Expanding Treatment Options for Older Persons

描述（由申请人提供）：在以患者为导向的研究中，职业中期研究者奖的具体目标是为主要研究者提供足够的受保护时间，以便：（1）扩大一项研究方案，致力于提高老年人共同决策的频率和质量，以便为患者提供最符合其治疗偏好的护理;正式确定一个导师计划，重点是为来自不同学科和从事老龄化研究的学校的学员提供跨学科导师。该研究项目将建立在弗里德博士过去的工作基础上：a）利用健康行为模型来阐明作为一种健康行为的提前护理计划，B）开发方法来引出患有多种合并症的老年人的偏好。该方案将利用定性和定量相结合的方法，更深入地了解老年人在作出困难的治疗决策方面的经历和看法，并制定以病人为中心的措施。导师计划将利用下面描述的资源来提供核心的教育和职业发展经验。在此基础上，学员的个人研究计划将作为导师计划的核心，并将通过对成功的研究生涯和具体职业指导至关重要的技能的导师来补充。指导计划将基于对受训者目标的明确考虑和文件记录，为实现这些目标而量身定制的指导计划，以及定期审查该计划如何帮助受训者实现其目标。耶鲁大学医学院的环境提供了广泛的资源来支持研究和导师计划。这些包括一些培训计划，吸引了大量有才华的博士后研究员，并提供完善的课程，在生物统计学，流行病学和卫生政策的高级教学培训的机会，并通过耶鲁大学老龄化/胡椒中心计划，研究基础设施提供熟练的领域，数据管理和生物统计支持，以及获得广泛的人群。此外，研究和导师计划将利用并继续建立弗里德博士与医学亚专业，精神病学以及护理和公共卫生学院建立的跨学科关系。

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.