SMART POR: Supporting and Mentoring Across Respiratory Topics in Patient Oriented Research

项目摘要 慢性阻塞性肺疾病(COPD)影响着1600多万美国成年人，其中许多人 在最初的COPD后经历高急诊率(急诊科和医院) 住院治疗。这些频繁的恶化通常是由于过渡护理(TOC)失败导致的，导致肺 功能衰退和早期死亡。需要进行大规模的多站点研究，以解决在以下方面的持续差距 在大规模实施有效的COPD TOC之前，基本有效性和实施数据 计划，并成功地减少了重复访问。我目前的NHLBI R01旨在解决以下方面的差距 通过在美国20家不同的医院测试COPD TOC计划的有效性和实施情况来改进 慢性阻塞性肺疾病患者的卫生保健提供和结果。我的R01同时使用实现 科学(IS)和以人为本的设计(HCD)方法。虽然这些方法是严格的和 互补的是，以前瞻性的方式集成这些定性方法可以优化它们的潜力 影响干预措施的设计和实施，以便获得数据并最终告知护理 转型。此外，标准化评估和报告COPD TOC计划的指标并重新访问 数据可以显著改善COPD TOC计划和研究之间的结果比较。K24 将使我能够通过构建我的R01研究、指导计划和 开发、测试和传播集成的IS和HCD定性和定量方法的基础设施 在以病人为中心的研究中使用。我将与我的导师和R01研究团队的专家在IS和 HCD方法来开发名为“Chimera”的集成方法；此外，我还将与 制定统一的报告指标，称为“SMART COPD”。我将通过我的工作来实现这些目标 指导学员开发、测试和传播“嵌合体”和“智能慢性阻塞性肺病”工具。Chimera将使用 确定HCD和IS域和方法的逐步方法，然后使用逻辑模型和 从我的R01目标1中绘制利益相关者评估的概念图，以开发Chimera“交叉通道” 整合这两种方法的方法论。奇美拉将与我的R01目标2和3一起测试， 实施和实施后。智能COPD指标将使用系统开发 文献综述和改进的Delphi方法，其中我们的R01团队将确定COPD TOC并确定其优先顺序 用于标准化报告的计划指标。这个K24将允许我为我的 通过开发新的研究工具来指导学员。我的K24的丰富的研究计划，题为： “智能POR：在以患者为中心的研究中对呼吸系统主题的支持和指导”也将 为我提供充足的机会来支持当前和未来的研究指导对象实施研究和 推动以调查员为基础的职业发展。

PROJECT ABSTRACT Chronic Obstructive Pulmonary Disease (COPD) affects more than 16 million US adults, many of whom experience high rates of acute care revisits (emergency department and hospital) after initial COPD hospitalization. These frequent exacerbations, often due to transition of care (TOC) failures, lead to lung function decline and earlier mortality. Large multi-site studies are needed to address ongoing gaps in fundamental effectiveness and implementation data, before widescale implementation of effective COPD TOC programs and successful reduction of revisits. My current NHLBI R01 aims to address these gaps in effectiveness and implementation by testing COPD TOC programs across 20 diverse US hospitals to improve health care delivery and outcomes for patients with COPD. My R01 simultaneously uses implementation science (IS) and human-centered design (HCD) methods. While these methods are rigorous and complimentary, integrating these qualitative approaches in a prospective manner could optimize their potential to impact the design and implementation of interventions in order to obtain data and ultimately inform care transformation. Further, standardizing metrics for evaluating and reporting COPD TOC program and revisit data could significantly improve outcome comparisons between COPD TOC programs and studies. The K24 will allow me to address these methodology gaps by building upon my R01 research, mentoring program, and infrastructure to develop, test, and disseminate integrated IS and HCD qualitative and quantitative methods for use in Patient Oriented Research. I will collaborate with my mentees and R01 research team experts in IS and HCD methods to develop an integrated approach named "CHIMERA"; additionally, I will collaboratively develop harmonized reporting metrics called "SMART COPD". I will complete these aims by working with my mentees to develop, test, and disseminate the "CHIMERA" and "SMART COPD" tools. CHIMERA will use a step-wise approach to identify HCD and IS domains and methods, followed by the use of logic models and concept mapping of stakeholder assessments from my R01 Aim 1 to develop a CHIMERA “cross walk” methodology that integrates both methods. CHIMERA will be tested in conjunction with my R01 Aims 2 and 3, implementation and post-implementation. The SMART COPD metrics will be developed using systematic literature review and a modified Delphi approach, in which our R01 team will identify and prioritize COPD TOC Program metrics to standardize reporting. This K24 will allow me to provide mentoring opportunities to my mentees through development of novel research tools. The enriched research program of my K24 entitled: "SMART POR: Supporting and Mentoring Across Respiratory Topics in Patient Oriented Research" will also provide ample opportunities for me to support current and future research mentees to implement research and drive investigator-based careers.