The purpose of the NIA Career Development Award (CDA) application is to provide the applicant with the knowledge, analytical skills, and preliminary database necessary to develop technology that will facilitate the transfer of interventions, specifically a quality assessment (QA) system for monitoring pressure ulcer (PU) care processes, into practice in nursing homes (NHs). The proposed CDA will allow the applicant to receive training in four primary areas, each of which compliments her existing knowledge: 1) expert consensus methodology, which builds on her experience with national PU panels and research developing a tool for assessing PUs; 2) health service research relevant to changing provider behavior and implementing practice guidelines in NHs, which builds on her clinical and teaching experience; 3) cost effectiveness and cost benefit analysis and 4) operations research modeling such that associated costs and staffing resources required for implementing the QA system can be determined, both of which expand her existing knowledge of research methodology and will strengthen her knowledge of statistical analysis. Specifically, this CDA application is designed to provide the applicant with the necessary knowledge and analytical skills to pursue her immediate career goal of refining and validating the QA system for monitoring PU care processes in NHs. The proposed CDA program of training incorporates formal coursework and individualized tutorials to provide the applicant with the requisite knowledge and skills to accomplish her immediate career goals. Dr. John F. Schnelle, PhD, a behavioral psychologist and expert in behavioral and environmental interventions in NHs, will serve as the applicant's sponsor and primary mentor, providing training in focus group methodology as well as designing, implementing, and evaluating interventions in NHs. Dr. Charlene Harrington, a nurse and expert in NH staffing, will serve as a mentor in nurse staffing issues in NHs and nurse staffing ratios needed for implementation of the QA system. Drs. George Xakellis, and Laurence Rubenstein will be her mentors in implementing practice guidelines, NH organizational structure, and cost benefit analysis related to implementation of the QA system. She will work with the Claude B. Pepper Older American Independence Center (OAIC) Data Management Core in developing software, and with two consultants to refine movement monitoring technology both of which are necessary for implementation of the system in NHs. Dr. Mary Cadogan will provide guidance for the nurse expert panel. Dr. Emmett Keeler, a senior mathematician at RAND, will provide training in cost analysis related to the intervention and operations research modeling techniques to determine systems costs and the necessary staff resources. Such training will permit the applicant to pursue her long-term career goal of developing behavioral and environmental interventions that improve the quality of life among institutionalized elders, and determine the NH staff resources and the associated costs necessary to implement such interventions in the NH setting. Thus, the proposed CDA training would be central to the applicant's ability to develop as an independent scientist within her chosen area of gerontologic research.
