Training in Interventions to Improve Outcomes in Chronic Conditions

描述（由申请人提供）：随着心脏病、中风、癌症和糖尿病等疾病的患病率在所有年龄组中持续上升，对基于证据的干预措施来改善慢性病结果的需求从未如此之大。护士研究人员在一个关键的位置，以解决和减少个人，家庭和医疗保健系统的负担，慢性病通过改善自我管理的方法，预防，自我护理和症状管理。埃默里大学护理学院提供了一个独特的跨学科环境，用于培训护理科学家进行干预研究，以满足慢性健康问题患者和家庭的需求。这项拟议的培训补助金的目的是提供严格的研究培训，重点是设计和测试基于理论和临床相关的干预措施，这将导致预防和改善那些有风险或患有慢性疾病的人的健康结果，例如但不限于心血管，癌症，神经和糖尿病/内分泌健康问题。目标是：1）理论和概念基础，以产生一个研究方案，研究自我管理干预措施改善个人，家庭或卫生资源使用结果的方式，2）方法学技能，以支持创新设计和严格测试干预措施，测量生物行为结果，生物标志物和卫生资源使用结果，指导学员支持他们的科学和职业发展，使他们能够在这一实质性领域开展和维持跨学科的学术研究。科学和培训活动将由一个广泛的概念模型指导，该模型针对通过干预影响自我管理行为的个人和背景/家庭因素，以实现改善的健康结果，这些健康结果被测量为降低的风险，改善的身体、社会和心理功能，改善的生活质量，改善的与慢性病相关的生理生物标志物，以及减少的卫生资源使用。每年招收两三名博士前和一名博士后学员的支持，要求准备总共13名博士前和5名博士后学员博士前研究员将参加现有博士课程的核心课程，其中包括对健康成果研究的强烈科学关注，包括对弱势群体的研究，分析技术，以及通过研究驻地参与研究。此外，他们将采取研究生水平选修生物，行为，公共卫生和护理科学。博士后工作将由一个跨学科的研究人员团队指导，并建立以满足每个学员的研究需求，强调在健康结果研究，复杂的条件和方法，并参与研究的课程。所有学员将制定和实施研究项目，发展赠款写作和研究传播技能。该计划联合了专家核心和合作教师，他们在充满活力和跨学科的学术，临床和研究环境中的实质性领域积极开展研究计划，为未来的护士科学家做好准备。 公共卫生相关性：这项研究培训计划将准备前和博士后护士科学家设计和测试方法，以改善慢性病患者的健康结果的能力。

DESCRIPTION (provided by applicant): The need for evidence based interventions to improve outcomes in chronic conditions has never been greater as the prevalence of heart disease, stroke, cancer, and diabetes, for example, continue to escalate across all age groups. Nurse researchers are in a pivotal position to address and reduce the individual, family, and health care system burden imposed by chronic illness through improved self management approaches for prevention, self care, and symptom management. The Emory University School of Nursing provides a unique and interdisciplinary environment for training nurse scientists in intervention research to address the needs of patients and families with chronic health problems. The purpose of this proposed training grant is to provide rigorous research training centered on design and testing of theory based and clinically relevant interventions which will lead to prevention of and improved health outcomes for those at risk for or with chronic conditions such as but not limited to cardiovascular, cancer, neurological and diabetes/endocrine health problems. The goals are to provide: 1) the theoretical and conceptual basis to generate a program of research examining ways in which self-management interventions improve individual, family or health resource use outcomes, 2) methodological skills to support innovative design and rigorous testing of interventions with measurement of biobehavioral outcomes, biomarkers, and health resource use outcomes, and 3) mentor trainees to support their science and career development so that they will initiate and sustain interdisciplinary scholarly inquiry in this substantive area. The science and training activities wll be guided by a broad conceptual model targeting individual and context/family factors that influence self management behaviors through interventions to achieve improved health outcomes measured as reduced risk, improved physical, social and psychological function, improved quality of life, improved physiological biomarkers pertinent to the chronic condition, and reduced health resource use. Support for enrolling two-three predoctoral and 1 postdoctoral trainees each year is requested to prepare a total of 13 predoctoral and 5 postdoctoral trainees Predoctoral fellows will take core courses in the existing doctoral program, which includes a strong science focus on health outcomes research including research with vulnerable populations, analytic techniques, and participation in research through research residencies. Additionally they will take graduate-level electives in the biological, behavioral, public health, and nursing sciences. Postdoctoral work will be guided by an interdisciplinary team of researchers and constructed to meet the research needs of each trainee, emphasizing coursework in health outcomes research, complex conditions and methods, and participation in research. All trainees will develop and implement research projects, develop grant writing and research dissemination skills. The program unites expert core and collaborating faculty who have active research programs in the substantive area within a vibrant and interdisciplinary academic, clinical and research environment to prepare future nurse scientists. PUBLIC HEALTH RELEVANCE: This research training program will prepare pre and post doctoral nurse scientists with the abilities to design and test approaches to improve health outcomes of persons with chronic conditions.