A health services research training program in CAM for a naturopathic physician

描述（由申请人提供）：自然疗法强调预防和整体生活方式的改变，为许多疾病的管理提供了传统护理的有吸引力的替代方案。令人惊讶的是，缺乏关于自然疗法和对抗疗法提供者提供的护理过程和结果的比较数据。需要对慢性病的自然疗法管理进行评估，特别是在获得其他提供者的机会有限的社区。糖尿病是一种主要流行病，低收入和少数群体受到这种疾病负担的影响不成比例。在这方面非常需要扩大保健服务和差距研究。提出了一个严格的博士后培训计划，在卫生服务和差距研究自然疗法医师。拟议培训的目标是：(1)培养自然疗法医师研究人员在卫生服务和差异研究方法方面的技能；(2)为评估自然疗法糖尿病护理的内容、成本和结果的研究项目建立科学基础。具体目标是：(1)通过公共卫生硕士课程获得卫生服务和差异研究原理方面的知识，(2)通过指导培训培养CAM中卫生服务和差异研究基本方面的技能，(3)进行混合方法（定量+定性）试点研究，检查自然疗法和对抗疗法医生提供的2型糖尿病（T2DM）护理内容。采用三角法来定义和比较护理内容。此外，一项旨在描述两种情况下患者群体特征的患者调查将被完善和验证，以用于未来的研究。从本次调查中收集的数据将揭示患者群体的显著特征，这些特征可能会影响获取、服务利用和满意度，从而为自然疗法卫生服务研究奠定基础。根据AHRQ的使命，这一研究方案调查了自然疗法护理作为一种手段，以提高在社区一级向低收入和无保险人口提供的卫生保健的质量、安全、效率和有效性，并符合NCCAM促进健康和预防疾病倡议的使命，即“健康人2010”。

DESCRIPTION (provided by applicant): Naturopathic care places emphasis on prevention and holistic lifestyle changes, presenting an attractive alternative to conventional care for the management of many illnesses. Surprisingly, comparative data on processes of care and outcomes provided by naturopathic versus allopathic providers are lacking. Evaluation of naturopathic management of chronic disease is needed, particularly in communities with limited access to other providers. Diabetes is a major epidemic and low-income and minority populations are disproportionately affected by the burden of this disease. There is great need for expanded health services and disparities research in this area. Proposed is a rigorous post-doctoral training program in health services and disparities research for a naturopathic physician. The goals of the proposed training are to; (1) cultivate skills for a naturopathic physician researcher in health services and disparities research methodology, and (2) build the scientific foundation for a program of research evaluating the content, costs and outcomes of naturopathic diabetes care. The specific aims are to: (1) Acquire knowledge in the principles of health services and disparities research through Master of Public Health coursework, (2) Develop skills in the fundamental aspects of health services and disparities research in CAM through mentored trainin, and (3) Conduct a mixed methods (quantitative + qualitative) pilot study examining the content of type 2 diabetes (T2DM) care provided by naturopathic and allopathic physicians, employing a triangulated approach to define and compare the content of care. In addition, a patient survey designed to characterize the patient populations in both settings will be refined and validated for use in future studies. Data gathered from this survey will reveal salient characteristics of the patient populations which may influence access, service utilization, and satisfaction, thus building a foundation for a naturopathic health services research career. In line with the mission of the AHRQ, this program of research investigates naturopathic care as a means to improve the quality, safety, efficiency, and effectiveness of health care delivered in low-income and uninsured populations at the community level, and is in line with NCCAM's mission towards the health promotion and disease prevention initiatives of "Healthy People 2010." PUBLIC HEALTH RELEVANCE: National initiatives have recognized the need to train CAM researchers in health services and disparities research. Diabetes is an enormous public health problem, and necessitates research on innovative approaches to prevention and management. The proposed training addresses these needs and will result in research findings that greatly contribute to the naturopathic evidence base.