time to expand her research in a new direction. Grounded in implementation science frameworks and community-engaged research, the candidate will conduct research to adapt the PREPARE programs with and for PMCI and caregivers and test the acceptability of a new delivery model of online, livestreaming, facilitated group classes. The candidate will also continue to 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 an individualized 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 the University of California, San Francisco (UCSF). She will leverage her leadership positions at UCSF and nationally to recruit mentees interested in aging research, ACP, and marginalized populations.

项目摘要 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 改善老年人的预先护理计划 (ACP) 和医疗决策，特别是历史上的 边缘化个人和健康素养有限的人； (2) 将研究范围扩大到患有以下疾病的老年人 轻度认知障碍 (PMCI) 有患阿尔茨海默病和相关痴呆 (ADRD) 的风险 PMCI 或 ADRD 的照顾者； (3) 利用她的研究平台指导对以下领域感兴趣的初级研究人员 以患者为导向的衰老研究，包括老年病学和其他亚专业。候选人是一位老年病学家 姑息医学医师，建立了一个资金充足、影响力大、独立的临床机构 研究计划具有出色的出版物和指导记录。在过去的十年里她 确立了自己作为学生、住院医师、研究员和初级教师的成功导师的地位。 发表高影响力的衰老研究，成功获得资助，并继续参与患者- 面向老龄化的研究。该候选人还开发了广泛的研究组合，重点关注 创建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 边缘化老年人的决策。她开发了一个扩展的 ACP 范式，该范式不关注 不仅针对一次性治疗决策，例如心肺复苏 (CPR)，而且还针对 使患者和护理人员做好沟通意愿并与临床医生一起参与的过程 随着时间的推移做出复杂的、即时的医疗决策。她将这种扩展的范式运用到 易于理解、以人为本的计划（即“为患者的护理做好准备”和“为患者做好准备”） 他们对照顾者的关怀）使用视频故事来教人们如何识别和交流他们的 医疗偏好并做出明智的医疗决定。候选人已收到持续的 R01 和 其他资金用于测试这些计划在初级保健机构中的有效性。该 K24 提案将提供 候选人有受保护的时间将她的研究扩展到新的方向。立足于实施科学 框架和社区参与的研究，候选人将进行研究以适应 PREPARE 与 PMCI 和护理人员一起开展计划，并测试在线新交付模式的可接受性， 直播，促进小组课程。候选人还将继续发展她的正式指导 计划，其中包括招募、选择、发展和评估将成为受训者的计划 衰老研究领域的领导者。她将与每位学员一起建立个性化的职业发展 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我院优秀的临床研究培训环境 加州大学旧金山分校 (UCSF)。她将利用她在加州大学旧金山分校的领导地位 在全国范围内招募对老龄化研究、ACP 和边缘化人群感兴趣的学员。