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

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.