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在所有年龄组的患病率持续上升，对以证据为基础的干预措施改善慢性病结局的需求从未像现在这样大。通过改善自我管理方法预防、自我护理和症状管理，护士研究人员在解决和减少个人、家庭和卫生保健系统对慢性病造成的负担方面处于关键地位。埃默里大学护理学院提供了一个独特的跨学科环境，培训护士科学家进行干预研究，以解决患有慢性健康问题的患者和家庭的需求。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，这些干预措施将导致预防和改善那些有慢性疾病风险或患有慢性疾病的人的健康结果，这些慢性疾病包括但不限于心血管、癌症、神经系统和糖尿病/内分泌健康问题。目标是提供：1)产生一个研究项目的理论和概念基础，以检验自我管理干预措施如何改善个人、家庭或健康资源使用结果；2)方法技能，以支持创新设计和严格测试干预措施，测量生物行为结果、生物标志物和健康资源使用结果；3)指导受训者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发起和维持跨学科的学术研究。科学和培训活动将以一个广泛的概念模型为指导，目标是影响自我管理行为的个人和环境/家庭因素，通过干预措施实现改善的健康结果，测量为降低风险，改善身体，社会和心理功能，改善生活质量，改善与慢性疾病相关的生理生物标志物，减少卫生资源的使用。支持每年招收2 - 3名博士预科生和1名博士后实习生，共培养13名博士预科生和5名博士后实习生。博士预科生将学习现有博士项目的核心课程，其中包括对健康成果研究的强烈科学关注，包括弱势群体研究、分析技术和通过研究实习参与研究。此外，他们还将选修研究生水平的生物、行为、公共卫生和护理科学。博士后工作将在跨学科研究团队的指导下，根据每个实习生的研究需求进行构建，强调健康结果研究的课程学习，复杂的条件和方法，以及研究的参与。所有受训者将发展和实施研究项目，发展拨款写作和研究传播技巧。该计划将专家核心和合作教师联合起来，在充满活力和跨学科的学术，临床和研究环境中，在实质性领域开展积极的研究项目，为未来的护士科学家做好准备。

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.