Expanding Treatment Options for Older Persons

描述(由申请人提供)：以患者为中心的研究生涯中期调查员奖的具体目标是为首席调查员提供足够的保护时间，以便：1)扩大一个研究计划，致力于提高老年人共同决策的频率和质量，以便为患者提供最符合他们治疗偏好的护理；2)正式设立一个导师计划，重点是向从事老龄研究的不同学科和学校的受训者提供跨学科指导。这项研究计划将建立在弗里德博士过去工作的基础上：a)利用健康行为模型来阐明提前护理计划是一种健康行为；b)开发方法来吸引患有多种并发症的老年人的偏好。这项计划将利用混合的定性和定量方法，以更好地了解老年人对困难治疗决策的经历和看法，并制定以患者为中心的措施。导师计划将利用下面介绍的资源，提供核心的教育和职业发展经验。在此基础上，学员的个人研究计划将作为导师计划的核心，并将以指导对成功的研究生涯至关重要的技能和具体的职业指导为补充。导师计划将基于对学员目标的明确考虑和记录，以及为实现这些目标量身定做的导师计划，以及定期审查该计划帮助学员实现其目标的情况。耶鲁医学院的环境提供了广泛的资源来支持研究和指导计划。其中包括一系列培训计划，这些计划吸引了大量有才华的博士后研究员，提供了完善的课程，提供了生物统计学、流行病学和卫生政策方面的高级教学培训机会，并通过耶鲁老龄/胡椒中心计划建立了研究基础设施，提供专业领域、数据管理、生物统计支持以及接触广泛人群的机会。此外，研究和指导计划将利用并继续建立弗里德博士与医学子专业、精神病学以及护理和公共卫生学院建立的跨学科关系。

DESCRIPTION (provided by applicant): The specific aim of the Midcareer investigator Award in Patient-Oriented Research is to provide the Principal Investigator with sufficient protected time in order: 1) to expand a research program devoted to enhancing the frequency and quality of shared decision-making for older persons in order to provide patients with care that best meets their treatment preferences and 2) to formalize a mentorship program focused on providing interdiscplinary mentorship to trainees from a diverse range of disciplines and schools pursuing aging research. The research program will build upon Dr. Fried's past work to: a) utilize health behavior models to explicate advance care planning as a health behavior and b) develop methods to elicit the preferences of older persons with multiple comorbidities. This program will utilize mixed qualitative- quantitative methods to provide greater insight into older persons' experiences with and perceptions of difficult treatment decision-making and to develop patient-centered measures. The mentorship program will utilize the resources described below to provide core educational and career development experiences. Building upon these, the trainee's individual research program will serve as the core of the mentorship program, and it will be supplemented by mentorship regarding skills critical to a successful research career and specific career guidance. The mentorship program will be based on an explicit consideration and documentation of the trainee's goals, a mentorship plan tailored to meet these goals, and regular review of how well the plan is assisting the trainee to meet his/her goals. The environment of the Yale School of Medicine offers extensive resources to support both the research and mentorship programs. These include a number of training programs that attract a large number of talented post-doctoral fellows and that provide well-developed curricula, opportunities for advanced didactic training in biostatistics, epidemiology, and health policy, and, through the Yale Program on Aging/Pepper Center, a research infrastructure providing skilled field, data management, and biostatistical support as well as access to a broad range of populations. In addition, the research and mentorship programs will utilize and continue to build the interdisciplinary relationships Dr. Fried has established with medical subspecialties, psychiatry, and the Schools of Nursing and Public Health.