Physician Screening of Older Drivers: Decision Rules for Geriatric Injury Prevent

老年驾驶员的医生筛查：预防老年损伤的决策规则

• 批准号: 9515420
• 负责人: Marian Elizabeth Betz
• 金额: $ 10.8万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-08-15 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9515420
• 关键词: Accident and Emergency department; Affect; Age; Aging; Ambulatory Care; Automobile Driving; Chronic Disease; Clinic; Clinical; Clinical Medicine; Clinical Sciences; Cognitive; Colorado; Communities; Counseling; Derivation procedure; Development; Development Plans; Discipline; Effectiveness; Elderly; Emergency Medicine; Emotional; Environment; Epidemiology; Ethics; Evaluation; Family; Family member; Fellowship; Focus Groups; Foundations; Fright; Future; General Population; Geriatrics; Goals; Gold; Group Structure; Growth; Hand; Health; Health Personnel; Impairment; Injury; Institutes; Interview; K-Series Research Career Programs; Knowledge; Leadership; Legal Obligations; Master of Public Health; Mentors; Mentorship; Methodology; Methods; Modeling; Monitor; NCI Scholars Program; Nursing Faculty; Outcome; Patients; Performance; Pharmaceutical Preparations; Physician Assistants; Physicians; Population; Positioning Attribute; Prevention; Program Evaluation; Provider; Psyche structure; Public Health; Public Health Nurses; Public Health Nursing; Public Health Schools; Published Comment; Qualitative Methods; Qualitative Research; Recommendation; Recruitment Activity; Research; Research Methodology; Research Personnel; Research Proposals; Resources; Risk; Role; Safety; Sampling; Scientist; Sensitivity and Specificity; Sensory; Standardization; Surveys; System; Techniques; Testing; Time; Training; Training Activity; Translational Research; Trust; Universities; Validation; Vehicle crash; Work; base; brief screening; career; career development; cost; cost effective; design; evidence base; experience; faculty research; injured; injury prevention; innovation; killings; medical schools; multidisciplinary; neighborhood safety; older driver; older patient; patient oriented; patient oriented research; patient safety; premature; prevent; professor; programs; prospective; public health intervention; public health relevance; research and development; research study; screening; skills; sound; tool

DESCRIPTION (provided by applicant): This is a resubmission for a Paul B. Beeson Patient-Oriented Research Career Development Award in Aging (K23) by Marian Betz, MD, MPH. Dr. Betz's overall career goal is to be a leading independent researcher in geriatric injury prevention and emergency medicine in order to help maintain functional independence in older adults. Her innovative research proposal applies the model of a clinical decision rule to a public health intervention, through tiered assessment of brief older driver screening in ambulatory care settings followed by referral for more comprehensive testing. Candidate: Dr. Betz is a board-certified Emergency Medicine physician, Assistant Professor of Emergency Medicine at the University of Colorado Denver (UCD) School of Medicine and Assistant Professor of Epidemiology at the Colorado School of Public Health. She completed a Masters of Public Health and the Emergency Medicine Foundation Research Fellowship, and she has finished a number of studies related to older drivers and injury epidemiology and prevention. Dr. Betz has established close working relationships with her primary mentor (Dr. Robert Schwartz, a leading researcher in geriatrics with a long track record of mentoring) and co-mentors in Driving (Dr. David Carr, a national expert and researcher on older driver issues), Research Methodology (Dr. Jason Haukoos, a researcher with expertise in clinical decision rule methodology) and Qualitative Methods (Dr. Jaqueline Jones, a qualitative researcher with a focus on older adults and emergency medicine). Training: The proposed career development plan augments Dr. Betz's prior training and experience to focus on specific, advanced training in: (1) qualitative research methods; (2) decision rule derivation, validation and implementation; (3) public health issues in geriatric injury prevention; and (4) study management and leadership. Dr. Betz proposes to acquire these skills through intensive focused mentorship, relevant advanced coursework, and guided research. These training activities will help Dr. Betz gain the necessary skills and knowledge to implement an effective tiered older driver assessment program with brief screening in a clinical setting followed by appropriate referral to more comprehensive driver evaluation programs. Mentors/Environment: Dr. Betz has a strong mentorship team of leaders in geriatrics, driving, research methods, injury prevention, and emergency medicine who are committed to guiding her through her research and career development activities as she develops into an independent investigator. In addition, an advisory panel of experts in geriatrics, injury, and research career development will monitor Dr. Betz's progress in addition to providing additional topical guidance. The Department of Emergency Medicine is committed to supporting Dr. Betz's growth into an independent researcher, including financial and time support for her participation in the competitive Colorado Clinical and Translational Sciences Institute (CCTSI) Clinical Faculty Scholars Program (with intensive mentoring of junior research faculty) and a commitment of protected time and resources for this career development award. In addition, the UCD provides Dr. Betz with a rich research environment, including access to resources and collaborators at the CCTSI, the interdisciplinary UCD Center on Aging, and the UCD professional Schools of Medicine, Public Health, Nursing, and other disciplines. Research: With the aging of the U.S. population, there is an urgent need for efficient, effective and acceptable methods of identifying, retraining or restricting unsafe older drivers without unfairly restrictingthe mobility of those who are safe. This proposal applies the model of a clinical decision rule to a public health program through the development of tiered older driver assessment, with widespread brief screening followed by referral for additional evaluation of those with a positive screen. The research plan aims to examine the viewpoints of older drivers and providers concerning driver assessment (Aim 1), to validate and refine a brief question-based screening tool (Aim 2), and to examine the feasibility of pilot program implementation (Aim 3) in order to prepare for future implementation of a model tiered older driver assessment program (planned R01). Summary: This innovative proposal applies a common approach from clinical medicine (clinical decision rules) to an important issue in geriatric injury prevention (older driver safety in a way that considers and values the perspectives of older drivers, their families, and their providers. This approach might be applied to other geriatric injuries or other settings, and the proposed mentored, patient-centered training and research will help Dr. Betz develop into an independent, nationally-recognized investigator and leader in geriatric injury prevention.

描述（由申请人提供）：这是一个保罗B重新提交。Beeson面向患者的研究职业发展奖在老龄化（K23）玛丽安贝茨，医学博士，公共卫生硕士。贝茨博士的总体职业目标是成为一个领先的独立研究人员在老年伤害预防 和急诊医学，以帮助老年人保持功能独立。她的创新研究建议将临床决策规则的模型应用于公共卫生干预，通过对门诊护理环境中的简短老年驾驶员筛查进行分层评估，然后进行更全面的测试。候选人：贝茨博士是一名董事会认证的急诊医学医生，科罗拉多丹佛大学（UCD）医学院急诊医学助理教授，科罗拉多公共卫生学院流行病学助理教授。她完成了公共卫生硕士和急诊医学基金会研究奖学金，她已经完成了一些与老年司机和伤害流行病学和预防有关的研究。贝茨博士与她的主要导师建立了密切的工作关系（Robert Schwartz博士，老年医学领域的领先研究员，拥有长期的指导记录）和驾驶领域的共同导师（大卫卡尔博士，国家老年驾驶员问题专家和研究员），研究方法（Jason Haukoos博士，临床决策规则方法学专家）和定性方法（杰奎琳·琼斯博士，一位专注于老年人和急诊医学的定性研究人员）。培训内容：拟议的职业发展计划增加了贝茨博士先前的培训和经验，重点放在以下方面的具体高级培训：（1）定性研究方法;（2）决策规则的推导、验证和实施;（3）老年损伤预防中的公共卫生问题;（4）研究管理和领导。贝茨博士建议通过集中的辅导，相关的高级课程和指导研究来获得这些技能。这些培训活动将帮助贝茨博士获得必要的技能和知识，以实施有效的分层老年驾驶员评估计划，在临床环境中进行简短的筛选，然后适当地转介到更全面的驾驶员评估计划。导师/环境：贝茨博士有一个强大的指导团队，由老年医学、驾驶、研究方法、伤害预防和急诊医学方面的领导者组成，他们致力于指导她完成研究和职业发展活动，使她成为一名独立的研究者。此外，一个老年病专家咨询小组， 受伤，研究职业发展将监测博士贝茨的进展，除了提供额外的专题指导。贝茨的成长为一个独立的研究人员，包括财政和时间支持她在竞争激烈的科罗拉多临床和转化科学研究所（CCTSI）临床教师学者计划（与初级研究教师的密集辅导）的参与，并为这个职业发展奖保护时间和资源的承诺。贝茨与丰富的研究环境，包括访问资源和合作者在CCTSI，跨学科的UCD中心老龄化，医学，公共卫生，护理和其他学科的UCD专业学校。调研：随着美国人口的老龄化，迫切需要一种高效、有效和可接受的方法来识别、再培训或限制不安全的老年驾驶员，而不会不公平地限制那些安全驾驶员的流动性。该提案将临床决策规则模型应用于公共卫生计划，通过分层老年驾驶员评估的发展，广泛进行简短筛查，然后对筛查阳性的患者进行额外评估。该研究计划旨在研究老年驾驶员和供应商关于驾驶员评估的观点（目标1），验证和完善一个简短的基于问题的筛选工具（目标2），并研究试点计划实施的可行性（目标3），以准备未来实施的模型分层老年驾驶员评估计划（计划R 01）。总结：这一创新提案将临床医学（临床决策规则）的一种常见方法应用于老年人伤害预防（老年驾驶员安全）的一个重要问题，并考虑和重视老年驾驶员、他们的家人和他们的供应商的观点。这种方法可能适用于其他老年伤害或其他设置，并建议指导，以病人为中心的培训和研究将帮助博士贝茨发展成为一个独立的，全国公认的调查员和领导者在老年伤害预防。

项目成果

Older adult drivers living in residential care facilities.

居住在住宿护理设施中的老年驾驶员。

• 发表时间: 2015
• 期刊: The annals of long-term care : the official journal of the American Medical Directors Association
• 作者: Lum,HillaryD;Ginde,AditA;Betz,MarianE
• 通讯作者: Betz,MarianE

Crash

碰撞

• 发表时间: 1997
• 作者: M. T. Blanche

Predictors of Readiness for Mobility Transition in Older Drivers.

• DOI: 10.1080/01634372.2018.1433260
• 发表时间: 2018-03
• 期刊: Journal of gerontological social work
• 影响因子: 3.2
• 作者: Kandasamy D;Harmon AC;Meuser TM;Carr DB;Betz ME
• 通讯作者: Betz ME

Older Adult Openness to Physician Questioning About Firearms.

老年人对医生关于枪支问题的询问持开放态度。

• DOI: 10.1111/jgs.13695
• 发表时间: 2015
• 期刊: Journal of the American Geriatrics Society
• 影响因子: 6.3
• 作者: Betz,MarianE;Flaten,HannaK;Miller,Matthew
• 通讯作者: Miller,Matthew

Prospective Validation of a Screening Tool to Identify Older Adults in Need of a Driving Evaluation.

• DOI: 10.1111/jgs.15222
• 发表时间: 2018-03
• 期刊: Journal of the American Geriatrics Society
• 影响因子: 6.3
• 作者: Betz ME;Haukoos JS;Schwartz R;DiGuiseppi C;Kandasamy D;Beaty B;Juarez-Colunga E;Carr DB
• 通讯作者: Carr DB