Facilitating adoption of COPD evidence-based care in outpatient settings (FACES)

促进在门诊环境中采用慢性阻塞性肺病循证护理 (FACES)

基本信息

批准号：
8628168
负责人：
Laura Cecere Feemster
金额：
$ 15.67万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-07-01 至 2018-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8628168
关键词：
Academic Detailing Academic Medical Centers Adherence Adoption Adult Affect American Award Belief Caring Characteristics Chronic Disease Chronic Obstructive Airway Disease Chronic lung disease Clinic Clinical Clinical Research Clinical Sciences Clinical Trials Clinical Trials Design Community Medicine Critical Care Cross-Sectional Studies Data Data Analyses Development Development Plans Diagnosis Disease Management Educational Background Effectiveness Environment Face Funding Future Goals Guidelines Health Health Expenditures Health behavior Heterogeneity Hospitalization Institutes Institution Insurance Coverage Internal Medicine Intervention Intervention Trial Interview Knowledge Lead Lung Medical Records Medical center Medicine Mentored Patient-Oriented Research Career Development Award Mentors Methods Modeling Motivation Outcome Outpatients Patient Care Patient Self-Report Patients Phase Physicians Practice Guidelines Protocols documentation Provider Public Health Schools Publications Qualitative Research Quality of Care Quality of life Records Research Research Design Research Methodology Research Personnel Research Proposals Research Training Resources Scientist Severity of illness Socioeconomic Status Structure Time Training Translating Translational Research Universities Variant Washington Work base care delivery career career development clinical practice cohort community based practice demographics design disease diagnosis efficacy testing evidence base evidence based guidelines experience health care service utilization health related quality of life improved innovation multi-component intervention patient oriented research patient population primary care setting success therapy design translational health science

项目摘要

DESCRIPTION (provided by applicant): This K23 award will provide an opportunity for Dr. Cecere to achieve her long-term goal of transitioning to an independently-funded physician-scientist with a focus on improving outcomes for patients with chronic lung diseases. The proposed project builds on her previous work investigating the effects of patient health behaviors and characteristics on health outcomes for patients with COPD and studying heterogeneity in delivered COPD care. Through this project, Dr. Cecere will achieve her immediate goals of attaining expertise in clustered and correlated data analysis, qualitative research methods, and designing and conducting intervention trials. This will be accomplished through an integrated career development plan consisting of formal coursework, guidance from highly skilled mentors, and protected time to gain practical research experience. Environment: The rich academic environment at the University of Washington (UW) is an ideal place for Dr. Cecere's continued training. The UW Division of Pulmonary and Critical Care Medicine Clinical Research Training Track prides itself on a collegial environment in which investigators are encouraged to collaborate with one another. The UW also offers a broad range of educational and research resources, including the School of Public Health and Community Medicine and the Institute of Translational Health Sciences (the UW's Clinical and Translational Science Awards (CTSA) institution). In addition, Dr. Cecere has assembled a mentoring team with expertise in health delivery and quality improvement interventions, strong records of funding and publication, and success in training early-investigators who have gone on to have careers as physician-scientists at major academic medical centers. Research: In this patient-oriented research proposal, Dr. Cecere will identify specific patient and provider characteristics associated with best-practice COPD care and intervene to improve delivery of that care in the outpatient setting. To accomplish this, she has identified a cohort of COPD patients and their providers at the two internal medicine clinics associated with the University of Washington Medical Center in Seattle. Dr. Cecere will: 1) conduct a cross-sectional study to determine patient and provider characteristics associated with adherence to evidence-based best-practice guidelines for COPD management; 2) perform a qualitative study to better understand patient and provider perspectives influencing the delivery of recommended care for patients with COPD; and 3) test the efficacy of a multi-faceted intervention for providers designed to improve the delivery of best practice care to COPD patients in the primary care setting, using a quasi-experimental clinical trial design. The proposed project is innovative in that it explores the interface between Phase 2 (T2) and Phase 3 (T3) research by examining the efficacy of an intervention designed to disseminate and implement evidence-based guidelines into clinical practice as a means of improving quality of care. This study has the potential to lead to additional intervention and dissemination studies designed to improve health outcomes for the growing population of patients with COPD. This model can also be translated to improve outcomes for patients with other chronic diseases.

描述（由申请人提供）：该K23奖将为Cecere博士提供一个实现其长期目标的机会，将其转变为独立资助的医师 - 科学家，重点是改善慢性肺部疾病患者的结果。拟议的项目以她先前的工作为基础，研究了患者健康行为和特征对COPD患者的健康结果的影响，并研究了交付的COPD护理中的异质性。通过这个项目，Cecere博士将实现她在集群和相关的数据分析，定性研究方法以及设计和进行干预试验方面获得专业知识的直接目标。这将通过一项综合职业发展计划来实现，该计划包括正式的课程，高技能的导师的指导以及受保护的时间来获得实践研究经验。环境：华盛顿大学（UW）的丰富学术环境是Cecere继续培训的理想场所。 UW肺和重症监护医学临床研究培训轨道以大学环境而自豪的是，鼓励研究人员相互合作。 UW还提供广泛的教育和研究资源，包括公共卫生和社区医学学院以及转化健康科学研究所（UW的临床和转化科学奖（CTSA）机构）。此外，Cecere博士还召集了一个指导团队，在健康分娩和质量改进干预措施，资金和出版物的良好记录以及在培训早期评估者方面的成功方面具有专业知识，这些培训的早期评估者在主要学术医疗中心的医师科学家担任职业。研究：在这项以患者为导向的研究建议中，Cecere博士将确定与最佳实践COPD护理和干预相关的特定患者和提供者特征，以改善在门诊环境中的护理。为此，她在与西雅图华盛顿大学医学中心有关的两个内科诊所中确定了一群COPD患者及其提供者。 Cecere博士将：1）进行横断面研究，以确定与遵守基于证据的COPD管理最佳实践指南有关的患者和提供者的特征； 2）进行定性研究，以更好地了解影响COPD患者推荐护理的患者和提供者的观点； 3）测试旨在改善最佳交付的提供商多面干预措施的功效使用准实验性临床试验设计，在初级保健环境中为COPD患者进行护理。拟议的项目具有创新性，因为它通过检查旨在将基于证据的指南传播和实施临床实践的干预措施的功效来探讨2阶段（T2）和第3阶段（T2）研究之间的接口，以作为提高护理质量的手段。这项研究有可能导致额外的干预和传播研究，旨在改善不断增长的COPD患者人群的健康状况。该模型也可以翻译成改善其他慢性疾病患者的预后。