Expanding Treatment Options for Older Persons

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DESCRIPTION (provided by applicant): The specific aim of the Midcareer investigator Award in Patient-Oriented Research is to provide the Principal Investigator with sufficient protected time in order: 1) to expand a research program devoted to enhancing the frequency and quality of shared decision-making for older persons in order to provide patients with care that best meets their treatment preferences and 2) to formalize a mentorship program focused on providing interdiscplinary mentorship to trainees from a diverse range of disciplines and schools pursuing aging research. The research program will build upon Dr. Fried's past work to: a) utilize health behavior models to explicate advance care planning as a health behavior and b) develop methods to elicit the preferences of older persons with multiple comorbidities. This program will utilize mixed qualitative- quantitative methods to provide greater insight into older persons' experiences with and perceptions of difficult treatment decision-making and to develop patient-centered measures. The mentorship program will utilize the resources described below to provide core educational and career development experiences. Building upon these, the trainee's individual research program will serve as the core of the mentorship program, and it will be supplemented by mentorship regarding skills critical to a successful research career and specific career guidance. The mentorship program will be based on an explicit consideration and documentation of the trainee's goals, a mentorship plan tailored to meet these goals, and regular review of how well the plan is assisting the trainee to meet his/her goals. The environment of the Yale School of Medicine offers extensive resources to support both the research and mentorship programs. These include a number of training programs that attract a large number of talented post-doctoral fellows and that provide well-developed curricula, opportunities for advanced didactic training in biostatistics, epidemiology, and health policy, and, through the Yale Program on Aging/Pepper Center, a research infrastructure providing skilled field, data management, and biostatistical support as well as access to a broad range of populations. In addition, the research and mentorship programs will utilize and continue to build the interdisciplinary relationships Dr. Fried has established with medical subspecialties, psychiatry, and the Schools of Nursing and Public Health.