Expanding Treatment Options for Older Persons

描述（由申请人提供）：面向患者的研究中职业中期研究者奖的具体目的是为主要研究者提供足够的保护时间，以便：1)扩大一个研究项目，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他们治疗偏好的护理；2)正式建立一个指导项目，专注于为来自不同学科和学校从事老龄化研究的学员提供跨学科指导。该研究项目将以弗里德博士过去的工作为基础：a)利用健康行为模型来解释作为一种健康行为的预先护理计划；b)开发方法来引出患有多种合并症的老年人的偏好。该项目将采用定性和定量相结合的方法，更深入地了解老年人对困难治疗决策的经历和看法，并制定以患者为中心的措施。导师计划将利用以下资源提供核心教育和职业发展经验。在此基础上，受训者的个人研究计划将作为指导计划的核心，并将辅以对成功的研究生涯至关重要的技能指导和具体的职业指导。指导计划将基于对受训者目标的明确考虑和记录，为实现这些目标而量身定制的指导计划，并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为研究和指导项目提供了广泛的资源支持。这些项目包括一些培训项目，这些项目吸引了大量有才华的博士后研究员，提供了完善的课程，提供了生物统计学、流行病学和卫生政策方面的高级教学培训机会，并通过耶鲁老龄化/胡椒中心项目，提供了一个研究基础设施，提供了熟练的领域、数据管理和生物统计学支持，并获得了广泛的人群。此外，研究和指导项目将利用并继续建立Fried博士与医学专科、精神病学、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.