Refining an Advance Care Planning Group Visit intervention – a novel intervention to engage older adults in advance care planning

项目总结 这是Hillary Lum博士为Paul B.Beeson新兴领袖职业生涯提交的初步意见书 老龄发展奖(K76)。林医生致力于成为预先护理计划(ACP)的领导者 研究、政策倡议和医疗体系改革，以改善对老年人的护理。她是个内科医生， 医学部老年医学部老年病学家、姑息内科医师， 科罗拉多大学医学院。Lum博士的研究重点是完善高级护理计划 团体访问(ACP-GV)干预以吸引老年人参与ACP。这项拟议的四年培训计划 加速Lum博士作为一名以患者为导向的研究人员和老龄化领域的领导者的职业发展 培训内容：1)高级定性分析；2)实施科学；3)老年实用临床试验 成年人。她将通过与她的指导团队Advanced进行密集互动来获得这些技能 课程工作、指导性研究和综合领导力发展，无论是机构上的还是作为健康和 老年政策研究员。Lum博士的导师团队和机构资源都非常出色。作为Lum医生的 初级导师，Cari Levy，医学博士，全国公认的老年姑息治疗研究人员和领导者 并将监督Lum博士的研究、职业生涯和领导力发展。Lum博士由Jean共同指导 Kutner，医学博士，MSPH，姑息治疗研究的熟练领导者和专家，包括老年人的临床试验 成年人。在国家姑息治疗研究中心和科罗拉多州健康基金会的资助下， Lum博士证明了一种新的ACP-GV干预原型增加了ACP的讨论和 在初级保健中的老年人中的记录。为了进行真实世界的临床试验，并最终 实施这项干预，下一步的研究步骤是对普通人群的干预进行标准化 并通过优先考虑患者、临床医生、工作人员和健康人员的意见，使干预措施适应临床环境 系统领导者。因此，研究的目标是：1)开发和完善ACP-GV干预措施，使其成为 对基本干预组件进行标准化，以适应临床环境，并确定优先顺序 ACP结果对关键的初级保健利益相关者很重要，以及2)进行试点随机对照试验以 检测改良ACP-GV干预的可行性、可接受性和初步疗效。最高潮 这一职业发展奖将确保林博士获得先进的研究技能和知识 对老年患者进行ACP-GV干预的全面有效性实施试验- 以结果为中心。此外，她将明确定位，承担起扩大和有影响力的任务 国家领导作用，领导政策倡议，以改善机场核心计划，对地方、地区和国家产生影响，并 改善医疗系统，提供与患者目标相一致的护理。

PROJECT SUMMARY This is an initial submission by Hillary Lum, MD, PhD for the Paul B. Beeson Emerging Leaders Career Development Award in Aging (K76). Dr. Lum is committed to being a leader in advance care planning (ACP) research, policy initiatives, and healthcare system change to improve care for older adults. She is an internist, geriatrician, and palliative medicine physician in the Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine. Dr. Lum's research focuses on refining an Advance Care Planning Group Visit (ACP-GV) intervention to engage older adults in ACP. This proposed 4-year training plan accelerates Dr. Lum's career development as a patient-oriented researcher and leader in aging through training in: 1) advanced qualitative analysis; 2) implementation science; and 3) pragmatic clinical trials in older adults. She will acquire these skills through intensive interactions with her mentoring team, advanced coursework, guided research, and integrated leadership development, both institutionally and as a Health and Aging Policy Fellow. Dr. Lum's mentorship team and institutional resources are exceptional. As Dr. Lum's primary mentor, Cari Levy, MD, PhD is a nationally recognized researcher and leader in geriatric palliative care and will supervise Dr. Lum's research, career, and leadership development. Dr. Lum is co-mentored by Jean Kutner, MD, MSPH, a skilled leader and expert in palliative care research, including clinical trials in older adults. With funding from the National Palliative Care Research Center and The Colorado Health Foundation, Dr. Lum demonstrated that a novel ACP-GV intervention prototype increased ACP discussions and documentation among older adults in primary care. In order to conduct a real-world clinical trial and ultimately implement this intervention, the next research steps are to standardize the intervention for a general population and adapt the intervention to clinical settings by prioritizing input from patients, clinicians, staff, and health system leaders. Thus, the study objectives are to: 1) develop and refine the ACP-GV intervention to be standardized to the essential intervention components, to be adaptable across clinic settings, and to prioritize ACP outcomes important to key primary care stakeholders, and 2) conduct a pilot randomized controlled trial to test the feasibility, acceptability, and preliminary efficacy of the refined ACP-GV intervention. The culmination of this career development award will assure that Dr. Lum gains the advanced research skills and knowledge to conduct a full-scale effectiveness-implementation trial of an ACP-GV intervention for older adults on patient- centered outcomes. Additionally, she will be specifically positioned to assume expanded and influential national leadership roles to lead policy initiatives to improve ACP with local, regional, and national impact and improve healthcare system delivery of care that is aligned with patient goals.