MIT Roybal Center for Translational Research to Improve Healthcare for the Aging

摘要 在中国，不乏行为干预的创新想法，以改善卫生保健服务的提供 美国。医疗服务提供改革有可能极大地改善健康和医疗保健 经验。对于老龄化人口来说尤其如此，他们与医疗保健系统的互动更多 经常发生，并遭受一些最严重的健康问题。然而，人们对哪一种情况知之甚少 干预措施可以有效地改善这些人的健康。这项提案旨在确定， 资助和支持针对中老年人的低成本、高影响的行为干预第一阶段试验。 Abdul Latif Jameel贫困行动实验室(J-PAL)成立于2003年，是一个由165多个附属机构组成的网络 超过55所大学的教授，通过使用随机评估来回答关键政策而团结在一起 问题。J-PAL北美(NA)于#年在麻省理工学院(MIT)推出 2013年，麻省理工学院的艾米·芬克尔斯坦和哈佛大学的劳伦斯·卡茨将J-PAL方法应用于该地区。J-PAL 北卡罗来纳州的医疗保健提供倡议(HCDI)侧重于催化高质量的随机对照试验 (随机对照试验)，以测试如何最好地改善医疗保健服务。我们建议利用这一基础来刺激和 支持早期随机对照试验测试行为干预措施，以改善医疗保健提供和健康结果 为老年人准备的。麻省理工学院罗伊巴尔中心将在第一年支持两名第一阶段飞行员，并将选择其他 通过严格的同行审查程序，在2-5年内开展试点项目。我们建议的第一年计划包括： 项目1：临终机构：信息和预先指令的作用。这个项目 重点关注与临终关怀和决策有关的政策，这是一个广泛相关的主题 老龄化的人口。 项目2：阿片类药物耐受患者的急性后疼痛管理：一项随机对照试验。这 该项目寻求提供严格的证据，说明如何有效地控制已经服用的患者的疼痛。 高剂量的阿片类药物，从而有可能产生一系列不良后果，包括过量用药。 这些项目中的每一个都将得到(I)管理和行政核心的支持，该核心将提供 对中心和(Ii)试点核心的全面领导和协调。试点核心将支持该项目 开发活动，确定有前景的第一阶段研究项目，协调选择最 承诺为试点提供资金，支持资助试点，并创建持续的行为干预发展 改善老年人健康状况的计划。

ABSTRACT There is no shortage of innovative ideas for behavioral interventions to improve health care delivery in the United States. Health care delivery reform has the potential to dramatically improve the health and health care experience. This is especially true for the aging population who interact with the health care system more frequently and suffer some of the gravest health problems. However, too little is known about which interventions could be effective for improving the health of these individuals. This proposal seeks to identify, fund, and support low-cost, high-impact Stage I trials of behavioral interventions for mid-life and older people. The Abdul Latif Jameel Poverty Action Lab (J-PAL), founded in 2003, is a network of more than 165 affiliated professors at over 55 universities, united by their use of randomized evaluations to answer critical policy questions. J-PAL North America (NA) was launched at the Massachusetts Institute of Technology (MIT) in 2013 by Amy Finkelstein (MIT) and Lawrence Katz (Harvard) to apply the J-PAL approach to the region. J-PAL NA’s Health Care Delivery Initiative (HCDI) focuses on catalyzing high-quality randomized controlled trials (RCTs) to test how best to improve health care delivery. We propose to leverage this foundation to spur and support early-stage RCTs to test behavioral interventions to improve health care delivery and health outcomes for older adults. The MIT Roybal Center will support two Stage I pilots in its first year, and will select additional pilot projects in Years 2-5 through a rigorous peer review process. Our proposed Year 1 projects are: Project 1: Deferring Agency at End-of-Life: The Role of Information and Advance Directives. This project focuses on policies related to medical care and decision-making at end-of-life, a topic that is broadly relevant to the aging population. Project 2: Post-Acute Pain Management for Opioid-Tolerant Patients: A Randomized Controlled Trial. This project seeks to provide rigorous evidence on how to effectively manage pain in patients who are already on high doses of opioids and thus at risk of a host of negative outcomes, including overdose. Each of these projects will be supported by (i) the Management and Administrative Core, which will provide overall leadership and coordination for the Center and (ii) the Pilot Core. The Pilot Core will support project development activities to identify promising Stage I research projects, coordinate selection of the most promising pilots for funding, support funded pilots, and create a sustained behavioral intervention development program to improve health outcomes for older adults.