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

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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.