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保健提供模式，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说，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，很少有人知道在城市服务水平低下的医院中，有多少住院患者在接受对抗疗法药物治疗的同时继续使用HDS。同样，对医院环境中与潜在HDS不良事件相关的因素知之甚少。健康信息技术有望成为向服务不足的患者及其医生提供HDS信息的创新和有效方式。该K 07申请提出了重要的第一步：（1）开发关于HDS在服务不足的医院患者中使用的坚实知识库，以及（2）设计和试点创新方法，以有效地向服务不足的住院患者及其医生提供基于证据的HDS信息，特别是通过健康信息技术。本申请的研究目标是：（1）为少数民族住院患者使用HDS的知识库做出贡献;（2）设计文化敏感的识字信息以患者为中心的信息技术系统，以教授HDS;（3）开发患者安全课程，帮助临床医生记录HDS的使用，并与患者有效地沟通HDS。为了实现这些目标，本K 07应用程序有三个具体目标：（1）在750名住院患者的样本中调查HDS使用、健康素养、药物使用和医院利用之间的关联;（2）在60名女性中进行随机临床试验，这些女性将接受虚拟患者倡导者提供的蔓越莓住院出院计划（一个电脑化的、动画的、有同理心的角色），和一个通过蔓越莓病人信息表接收相同信息的控制组;和（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，然后利用前后测量和图表审查来评估其对临床医生-患者HDS沟通的影响。这项研究的完成将得到以下方面的支持：（1）高技能的导师和顾问的核心;和（2）在教育的波士顿大学学校的教学技术研究生证书的完成。候选人的职业目标是成为（1）一个独立的HDS研究调查员和教育工作者为服务不足的人群，和（2）在HDS患者和临床医生教育的健康信息技术的使用的国家领导者。为了准备自己完成这些职业目标，以及上述研究目标，候选人建议（1）进行患者安全，卫生保健差异，健康素养和流行病学方法的指导培训，以及（2）追求课程工作临床试验设计，统计分析，人类受试者保护和在线课程开发。该奖项将有效地准备候选人成为一个成功的独立资助的HDS研究者，专注于服务不足的患者的需求，并在应用健康信息技术的CAM的研究和教学的专家。 公共卫生相关性：尽管广泛使用草药，很少有人知道住院使用草药和非维生素膳食补充剂在城市服务不足的医院。在K 07学术职业发展申请中，候选人提出了基本的第一步：（1）在服务不足的医院患者中开发有关草药使用的坚实知识基础，以及（2）设计和试点创新方法，以有效地向服务不足的住院患者及其医生提供基于证据的草药信息。

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.