SMART POR: Supporting and Mentoring Across Respiratory Topics in Patient Oriented Research

项目摘要 慢性阻塞性肺疾病（COPD）影响着超过1600万美国成年人，其中许多人 初次COPD后急性护理复诊率高（急诊科和医院） 住院这些频繁的恶化，通常是由于过渡护理（TOC）失败，导致肺 功能下降和早期死亡。需要进行大型多地点研究，以解决 在大规模实施有效的COPD TOC之前，基本有效性和实施数据 计划和成功减少重访。我目前的NHLBI R 01旨在解决这些差距， 通过在20家不同的美国医院测试COPD TOC计划， COPD患者的医疗保健服务和结局。我的R 01同时使用实现 科学（IS）和以人为本的设计（HCD）方法。虽然这些方法是严格的， 作为补充，以前瞻性的方式整合这些定性方法可以优化其潜力 影响干预措施的设计和实施，以获得数据并最终为护理提供信息 转型此外，标准化用于评估和报告COPD TOC计划和回访的指标 数据可以显著改善COPD TOC项目和研究之间的结果比较。K24 将允许我通过建立在我的R 01研究，指导计划， 开发、测试和传播综合信息系统和人力资源开发定性和定量方法的基础设施， 用于面向患者的研究。我将与我的学员和R 01研究团队的IS专家合作， HCD方法开发一种名为“CHIMERA”的综合方法;此外，我将与 制定名为“智能COPD”的统一报告指标。我将通过与我的同事合作来实现这些目标。 指导者开发、测试和传播“CHIMERA”和“SMART COPD”工具。CHIMERA将使用 逐步的方法来确定HCD和IS域和方法，然后使用逻辑模型， 从我的R 01目标1中绘制利益相关者评估的概念图，以开发CHIMERA“交叉步行” 整合这两种方法的方法。CHIMERA将与我的R 01目标2和3一起进行测试， 执行和执行后。SMART COPD指标将使用系统性 文献综述和改良的德尔菲方法，其中我们的R 01团队将识别并优先考虑COPD TOC 制定指标以标准化报告。这个K24将使我能够为我的 通过开发新的研究工具，指导学员。我的K24丰富的研究计划题为： “SMART POR：在面向患者的研究中支持和指导呼吸主题”还将 为我提供充足的机会，以支持当前和未来的研究学员实施研究， 推动以汽车为基础的事业。

PROJECT ABSTRACT Chronic Obstructive Pulmonary Disease (COPD) affects more than 16 million US adults, many of whom experience high rates of acute care revisits (emergency department and hospital) after initial COPD hospitalization. These frequent exacerbations, often due to transition of care (TOC) failures, lead to lung function decline and earlier mortality. Large multi-site studies are needed to address ongoing gaps in fundamental effectiveness and implementation data, before widescale implementation of effective COPD TOC programs and successful reduction of revisits. My current NHLBI R01 aims to address these gaps in effectiveness and implementation by testing COPD TOC programs across 20 diverse US hospitals to improve health care delivery and outcomes for patients with COPD. My R01 simultaneously uses implementation science (IS) and human-centered design (HCD) methods. While these methods are rigorous and complimentary, integrating these qualitative approaches in a prospective manner could optimize their potential to impact the design and implementation of interventions in order to obtain data and ultimately inform care transformation. Further, standardizing metrics for evaluating and reporting COPD TOC program and revisit data could significantly improve outcome comparisons between COPD TOC programs and studies. The K24 will allow me to address these methodology gaps by building upon my R01 research, mentoring program, and infrastructure to develop, test, and disseminate integrated IS and HCD qualitative and quantitative methods for use in Patient Oriented Research. I will collaborate with my mentees and R01 research team experts in IS and HCD methods to develop an integrated approach named "CHIMERA"; additionally, I will collaboratively develop harmonized reporting metrics called "SMART COPD". I will complete these aims by working with my mentees to develop, test, and disseminate the "CHIMERA" and "SMART COPD" tools. CHIMERA will use a step-wise approach to identify HCD and IS domains and methods, followed by the use of logic models and concept mapping of stakeholder assessments from my R01 Aim 1 to develop a CHIMERA “cross walk” methodology that integrates both methods. CHIMERA will be tested in conjunction with my R01 Aims 2 and 3, implementation and post-implementation. The SMART COPD metrics will be developed using systematic literature review and a modified Delphi approach, in which our R01 team will identify and prioritize COPD TOC Program metrics to standardize reporting. This K24 will allow me to provide mentoring opportunities to my mentees through development of novel research tools. The enriched research program of my K24 entitled: "SMART POR: Supporting and Mentoring Across Respiratory Topics in Patient Oriented Research" will also provide ample opportunities for me to support current and future research mentees to implement research and drive investigator-based careers.