The need for evidence based interventions to improve outcomes in chronic conditions has never been greater as the prevalence of heart disease, stroke, cancer, and diabetes, for example, continue to escalate across all age groups. Nurse researchers are in a pivotal position to address and reduce the individual, family, and health care system burden imposed by chronic illness through improved self management approaches for prevention, self care, and symptom management. The Emory University School of Nursing provides a unique and interdisciplinary environment for training nurse scientists in intervention research to address the needs of patients and families with chronic health problems. The purpose of this proposed training grant is to provide rigorous research training centered on design and testing of theory based and clinically relevant interventions which will lead to prevention of and improved health outcomes for those at risk for or with chronic conditions such as but not limited to cardiovascular, cancer, neurological and diabetes/endocrine health problems. The goals are to provide: 1) the theoretical and conceptual basis to generate a program of research examining ways in which self-management interventions improve individual, family or health resource use outcomes, 2) methodological skills to support innovative design and rigorous testing of interventions with measurement of biobehavioral outcomes, biomarkers, and health resource use outcomes, and 3) mentor trainees to support their science and career development so that they will initiate and sustain interdisciplinary scholarly inquiry in this substantive area. The science and training activities wll be guided by a broad conceptual model targeting individual and context/family factors that influence self management behaviors through interventions to achieve improved health outcomes measured as reduced risk, improved physical, social and psychological function, improved quality of life, improved physiological biomarkers pertinent to the chronic condition, and reduced health resource use. Support for enrolling two-three predoctoral and 1 postdoctoral trainees each year is requested to prepare a total of 13 predoctoral and 5 postdoctoral trainees Predoctoral fellows will take core courses in the existing doctoral program, which includes a strong science focus on health outcomes research including research with vulnerable populations, analytic techniques, and participation in research through research residencies. Additionally they will take graduate-level electives in the biological, behavioral, public health, and nursing sciences. Postdoctoral work will be guided by an interdisciplinary team of researchers and constructed to meet the research needs of each trainee, emphasizing coursework in health outcomes research, complex conditions and methods, and participation in research. All trainees will develop and implement research projects, develop grant writing and research dissemination skills. The program unites expert core and collaborating faculty who have active research programs in the substantive area within a vibrant and interdisciplinary academic, clinical and research environment to prepare future nurse scientists.
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