Hopkins Center to Promote resilience in persons and families living with multiple chronic conditions (the PROMOTE Center)

开发可行、有效和可扩展的干预措施，以改善多发性慢性病患者的健康 情况很紧急。然而，研究差距阻碍了干预的发展。大多数干预措施不起作用 考虑共同出现的功能限制、家庭照顾者的观点或背景因素 健康的社会决定因素。此外，干预通常关注赤字，而不是实力。这些 由于从业者和经历了多次 关于他们的目标、价值观和喜好的慢性疾病。拟议中的霍普金斯中心将促进 患有多种慢性病的个人和家庭的复原力(促进中心)已做好准备 以弥补这些差距。促进中心将利用跨学科专业知识的独特组合 1)行为干预研究；2)研究和统计方法；3)生理过程 包括汗液中发现的细胞因子。早期、中期和高级研究人员、个人和家庭经历 多种慢性疾病，以及关键的翻译利益相关者将共同努力，推动 利用我们创新的生态弹性改善患有多种慢性病的人的健康 框架。该框架将复原力概念化为受累积交互作用影响的终生过程 多种相互关联的因素，如社会、社区和家庭、个人、生理和基因组 各种因素。促进中心将推动科学进步，以改善患有多发性慢性病的成年人的健康和护理 通过为发展、执行和评价提供专门知识、指导和资源，创造条件 通过三个目标实现理论驱动的跨学科研究。目标1：建立一个消息灵通、 可持续的基础设施，具有专门的资源，以促进跨学科护理科学的进步 患有多种慢性病的弱势成年人及其家庭照顾者的健康：目标2：培养一种新的 一代具有领导跨学科研究以提高成年人复原力的护理学者 患有多种慢性病。目标3：利用独特的环境优势加强传播和 通过与KEY建立伙伴关系，将循证的多种慢性病干预措施转化为 利益相关者。推广中心的主要创新包括： 1)使用社会到细胞复原力框架，支持关注人们最健康的阶段 可能会对新的信息和习惯持开放态度；2)将探索性目标整合到衡量生物多样性的先导研究中 NINR开发的非侵入性汗液测量的弹性标记；以及3)以用户为中心的优势- 在试点开发的每个阶段采用基于协同设计的方法，从而增强参与者的接受度和 更高的可持续性和转换到其他环境的可能性。

Developing feasible, effective and scalable interventions to improve health among people with multiple chronic conditions is urgent. However, research gaps hinder intervention development. Most interventions do not consider co-occurring functional limitations, family caregivers' perspectives or contextual factors that define social determinants of health. Moreover, interventions commonly focus on deficits rather than strengths. These limitations are compounded by lack of communication among practitioners and people experiencing multiple chronic conditions about their goals, values, and preferences. The proposed Hopkins Center to Promote resilience in persons and families living with multiple chronic conditions (the PROMOTE Center) is poised to address these gaps. The PROMOTE Center will leverage a unique combination of interdisciplinary expertise in 1) behavioral intervention research 2) research and statistical methodology and 3) physiological processes including cytokines found in sweat. Early, mid-career and senior researchers, persons and families experiencing multiple chronic conditions, and key translational stakeholders will work together to advance the science of improving health among those with multiple chronic conditions using our innovative ecological resilience framework. This framework conceptualizes resilience as a life-long process impacted by cumulative interaction of multiple inter-related factors, such as society, community, and family, individual, physiologic and genomic factors. The PROMOTE Center will advance science to improve health and care of adults with multiple chronic conditions by providing expertise, mentorship and resources for the development, implementation and evaluation of theory-driven interdisciplinary research through three Aims. Aim 1: Establish a community-informed, sustainable infrastructure with dedicated resources to advance interdisciplinary nursing science that improves the health of vulnerable adults with multiple chronic conditions and their family caregivers: Aim 2: Foster a new generation of nursing scholars with skills to lead interdisciplinary research that improves the resilience of adults with multiple chronic conditions. Aim 3: Leverage unique environmental strengths to enhance dissemination and translation of evidence-based multiple chronic condition interventions through established partnerships with key stakeholders. Key innovations of the PROMOTE Center include: 1) Use of Society to Cells Resilience Framework that supports focus on health phases in which people are most likely to be open to new information and habits; 2) Integration of exploratory aims in pilot studies measuring bio- markers of resilience with non-invasive sweat measures developed at NINR; and 3) User-centered strengths- based co-design approaches at each phase of pilot development leading to enhanced participant uptake and higher likelihood of sustainability and translation to other settings.