Mentoring Intervention Development in Fall and Fracture Prevention

 描述（由申请人提供）：我在预防老年人福尔斯和骨折方面以患者为导向的研究平台使我有机会发展针对弱势群体的复杂干预开发技能。这些技能包括纵向和行政数据分析，定性方法，试点研究，随机试验和经济分析。复杂性科学和适应性领导模型已经为复杂综合征和医疗环境的干预设计提供了信息的概念框架。作为杜克大学医学中心的副教授，我已经开始培训来自不同职业和专业的老龄化研究方法的老龄化研究人员，但是，我将受益于保护时间来制定一个指导计划，在老年人复杂问题的干预发展。 这个K24提案的直接目标是通过整合我的跌倒和骨折研究项目来扩展我的研究平台，并通过培训下一代以患者为导向的研究人员来提高我的指导技能，开发务实的干预措施来减少福尔斯和骨折。我的长期职业目标是制定和实施务实的干预措施，以减少老年人骨质疏松性骨折的破坏性后果。环境：杜克大学医学中心为老龄化研究人员提供了丰富的环境。杜克老龄化和人类发展研究中心包括在整个大学具有广泛的专业知识的教师。杜克克劳德·O.胡椒老年美国人独立中心提供研究支持服务;我目前担任领导核心和共同主持的研究职业发展核心。我的研究和指导活动也发生在达勒姆VA老年医学研究和教育中心，在那里我是助理主任，达勒姆VA健康服务卓越研究中心（COIN和CREATE中心），杜克临床转化科学奖中心（CTSA），和护理NIH资助的ADAPT中心的杜克学校。调研：我的指导计划（具体目标1）的关键要素包括在我的研究领域的培训和课程开发，以提高我的指导技能。具体来说，我将通过杜克CTSA导师管道计划参加正式的导师培训，运行一个以患者为导向的研究人员的职业生涯中期同伴指导小组，专注于指导，并开发一个关于干预开发的12部分系列研讨会。对于具体目标2，我将通过正式的专业发展和务实的研究设计（自适应设计，社区参与研究）的实践经验来提高我的研究技能。对于具体目标3，我将指导以患者为导向的研究，从目前的6个赠款和涉及7名学员的跌倒和骨折预防。这些项目包括为该申请新提出的3项研究。这些研究的核心是在现有的区域骨折联络服务中开发和试点测试护士主导的多因素跌倒预防协议，使用远程医疗技术扩大其范围和覆盖面。在该奖项结束时，我将有能力获得资金，用于在卫生系统内提供针对高风险老年人的大型务实试验测试综合跌倒和骨折预防计划。

 DESCRIPTION (provided by applicant): My patient-oriented research platform in preventing falls and fractures in older adults has given me the opportunity to develop skills in complex intervention development for frail populations. These skills include analysis of longitudinal and administrative data, qualitative methods, pilot studies, randomized trials, and economic analysis. Complexity Science and Adaptive Leadership models have been informative conceptual frameworks for designing interventions for complex syndromes and healthcare settings. As an Associate Professor at Duke University Medical Center, I have begun to train aging researchers from diverse professions and specialties in aging research methods, however, I would benefit from protected time to develop a mentoring program in intervention development for complex problems in older adults. The immediate goal of this K24 proposal is to expand my research platform by integrating my fall and fracture research programs, and improve my mentoring skills through training the next generation of patient oriented researchers developing pragmatic interventions to reduce falls and fractures. My long-term career goal is to develop and implement pragmatic interventions to reduce the devastating consequences of osteoporotic fractures in older adults. Environment: Duke University Medical Center is a rich environment for aging researchers. The Duke Center for the Study of Aging and Human Development includes faculty with a wide range of expertise across the University. The Duke Claude O. Pepper Older Americans Independence Center provides research support services; I currently serve on the Leadership Core and co-chair the Research Career Development Core. My research and mentoring activities also occur within the Durham VA Geriatrics Research and Education Center, where I am Assistant Director, the Durham VA Health Services Research Center of Excellence (COIN and CREATE Centers), the Duke Clinical Translational Science Award Center (CTSA), and the Duke School of Nursing NIH-funded ADAPT Center. Research: Key elements of my mentoring plan (Specific Aim 1) include training and curriculum development in my research area to improve my mentoring skills. Specifically, I will participate in formal mentor training through the Duke CTSA Mentor Pipeline Program, run a mid-career peer mentoring group of patient oriented researchers focused on mentoring, and develop a 12 part workshop series on Intervention Development. For Specific Aim 2, I will enhance my research skills through formal professional development and practical experiences in pragmatic study design (adaptive designs, community engaged research). For Specific Aim 3, I will mentor patient oriented research in fall and fracture prevention emerging from 6 current grants and involving 7 trainees. These projects include 3 studies newly proposed for this application. The centerpiece of these studies is the development and pilot testing of nurse-led multifactorial fall prevention protocols within an existing regional Fracture Liaison Service, delivered using telehealth technologies to expand their scope and reach. At the conclusion of the award, I will be well positioned to obtain funding for a large pragmatic trial testing integrated fall and fracture prevention programs delivered within a health system and targeted to high risk older adults.