Training in Interventions to Improve Outcomes in Chronic Conditions

描述(由申请人提供)：随着心脏病、中风、癌症和糖尿病在所有年龄段的患病率继续上升，改善慢性病预后的循证干预的必要性从未像现在这样强烈。护理研究人员处于关键地位，通过改进预防、自我护理和症状管理的自我管理方法，解决和减轻慢性病给个人、家庭和医疗保健系统带来的负担。埃默里大学护理学院为培训护理科学家进行干预研究提供了独特的跨学科环境，以满足患有慢性健康问题的患者和家庭的需求。这项拟议的培训赠款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，以预防心血管、癌症、神经和糖尿病/内分泌健康问题等慢性疾病的风险人群，并改善他们的健康结果。目标是：1)提供理论和概念基础，以生成研究计划，审查自我管理干预措施如何改善个人、家庭或卫生资源使用结果的方法；2)方法技能，通过测量生物行为结果、生物标记物和卫生资源使用结果来支持干预措施的创新设计和严格测试；以及3)指导受训人员，以支持他们的科学和职业发展，以便他们能够在这一实质性领域发起并维持跨学科的学术探索。科学和培训活动将以一个广泛的概念模型为指导，以个人和背景/家庭因素为目标，通过干预措施影响自我管理行为，以实现更好的健康结果，包括降低风险、改善身体、社会和心理功能、提高生活质量、改善与慢性病有关的生理生物标记物以及减少卫生资源使用。要求每年支持招收2-3名博士后和1名博士后实习生，以准备总共13名博士前和5名博士后实习生。博士前研究员将在现有博士后计划中学习核心课程，其中包括对健康结果研究的强烈科学关注，包括对弱势群体的研究、分析技术，以及通过常驻研究参与研究。此外，他们还将选修生物学、行为学、公共卫生和护理学等研究生水平的选修课。博士后工作将由一个跨学科的研究人员团队指导，并根据每个受训人员的研究需求进行构建，强调健康结果研究、复杂条件和方法以及参与研究方面的课程工作。所有受训人员将开发和实施研究项目，发展拨款撰写和研究传播技能。该计划将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拥有积极研究计划的专家核心和合作教师联合起来，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.