Mentoring Researchers in Advance Care Planning for Underrepresented Older Adults at Risk for Alzheimer’s Disease and Related Dementias and Their Caregivers

项目摘要 这项提议的目的是(1)使应聘者能够进一步发展她的研究计划，重点是 改善老年人的高级护理计划(ACP)和医疗决策，特别是在历史上 被边缘化的个人和健康素养有限的人；(2)将其研究扩大到有以下情况的老年人 轻度认知障碍(PMCI)有患阿尔茨海默病和相关痴呆(ADRD)的风险 PMCI或ADRD的护理人员；以及(3)使用她的研究平台指导有兴趣的初级调查人员 以患者为中心的老龄化研究，包括老年病学和其他子专科。应聘者是一位老年病学家。 和姑息内科医生，建立了资金雄厚、影响巨大、独立的临床 研究项目，具有出色的出版和指导记录。在过去的十年里，她 将自己确立为学生、住院医生、研究员和初级教职员工的成功导师 发表了高影响力的老龄化研究，获得了成功的资助，并继续参与患者- 以老龄化研究为导向。候选人还开发了广泛的研究组合，专注于 编写和测试识字和符合文化的健康教育材料，以改善非物质文化遗产和医疗 为被边缘化的老年人制定决策。她开发了一种扩展的ACP范例，重点不是 仅限于一次性治疗决定，如心肺复苏(CPR)，也包括 患者和护理人员准备好传达他们的意愿并与临床医生一起参与 随着时间的推移做出复杂的、即刻的医疗决定。她将这一扩展的范例应用于 易于理解、以人为本的计划(例如，为您的患者护理做准备和为 他们对照顾者的关怀)，使用视频故事来教人们如何识别和传达他们的 医疗偏好和做出知情的医疗决定。候选人已收到正在进行的R01和 其他资金，用于测试这些方案在初级保健环境中的效果。这份K24提案将提供 候选人有受保护的时间，以新的方向扩大她的研究。以实施科学为基础 框架和社区参与的研究，候选人将进行研究，以适应准备 针对PMCI和照顾者的计划，并测试在线、 直播，便利的小组课程。候选人还将继续发展她的正式指导 计划，包括招募、选拔、发展和评估将成为 老龄化研究领域的领先者。她将与每个辅导者合作，建立个性化的职业发展 制定计划，完成研究项目并培养独立所需的技能 调查人员。这些计划将充分利用香港大学卓越的临床研究培训环境。 加州大学旧金山分校(UCSF)。她将利用她在加州大学旧金山分校的领导职位 在全国范围内招募对老龄化研究、非物质文化遗产和边缘化人口感兴趣的导师。

PROJECT 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 medical decision making for older adults, particularly historically marginalized individuals and persons with limited health literacy; (2) expand her research to older persons with mild cognitive impairment (PMCI) at risk for Alzheimer's Disease and Related Dementias (ADRD) and caregivers of PMCI or ADRD; and (3) use her research platform to mentor junior investigators interested in patient-oriented aging research, both within Geriatrics and other subspecialties. The candidate is a Geriatrician and Palliative Medicine physician who has established a well-funded, high-impact, independent clinical research program with an outstanding publication and mentoring record. In the past decade she has established herself as a successful mentor of students, residents, 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 also 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 marginalized older adults. She developed an expanded ACP paradigm that focuses not only on one-time treatment decisions, such as for cardiopulmonary resuscitation (CPR), but also on the process of preparing patients and caregivers to communicate their wishes and to participate with clinicians in making complex, in-the-moment medical decisions over time. She operationalized this expanded paradigm into easy-to-understand, person-centered programs (i.e., PREPARE for YOUR Care for patients and PREPARE for THEIR Care for caregivers) that use video stories to teach people how to identify and communicate their medical preferences and to make informed medical decisions. The candidate has received ongoing R01 and other funding to test the efficacy of these programs in primary care settings. This K24 proposal will provide the candidate with protected time to expand her research in a new direction. Grounded in implementation science frameworks and community-engaged research, the candidate will conduct research to adapt the PREPARE programs with and for PMCI and caregivers and test the acceptability of a new delivery model of online, livestreaming, facilitated group classes. The candidate will also continue to 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 an individualized 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 the University of California, San Francisco (UCSF). She will leverage her leadership positions at UCSF and nationally to recruit mentees interested in aging research, ACP, and marginalized populations.