Translating Clinical Decision Making into Systems of Care: A Mid-Career Mentor

描述(由申请人提供)：这笔赠款将资助斯坦福大学医学院斯坦福预防研究中心预防结果和实践计划(PPOP)中的学员培训计划。培训计划将由PPOP主任Randall S.Stafford，医学博士，博士指导。通过培训计划，斯塔福德博士将：1)开发和应用一种系统的指导方法，用各种其他教育和职业发展经验来补充传统的学徒模式。这些技能是从事以患者为导向的研究的职业生涯所必需的，但往往被忽视；2)通过工资支持和指导时间的提供，增加斯塔福德博士的能力，为更多的指导对象提供更深入的指导；3)解决目前科学知识难以转化为广泛实践的问题，方法是让指导对象参与旨在医疗保健系统中更多采用推荐的心脏病指南的研究项目。与斯塔福德博士和PPOP研究分析师密切合作，为该计划的受训者提供创新的教育和职业发展经验，包括：协助临床试验设计，包括招募战略、数据统计分析、口头陈述结果、撰写研究手稿、开发他们的项目组合、制定研究结果传播战略和战略职业规划。在该奖项下接受指导的学员将通过四个研究项目的培训获得以患者为导向的研究经验：1)斯坦福大学和圣马特奥县心连心项目：这项正在进行的临床试验将实施和评估心脏风险因素的病例管理方法。2)针对社会经济弱势群体的基于互联网的心血管干预：该项目将开发和试点一种基于互联网的干预，将教育材料和行为干预结合在一起，以降低心血管疾病风险。3)减少女性骨质疏松性骨折风险的分阶段在线干预：该项目将开发和试点基于互联网的骨健康干预措施。4)通过病例管理和环境支持实现持久减肥：该项目将通过随机临床试验，评估在有或没有家庭“环境支持”成分的情况下，病例管理减肥方法的有效性。总而言之，如果我们不能制定将基础科学知识应用于临床的战略，然后制定确保有效应用于卫生保健系统的方法，我们在基础科学研究方面的巨大投资就会受到威胁。这一奖项将有助于解决第二个翻译“瓶颈”，方法是系统地培训受训者，开展以病人为导向的研究，以改进循证做法的采用。

DESCRIPTION (provided by applicant): This grant will fund a mentee training program in the Program on Prevention Outcomes and Practices (PPOP) in the Stanford Prevention Research Center at the Stanford School of Medicine. The training program will be directed by Randall S. Stafford, MD, PhD, Director of the PPOP. Through the training program, Dr. Stafford will: 1) develop and apply a systematic approach to mentoring that supplements the traditional apprenticeship model with a variety of other educational and career building experiences. These skills are required for a career in patient-oriented research, but are often overlooked; 2) Through salary support and the availability of mentoring time, increase Dr. Stafford's capacity to provide a greater depth of mentoring to a larger number of mentees; 3) address current problems with the poor translation of scientific knowledge into widespread practice by involving mentees in research projects aimed at increasing the adoption of recommended heart disease guidelines in health care systems. Working closely with Dr. Stafford and PPOP research analysts, innovative educational and career building experiences for the mentees in this program will include: assisting in clinical trial design including recruitment strategies, statistical analysis of data, oral presentation of findings, writing research manuscripts, developing their portfolio of projects, developing strategies for the dissemination of research results, and strategic career planning. Trainees being mentored under this award will gain experience in patient-oriented research by training on four research projects: 1) The Stanford and San Mateo County Heart to Heart Project: This ongoing clinical trial will implement and evaluate a case-management approach to cardiac risk factors. 2) An Internet-based Cardiovascular Intervention for the Socioeconomically Disadvantaged: This project will develop and pilot test an internet-based intervention that incorporates educational material and behavioral interventions for cardiovascular disease risk reduction. 3) A Stage-tailored Online Intervention to Reduce Women's Risk for Osteoporotic Fractures: This project will develop and pilot test an Internet-based bone-health intervention. 4) Achieving Lasting Weight Loss through Case-Management and Environmental Support: This project will evaluate, through a randomized clinical trial, the effectiveness of a case- management approach to weight loss with and without a home-based "environmental support" component. In summary, our enormous investment in basic science research is jeopardized if we fail to develop strategies for bringing basic science knowledge to clinical application and then develop methods of ensuring that effective applications are incorporated into health care systems. This award will help address the second translational "bottleneck" through a systematic approach to training mentees in the conduct of patient-oriented research aimed at improving the adoption of evidence-based practices.