Mentoring Researchers in Advance Care Planning and Communication for Vulnerable Older Populations

摘要 该建议的目的是（1）使候选人能够进一步发展她的研究计划，重点是 改善针对弱势老年人的提前护理计划（ACP）和知情医疗决策， (2)利用她的研究项目作为指导对以患者为导向的研究感兴趣的初级研究人员的平台， 老龄化研究，包括老年医学和其他医学亚专业。候选人是一名老年病学家， 姑息医学医生谁已经建立了一个高影响力的独立临床研究计划， 资金充足，出版记录出色。在完成老年医学奖学金后的10年里， 她已经确立了自己作为一个成功的导师的学生，研究员，和初级教师谁出版了 高影响力的老龄化研究，成为成功的资助，并继续参与以病人为导向的 研究老化。候选人已经开发了广泛的研究组合，专注于创造和 测试识字和文化上适当的健康教育材料，以改善ACP和医疗决策 为老年人制作。她开发了一个更广泛的ACP范式，不仅关注一次性 治疗决定，如心肺复苏术（CPR），但也对过程的准备 患者沟通他们的愿望，并与临床医生参与实时，复杂的医疗 在疾病过程中的决定。她将这种模式转化为一种易于理解的，耐心的- 一个名为“健康教育”的中心网站，通过视频教病人如何识别他们的愿望， 与代理人和临床医生沟通。候选人从NIA获得R 01资金，以测试 有效性的caseE网站，以吸引不同的，脆弱的老年人从城市，县医院， ACP使用经验证的患者问卷。此K24提案将为候选人提供受保护的时间， 将她的研究扩展到一个新的方向，专注于直接观察（即，录音） 初级保健接触中的沟通，以应对CMEE干预。这项新研究 将确定以患者为中心的ACP网站是否可以授权和激活患者讨论ACP， 以促进与其初级保健提供者的沟通。候选人还将发展她的正式 指导计划，包括招募、选择、发展和评估学员的计划， 成为老龄化研究的领导者。她将与每位学员合作，建立一个有重点的职业发展 完成研究项目并发展独立所需的技能的计划 investigators.这些计划将充分利用UCSF出色的临床研究培训环境。 她将利用她在加州大学旧金山分校的领导地位，招募更多对ACP研究感兴趣的学员， 弱势群体的老龄化。

ABSTRACT The aims of this proposal are to (1) enable the candidate to further develop her research program focused on improving advance care planning (ACP) and informed medical decision making for vulnerable older adults and (2) use her research program as a platform for mentoring junior investigators interested in patient-oriented aging research, both within Geriatrics and other medical subspecialties. The candidate is a Geriatrician and Palliative Medicine physician who has established a high-impact independent clinical research program that is well funded with an outstanding publication record. In the 10 years since completing her Geriatrics fellowship, she has established herself as a successful mentor of students, fellows, and junior faculty who have published high-impact aging research, become successfully funded, and continue to participate in patient-oriented research in aging. The candidate has developed an extensive research portfolio focused on creating and testing literacy- and culturally appropriate health education materials to improve ACP and medical decision making for older adults. She developed a broader paradigm of ACP that focuses not only on one-time treatment decisions, such as for cardiopulmonary resuscitation (CPR), but also on the process of preparing patients to communicate their wishes and to participate with clinicians in making real-time, complex medical decisions over the course of illness. She operationalized this paradigm into an easy-to-understand, patient- centered website called PREPARE that teaches patients, through videos, how to identify their wishes and communicate with surrogates and clinicians. The candidate received R01 funding from the NIA to test the efficacy of the PREPARE website to engage diverse, vulnerable older adults from an urban, county hospital in ACP using validated patient questionnaires. This K24 proposal will provide the candidate with protected time to expand her research in a new direction focused on direct observation (i.e., audio recording) of patient-clinician communication within primary care encounters in response to the PREPARE intervention. This new research will determine whether a patient-centered ACP website can empower and activate patients to discuss ACP and to facilitate communication with their primary care providers. The candidate will also develop her formal mentoring program with plans for the recruitment, selection, development, and evaluation of mentees who will become leaders in aging research. She will work with each mentee to establish a focused career development plan in which they complete research projects and develop the skills needed to become independent investigators. These plans will make full use of the outstanding clinical research training environment at UCSF. She will leverage her leadership positions at UCSF to recruit more mentees interested in research on ACP and aging in vulnerable populations.