Bridging the Science-to-Service Gap in Aging Care: Prevention, Optimization and Living Well with Persistent or Serious Illnesses

项目概要：弥合老龄护理中的科学与服务差距（弥合差距）：预防， 优化和生活以及持续或严重的疾病 拟议的T32博士后研究金将解决加强和多样化管道的迫切需要， 训练有素的临床研究人员定位于通过开发，测试和 实施从健康到疾病的临床和行为预防干预措施（CBPI）， 所有护理环境（例如，医院、疗养院）和社区为个人及其非正式照顾者提供服务。尽管 尽管医学、社会和行为科学取得了进步，但广泛承认的科学与服务之间的差距仍然存在， 在临床或社区环境中，对老年人的日常护理很少采取干预措施。这种差距 特别是在阿尔茨海默病和相关痴呆症（ADRD）的护理中， 以证据为基础的方法，以支持痴呆症患者（PLWD）及其照顾者的疾病 弹道造成这种“执行悬崖”的一个关键原因是， 为进入衰老领域的新临床研究者提供的NIH模型。此外，迄今为止，很少有研究 重点是预防与年龄有关的不良后果。我们有能力解决这一重要差距，因为 我们有机会获得一个非常有才华的跨学科学员（博士和医学博士）和无与伦比的 跨学科网络，NIH资助的教师导师和研究人员在CBPI方面具有互补的专业知识， 一级预防（例如，治疗ADRD风险因素以预防发作），二级预防（例如，情绪预防 ADRD中的痛苦）和三级预防（例如，提高ADRD的生活质量）。两名新学员最近 完成临床培训后，每年将进入该计划，并将获得最多三年的支持 （一次最多6名学员）。学员将接受跨学科的指导1）内部部门 医学蒙干研究所（包括老龄和严重疾病中心）2）精神病学系（包括 健康结果和跨学科研究中心）和3）神经病学系（包括 马萨诸塞州ADRD研究中心）。受训人员将接受专门的教学培训， NIH阶段模型、试验设计和社区参与的一级、二级和三级预防研究， 生物统计学，临床试验管理，科学写作，健康差异和健康的社会决定因素，领导力 技能和职业规划，以准备职业发展奖或其他独立申请提交 在奖学金期结束之前。学员将开发使用NIH阶段模型的指导临床研究项目 并将通过他们导师的NIH资助的临床试验接受体验式培训。我们的学员毕业时 深入了解NIH阶段模型，开发和实施可扩展和公平的预防干预措施的技能 在所有的护理环境中，以及推进衰老科学和改善对我们不断增长的老年人的护理所必需的研究工具。 成人人口。

PROJECT SUMMARY: Bridging the Science-to-Service Gap in Aging Care (BRIDGE THE GAP): Prevention, Optimization and Living Well with Persistent or Serious Illnesses The proposed T32 postdoctoral fellowship will address the pressing need for strengthening and diversifying the pipeline for well-trained clinician investigators positioned to advance the field of aging research through the development, testing, and implementation of clinical and behavioral preventive interventions (CBPIs) across the spectrum from health to illness across all care settings (e.g., hospital, nursing homes) and in the community for individuals and their informal caregivers. Despite advances in medical, social and behavioral sciences, a widely acknowledged science-to-service gap remains such that most interventions are rarely implemented in the routine care of older adults in clinical or community settings. This gap is particularly apparent in the care of those with Alzheimer’s Disease and related dementias (ADRD), where there is a dearth of evidence-based approaches to support persons living with dementia (PLWD) and their caregivers across the disease trajectory. A key reason for this “implementation cliff” is the lack of rigorous and comprehensive training in all stages of the NIH model for new clinical investigators that enter the field of aging. Further, to date, very little research has been focused on prevention of age-related negative consequences. We are well positioned to address this important gap because we have access to both an exceptionally talented pool of interdisciplinary trainees (PhD and MD) and an unparalleled network of interdisciplinary, NIH funded faculty mentors and investigators with complementary expertise in CBPIs in primary prevention (e.g. treating ADRD risk factors to prevent onset), secondary prevention (e.g., prevention of emotional distress in ADRD), and tertiary prevention (e.g., increasing quality of life in ADRD). Two new trainees who have recently completed their clinical training will enter the program each year and will receive a maximum of three years of support (maximum 6 trainees at one time). Trainees will receive interdisciplinary mentorship across 1) the Department of Internal Medicine Mongan Institute (including the Center for Aging and Serious Illness) 2) the Department of Psychiatry (including the Center for Health Outcomes and Interdisciplinary Research) and 3) the Department of Neurology (including the Massachusetts ADRD Research Center). Trainees will receive specialized didactic training that covers methods across the NIH stage model, trial design and community engaged research across primary, secondary and tertiary prevention, biostatistics, clinical trial management, scientific writing, health disparities and social determinants of health, leadership skills and career planning, in preparation for career development awards or other independent applications to be submitted by the end of the fellowship period. Trainees will develop mentored clinical research projects that use the NIH stage model and will receive experiential training through their mentors’ NIH funded clinical trials. Our trainees will graduate with a deep understanding of the NIH stage model, skills to develop and implement scalable and equitable preventive interventions in all care settings, and the research tools necessary to advance the science of aging and improve care for our growing older adult population.