Mentoring Intervention Development in Fall and Fracture Prevention

 描述(申请人提供)：我的老年人预防跌倒和骨折的以患者为中心的研究平台使我有机会发展针对脆弱人群的复杂干预开发技能。这些技能包括纵向和行政数据分析、定性方法、试点研究、随机试验和经济分析。复杂性科学和适应性领导模型一直是为复杂综合症和医疗保健环境设计干预措施的信息性概念框架。作为杜克大学医学中心的一名副教授，我已经开始对来自不同专业和专业的老年研究人员进行老龄研究方法方面的培训，然而，我将受益于有保护的时间来制定一个针对老年人复杂问题的干预开发指导计划。这项K24建议的直接目标是通过整合我的跌倒和骨折研究项目来扩大我的研究平台，并通过培训下一代以患者为导向的研究人员来提高我的指导技能，这些研究人员开发实用的干预措施来减少跌倒和骨折。我的长期职业目标是开发和实施实用的干预措施，以减少老年人骨质疏松性骨折的破坏性后果。环境：杜克大学医学中心是老年研究人员的丰富环境。杜克大学老龄化和人类发展研究中心包括在大学拥有广泛专业知识的教职员工。杜克·克劳德·O·佩珀老年美国人独立中心提供研究支持服务；我目前是领导力核心组织的成员，也是研究职业发展核心组织的联席主席。我的研究和指导活动还发生在达勒姆弗吉尼亚州老年医学研究和教育中心，在那里我是助理主任，达勒姆弗吉尼亚州卓越卫生服务研究中心(CON和CREATE中心)，杜克临床转化科学奖励中心(CTSA)，以及杜克护理学院NIH资助的适应中心。研究：我的指导计划的关键要素(具体目标1)包括在我的研究领域进行培训和课程开发，以提高我的指导技能。具体地说，我将通过杜克大学CTSA导师管道计划参加正式的导师培训，运营一个由专注于导师的以患者为导向的研究人员组成的职业生涯中期同行导师小组，并开发一个关于干预发展的12部分研讨会系列。对于具体目标2，我将通过正式的专业发展和实用研究设计(适应性设计，社区参与研究)的实践经验来提高我的研究技能。对于具体目标3，我将指导从6项现有拨款中产生的、涉及7名学员的以患者为导向的跌倒和骨折预防研究。这些项目包括为这一申请新提出的3项研究。这些研究的中心是在现有的地区性骨折联络服务中开发和试点测试护士领导的多因素预防跌倒协议，使用远程医疗技术扩大其范围和覆盖范围。在颁奖结束时，我将处于有利地位，可以获得资金，用于在医疗系统内提供针对高危老年人的综合跌倒和骨折预防计划的大型务实试验测试。

 DESCRIPTION (provided by applicant): My patient-oriented research platform in preventing falls and fractures in older adults has given me the opportunity to develop skills in complex intervention development for frail populations. These skills include analysis of longitudinal and administrative data, qualitative methods, pilot studies, randomized trials, and economic analysis. Complexity Science and Adaptive Leadership models have been informative conceptual frameworks for designing interventions for complex syndromes and healthcare settings. As an Associate Professor at Duke University Medical Center, I have begun to train aging researchers from diverse professions and specialties in aging research methods, however, I would benefit from protected time to develop a mentoring program in intervention development for complex problems in older adults. The immediate goal of this K24 proposal is to expand my research platform by integrating my fall and fracture research programs, and improve my mentoring skills through training the next generation of patient oriented researchers developing pragmatic interventions to reduce falls and fractures. My long-term career goal is to develop and implement pragmatic interventions to reduce the devastating consequences of osteoporotic fractures in older adults. Environment: Duke University Medical Center is a rich environment for aging researchers. The Duke Center for the Study of Aging and Human Development includes faculty with a wide range of expertise across the University. The Duke Claude O. Pepper Older Americans Independence Center provides research support services; I currently serve on the Leadership Core and co-chair the Research Career Development Core. My research and mentoring activities also occur within the Durham VA Geriatrics Research and Education Center, where I am Assistant Director, the Durham VA Health Services Research Center of Excellence (COIN and CREATE Centers), the Duke Clinical Translational Science Award Center (CTSA), and the Duke School of Nursing NIH-funded ADAPT Center. Research: Key elements of my mentoring plan (Specific Aim 1) include training and curriculum development in my research area to improve my mentoring skills. Specifically, I will participate in formal mentor training through the Duke CTSA Mentor Pipeline Program, run a mid-career peer mentoring group of patient oriented researchers focused on mentoring, and develop a 12 part workshop series on Intervention Development. For Specific Aim 2, I will enhance my research skills through formal professional development and practical experiences in pragmatic study design (adaptive designs, community engaged research). For Specific Aim 3, I will mentor patient oriented research in fall and fracture prevention emerging from 6 current grants and involving 7 trainees. These projects include 3 studies newly proposed for this application. The centerpiece of these studies is the development and pilot testing of nurse-led multifactorial fall prevention protocols within an existing regional Fracture Liaison Service, delivered using telehealth technologies to expand their scope and reach. At the conclusion of the award, I will be well positioned to obtain funding for a large pragmatic trial testing integrated fall and fracture prevention programs delivered within a health system and targeted to high risk older adults.