Refining an Advance Care Planning Group Visit intervention a novel intervention to engage older adults in advance care planning

完善预先护理计划小组访问干预是一种让老年人参与预先护理计划的新颖干预措施

• 批准号: 9716835
• 负责人: Hillary Lum
• 金额: $ 14.1万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-15 至 2020-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9716835
• 关键词: Address; Adult; Advance Care Planning; Advance Directives; Affect; Aging; Alzheimer' s Disease; Americas; Basic Science; Caregivers; Caring; Clinic; Clinical; Clinical Trials; Cognitive; Colorado; Communication; Communities; Consent; Decision Making; Dementia; Disease; Disease Management; Doctor of Philosophy; Documentation; Effectiveness; Elderly; Enrollment; Evaluation; Family member; Feasibility Studies; Focus Groups; Foundations; Friends; Funding; Future; General Population; Geriatrics; Goals; Health; Health Promotion; Health system; Healthcare Power of Attorney; Healthcare Systems; Human; Impaired cognition; Individual; Influentials; Institute of Medicine (U.S.); Internist; Intervention; K-Series Research Career Programs; Knowledge; Lead; Leadership; Living Wills; Longitudinal cohort; Medical; Medicine; Mentors; Mentorship; Modification; Outcome; Palliative Care; Palliative Medicine; Parents; Participant; Patient-Focused Outcomes; Patients; Physicians; Policies; Positioning Attribute; Pragmatic clinical trial; Primary Health Care; Process; Qualitative Evaluations; Qualitative Methods; Randomized Controlled Trials; Readiness; Reporting; Research; Research Personnel; Resources; Role; Spouses; Standardization; Supervision; Testing; Thinking; Training; Translational Research; Universities; Update; Visit; amnestic mild cognitive impairment; arm; base; care delivery; career development; combat; decision-making capacity; design; disease diagnosis; effective intervention; evidence base; falls; implementation science; implementation trial; improved; improved outcome; leadership development; loved ones; medical schools; novel; patient oriented; person centered; preference; prototype; recruit; research and development; shared decision making; skills; theories; therapy design; tool

Project Summary This is an initial submission by Hillary Lum, MD, PhD for the Paul B. Beeson Emerging Leaders Career Development Award in Aging (K76). Dr. Lum is committed to being a leader in advance care planning (ACP) research, policy initiatives, and healthcare system change to improve care for older adults. She is an internist, geriatrician, and palliative medicine physician in the Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine. Dr. Lum's research focuses on refining an Advance Care Planning Group Visit (ACP-GV) intervention to engage older adults in ACP. This proposed 4-year training plan accelerates Dr. Lum's career development as a patient-oriented researcher and leader in aging through training in: 1) advanced qualitative analysis; 2) implementation science; and 3) pragmatic clinical trials in older adults. She will acquire these skills through intensive interactions with her mentoring team, advanced coursework, guided research, and integrated leadership development, both institutionally and as a Health and Aging Policy Fellow. Dr. Lum's mentorship team and institutional resources are exceptional. As Dr. Lum's primary mentor, Cari Levy, MD, PhD is a nationally recognized researcher and leader in geriatric palliative care and will supervise Dr. Lum's research, career, and leadership development. Dr. Lum is co-mentored by Jean Kutner, MD, MSPH, a skilled leader and expert in palliative care research, including clinical trials in older adults. With funding from the National Palliative Care Research Center and The Colorado Health Foundation, Dr. Lum demonstrated that a novel ACP-GV intervention prototype increased ACP discussions and documentation among older adults in primary care. In order to conduct a real-world clinical trial and ultimately implement this intervention, the next research steps are to standardize the intervention for a general population and adapt the intervention to clinical settings by prioritizing input from patients, clinicians, staff, and health system leaders. Thus, the study objectives are to: 1) develop and refine the ACP-GV intervention to be standardized to the essential intervention components, to be adaptable across clinic settings, and to prioritize ACP outcomes important to key primary care stakeholders, and 2) conduct a pilot randomized controlled trial to test the feasibility, acceptability, and preliminary efficacy of the refined ACP-GV intervention. The culmination of this career development award will assure that Dr. Lum gains the advanced research skills and knowledge to conduct a full-scale effectiveness-implementation trial of an ACP-GV intervention for older adults on patient- centered outcomes. Additionally, she will be specifically positioned to assume expanded and influential national leadership roles to lead policy initiatives to improve ACP with local, regional, and national impact and improve healthcare system delivery of care that is aligned with patient goals.

项目总结