Translating Clinical Decision Making into Systems of Care: A Mid-Career Mentor

描述（由申请人提供）：Randall S. Stafford，医学博士，临床流行病学家，肥胖研究员，执业初级保健内科医生。这项K24更新提案利用了Stafford博士的临床研究专业知识、正在进行的研究项目和指导经验。斯塔福德博士接受过内科（UCSF医学博士，住院医师MGH）和流行病学（UC Berkeley博士，CDC博士后）的培训，目前是斯坦福大学医学副教授。他指导斯坦福大学预防结果和实践项目（PPOP），并在预防心脏病学和初级保健内科临床活跃。斯坦福大学为以患者为导向的研究培训提供了一个特殊的环境。斯塔福德博士的指导计划利用了现有的培训资源，特别是斯坦福大学CTSA的培训资源。这一更新奖项的具体目标是：1)利用斯塔福德博士成功的贫困教育议程，以及斯坦福大学的优秀环境，扩大贫困教育培训的创新和动态环境；2)以Stafford博士作为K24导师的成功为基础，继续发展新的研究和指导技能，应用更系统的指导方法，补充传统的学徒模式；3)通过工资支持和增加受保护的指导时间，提高Stafford博士的能力，为更多的学员提供更深入的指导；4)通过技能增长、职业重新聚焦和以影响为导向的强调，丰富斯塔福德博士的研究生涯。临床研究，特别是面向患者的研究，对于将科学知识转化为人口健康效益至关重要。然而，传播新的医疗实践和知识的过程往往不能为患者的最佳利益服务。有些新做法在没有充分评估的情况下就被轻易采用，而另一些有强有力证据支持的做法则被缓慢而不一致地采用。如果我们不能指导将科学证据转化为实践，国家对生物医学科学的投资就会受到损害。鉴于将研究成果转化为实践的重要性，具有讽刺意味的是，经过临床培训的医生在贫困地区从事强调人口健康的职业是多么困难。充分的指导已被确定为临床研究职业发展途径中一个关键但往往缺失的资源。斯塔福德博士致力于支持学员的职业需求，以确保他们能够以理想主义和目标追求人口科学的长期职业。斯塔福德博士自己的贫困人口研究组合提供的研究机会为人口科学和贫困人口培训提供了良好的环境。斯塔福德博士的研究旨在了解影响医生和患者行为的力量，重点是通过预防干预来改善健康结果。Stafford博士的目标是进一步发展卫生保健创新科学，作为设计预防干预措施的工具，以促进患者、其护理提供者和卫生保健系统的循证实践。这一研究议程通过一系列临床和教学/指导活动得到加强和刺激。指导各种各样的学员和初级教员不仅提供了一个多学科的知识社区，使这些问题变得至关重要，而且还创造了成功的科学家和未来的领导者。

DESCRIPTION (provided by applicant): Randall S. Stafford, MD, PhD is a clinical epidemiologist, obesity researcher, and practicing primary care internist. This K24 renewal proposal capitalizes on Dr. Stafford's clinical research expertise, ongoing research program, and mentoring experience. With training in Internal Medicine (MD UCSF, Residency MGH) and Epidemiology (PhD UC Berkeley, post-doc CDC), Dr. Stafford is currently an Associate Professor of Medicine at Stanford University. He directs the Stanford Program on Prevention Outcomes and Practices (PPOP) and is clinically active in Preventive Cardiology and Primary Care Internal Medicine. Stanford University provides an exceptional setting for patient-oriented research training. Dr. Stafford's mentoring plan leverages existing training resources, particularly those of Stanford's CTSA. The Specific Aims of this renewal award are to: 1) Leverage Dr. Stafford's successful POR agenda, as well as the outstanding environment of Stanford University to enlarge an innovative and dynamic setting for POR training; 2) Build on Dr. Stafford's success as a K24 mentor and his continued development of new research and mentoring skills to apply a more systematic approach to mentoring that supplements the traditional apprenticeship model; 3)Through salary support and the increased availability of protected mentoring time, enhance Dr. Stafford's capacity to provide a greater depth of mentoring to a larger number of mentees; 4) Enrich Dr. Stafford's research career through skill growth, career re-focusing, and an impact-oriented emphasis. Clinical research, particularly patient-oriented research (POR), is critical to the translation of scientific knowledge into population health benefits. The process by which new medical practices and knowledge are disseminated, however, often fails to serve patients' best interests. Some new practices are readily adopted without adequate assessment while others with strong evidence-based support are adopted slowly and inconsistently. National investment in biomedical science is jeopardized if we fail to guide the translation of scientific evidence into practice. Given the importance of translating research into practice, it is ironic how difficult it is for clinically trained physicins to pursue careers in POR that emphasize population health. Adequate mentoring has been identified as a critical, but often missing, resource in the clinical research career development pathway. Dr. Stafford is intent on supporting the career needs of mentees to ensure that they can pursue long-term careers in population science with idealism and purpose. The research opportunities available from Dr. Stafford's own POR portfolio provide an excellent milieu for population science and POR training. Dr. Stafford's research aims to understand the forces influencing physician and patient behavior, with a focus on intervening to improve health outcomes through prevention. Dr. Stafford's objective is to further develop the science of health care innovation as a vehicle for designing prevention interventions to facilitate evidence-based practices by patients, their care providers, and health care systems. This research agenda is reinforced and stimulated by an array of clinical and teaching/mentoring activities. Mentoring a wide variety of trainees and junior faculty members not only provides a multidisciplinary intellectual community that brings to life the vital importance of these issues, but also creates successful scientists and future leaders.