MODERATE ALCOHOL USE AND HEALTH--PREFERENCES AND OUTCOME

本提案寻求以患者为导向的指导研究职业发展奖。候选人建议利用这一奖项促进适度饮酒对具体健康措施的影响的研究事业。职业发展计划的目标有四个方面：(1)发展方法上的专门知识，以引出个人的偏好和价值观，特别是与饮酒有关的偏好和价值观；(2)在量化行为因素对患者群体中指定健康结果的影响方面获得经验；(3)结合个人偏好和结果数据，发展决策分析的专业知识，为患者决策提供信息；(4)利用这些研究结果建立研究独立性。在一个结构化的项目中，申请人将在哈佛大学公共卫生学院接受正式培训，并在Murray Mittleman， MD， DrPH的指导下毕业，Murray Mittleman是波士顿Beth Israel Deaconess医疗中心心脏病行为决定因素的活跃研究者。这些职业发展目标与研究计划密切相关，研究计划将在他们相继掌握时使用他们。该研究项目的总体目标是了解个人如何看待适度饮酒的风险和益处，以及这些竞争因素实际上如何影响健康。该研究项目将包括三个相关的研究：(1)开发一种由申请人管理的调查工具，用于不同门诊环境的患者，以确定他们对适度饮酒的偏好及其影响；(2)在心肌梗死发病决定因素研究中分析酒精使用对急性心肌梗死后生存的影响；(3)使用冠心病政策模型评估适度饮酒对总体死亡率的影响，利用调查结果完善政策模型结果的适用性。

This proposal seeks a Mentored Patient-Oriented Research Career Development Award. The candidate proposes to use this award to foster a research career in the study of the effect of moderate alcohol consumption on specific health measures. The aims of the career development plan are fourfold: (1) to develop methodologic expertise in eliciting personal preferences and values from individuals, particularly related to alcohol use; (2) to gain experience in quantifying the effect of behavioral factors on designated health outcomes amongst groups of patients; (3) to develop expertise in the use of decision analysis to inform patient decision-making by combining personal preferences and outcomes data; and (4) to use the results of these studies to establish research independence. In a structured program, the applicant will receive formal training at the Harvard School of Public Health and graduated supervision from Murray Mittleman, MD, DrPH, an active investigator in the behavioral determinants of heart disease at Beth Israel Deaconess Medical Center in Boston. These career development goals closely parallel the research plan, which will employ them as they are mastered in succession. The overall aim of the research program is to understand how individuals view the competing risks and benefits of moderate alcohol consumption and how those competing factors actually influence health. The research program will comprise three related studies: (1) development of a survey instrument to be administered by the applicant to patients in different outpatient settings to determine their preferences about moderate alcohol consumption and its effects; (2) analysis of the effect of alcohol use on survival following acute myocardial infarction in the Determinants of Myocardial Infarction Onset Study; and (3) assessment of the populationwide effect of moderate alcohol use on total mortality with the Coronary Heart Disease Policy Model, using the survey results to refine the applicability of the Policy Model findings.