By the year 2040, the number of women ages 65 and older in the US will approximately double from 20.4 to 40.8 million. Although women live longer than men, at every age over 65 women's disabled life expectancy is doubled that of men and their institutionalized life expectancy is 3-4 fold longer than older men. Medicare expenditures are 7-23% higher and nursing home expenditures are 60-100% higher for older women than men. The purpose of this training program application is to prepare postdoctoral public health scientists, primarily epidemiologists, health services researchers, behavioral scientists, and academic clinicians, to produce the evidence that will guide optimum, efficient, and cost-effective healthcare practices for older women in the future. The program will be housed in the Center for Health Studies, Group Health Cooperative (CHS/GHC), a nationally recognized leader in health care innovation. The program and its faculty are closely linked with the Departments of Epidemiology and Health Services at the University of Washington. Trainees will thus have access to the broad range of resources available at both institutions, including an invigorated scientific community, formal/informal coursework, and degree granting programs. We propose to build the training program up to 3 postdoctoral positions in the initial funding period. Women's health faculty at CHS have a rich program of research focused in areas critically important to improving healthcare for aging women including: 1) screening and preventive services;2) bone health;3) urinary health;4) the menopausal transition;5) chronic disease prevention and management;and 6) frailty and disability. Twenty-three faculty preceptors will participate. The training program has 8 primary learning objectives: 1) Develop skills in defining research questions and appropriate study designs;2) Acquire basic knowledge in the 6 aforementioned research focus areas in women's health;3) Acquire in-depth expertise in one or more research domains relevant to healthcare improvement for aging women;4) Complete training in protection of human subjects;5) Gain experience implementing research protocols;6) Improve skills in making scientific presentations;7) Improve skills in scientific writing and publishing;8) Develop skills in grant writing. Over the long term, this training program aims to build a critical mass of outstanding public health scientists prepared to have major impacts on health care delivery for aging women.
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