Academic Career Award in Complementary and Alternative Medicine

描述（由申请人提供）：NCCAM的2005年战略计划包括探索有组织的医疗服务模式，将补充和替代药物（CAM）与传统护理相结合。2007年全国健康访谈调查报告称，大约五分之一的成年人使用草药和非维生素膳食补充剂（HDS）。然而，在服务不足的城市医院，有多少住院病人在接受对抗疗法药物治疗的同时继续使用HDS，这一情况鲜为人知。同样，在医院环境中，与HDS潜在不良事件相关的因素也知之甚少。卫生信息技术有望成为向得不到充分服务的患者及其医生提供HDS信息的一种创新而有效的方式。这个K07应用程序提出了必要的第一步，以实现以下目标：(1)开发一个关于HDS在得不到充分服务的医院患者中使用的坚实知识库；(2)设计和试点创新方法，特别是通过卫生信息技术，有效地向得不到充分服务的住院患者及其医生提供基于证据的HDS信息。本应用程序的研究目标是：(1)建立少数民族住院患者HDS使用的知识库；(2)设计文化敏感的识字病人为中心的信息技术系统来教授HDS；(3)制定患者安全课程，帮助临床医生记录HDS的使用情况，并有效地与患者就HDS进行沟通。为了实现这些目标，本K07应用程序有三个具体目标：(1)调查750名住院患者样本中HDS使用、健康素养、药物使用和医院利用之间的关系；(2)对60名女性进行随机临床试验，这些女性将接受由虚拟患者倡导者（一个计算机化的、动画化的、移情的角色）提供的蔓越莓出院计划，而对照组则通过蔓越莓患者信息表接收相同的信息；(3)为临床医生设计、规划和评估基于网络的HDS患者安全课程，然后利用前后措施和图表审查来评估其对临床-患者HDS沟通的影响。本研究的完成将得到以下方面的支持：(1)高技能的核心导师和顾问；(2)在波士顿大学教育学院完成教学技术研究生证书。候选人的职业目标是成为(1)独立的HDS研究调查员和教育工作者，为服务不足的人群服务；(2)在HDS患者和临床医生教育中使用卫生信息技术的国家领导者。为了准备完成这些职业目标，以及上面概述的研究目标，候选人建议(1)接受患者安全，医疗保健差异，健康素养和流行病学方法方面的指导培训，(2)追求课程临床试验设计，统计分析，人类受试者保护和在线课程开发。该奖项将有效地为候选人做好准备，使其成为一名成功的独立资助的HDS研究者，专注于服务不足的患者的需求，以及将卫生信息技术应用于CAM的研究和教学的专家。

DESCRIPTION (provided by applicant): NCCAM's 2005 Strategic Plan includes the exploration of organized health care delivery models which integrate complementary and alternative medicines (CAM) with conventional care. The 2007 National Health Interview Survey reports that approximately one in five adults use Herbs and non-vitamin Dietary Supplements (HDS). However, little is known about the number of inpatients in urban underserved hospitals who continue to use HDS while receiving treatment with allopathic medicines. Similarly, little is known about factors associated with potential HDS adverse events in hospital settings. Health information technology holds promise as an innovative and effective way to deliver HDS information to underserved patients and their physicians. This K07 application proposes essential first steps toward (1) developing a solid knowledge base about HDS use in underserved hospital patients, and (2) designing and piloting innovative methods to effectively deliver evidenced-based HDS information to underserved inpatients and their physicians, in particular through health information technology. The research objectives of this application are: (1) to contribute to the knowledge base about HDS use among minority inpatients; (2) to design culturally sensitive literacy-informed patient-centered information technology systems to teach about HDS; and (3) to develop a patient safety curriculum that will help clinicians document HDS use and communicate effectively with their patients about HDS. To achieve these objectives, this K07 application has three specific aims: (1) Investigate the association between HDS use, health literacy, medication use, and hospital utilization in a sample of 750 hospitalized patients; (2) Conduct a randomized clinical trial in sixty women who will receive a hospitalized discharge plan on cranberry delivered by a virtual patient advocate (a computerized, animated, empathic character), and a control group who receives the same information via a cranberry patient information sheet; and (3) Design, program, and evaluate a web-based HDS patient safety curriculum for clinicians, then utilize pre and post measures and chart reviews to assess its impact on clinician-patient HDS communication. Completion of this research will be supported by: (1) a core of highly skilled mentors and consultants; and (2) completion of a Graduate Certificate in Instructional Technology at the Boston University School of Education. The candidate's career goals are to become (1) an independent HDS research investigator and educator for underserved populations, and (2) a national leader in the use of health information technology for HDS patient and clinician education. To prepare herself to accomplish these career goals, as well as the research objectives outlined above, the candidate proposes (1) to undertake mentored training in patient safety, health care disparities, health literacy, and epidemiologic methods, and (2) to pursue course-working clinical trial design, statistical analysis, human subject protections, and online curriculum development. This award will effectively prepare the candidate to become a successful independently-funded HDS investigator, focused on the needs of underserved patients, and an expert in applying health information technology to the study and teaching of CAM. PUBLIC HEALTH RELEVANCE: Despite widespread herb use, little is known about inpatient use of herbs and non-vitamin dietary supplements in urban underserved hospitals. In this K07 Academic Career Development application, the candidate proposes essential first steps toward (1) developing a solid knowledge base about herb use in underserved hospital patients, and (2) designing and piloting innovative methods to effectively deliver evidenced-based herbal information to underserved inpatients and their physicians using health information technology.