Systems Science for Translational Health Disparities Research

转化健康差异研究的系统科学

基本信息

批准号：
10319529
负责人：
John William Jackson
金额：
$ 17.04万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-01-01 至 2023-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10319529
关键词：
Accounting Achievement Address Award Awareness Black Populations Cardiovascular Diseases Cardiovascular system Caring Case Manager Clinical Trials Cluster randomized trial Collaborations Communities Community Healthcare Community Physician Complex Computerized Medical Record Data Data Analytics Decision Making Development Plans Effectiveness Effectiveness of Interventions Epidemiology Ethnic Origin Evidence based intervention Foundations Funding Goals Health Disparities Research Health behavior Healthcare Healthcare Systems Hypertension Infrastructure Institution Intervention Intervention Trial K-Series Research Career Programs Knowledge Lead Link Low income Mentors Mentorship Methodology Methods Modeling Morbidity - disease rate Movement Not Hispanic or Latino Pathway interactions Patient Care Patients Phase Population Population Heterogeneity Prevention strategy Primary Care Physician Primary Health Care Program Development Provider Public Health Schools Race Research Research Personnel Research Proposals Resources Retrospective cohort Science Self Management System Testing Therapeutic Time Training Translating Translations Work base cardiovascular disorder epidemiology cardiovascular health career career development causal model collaborative trial disparity reduction effective therapy ethnic minority experience follow-up hypertension control implementation science income disparities intervention effect meetings mortality multi-component intervention novel strategies organizational structure patient population pragmatic trial professor programs racial and ethnic racial and ethnic disparities racial minority skills social social disadvantage socioeconomics theories translational health science working group

项目摘要

PROJECT ABSTRACT Disparities in hypertension control, a major determinant of cardiovascular disease, are driven by a confluence of barriers that operate at patient, provider, healthcare institution, and community levels. Developing multilevel interventions that overcome these barriers can take years, high levels of funding, and infrastructure. Healthcare institutions that serve disparity populations may lack these resources and be unable to rigorously develop and evaluate such complex interventions. The question, then, is how to best adapt evidence-based interventions for hypertension control so institutions can implement and sustain them? Dr. John W. Jackson is an Assistant Professor in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health. Dr. Jackson seeks a K01 Mentored Career Development Award to gain the skills, experience, and preliminary data needed for an independent, methods-focused research program in translational health disparities research. Through the training and research experience outlined in this award, Dr. Jackson will integrate his background in causal inference with methods and theories that capture the ecological complexity of healthcare systems and patient care. The career development plan includes training in (a) systems science (b) implementation science (c) social ecological theory, and (d) cardiovascular disease epidemiology through mentorship, coursework, and participation in working groups, professional development programs, and scientific meetings. Using this training, Dr. Jackson will build microsimulation models that address three critical phases of translational health disparities research. Aim 1 empirically identifies patient-level factors that a multilevel intervention must address to reduce disparities in a target institution. Aim 2 empirically identifies the active components of a multilevel intervention that must be translated to the target institution. Aim 3 estimates the effect of a multilevel intervention in the target institution, after accounting for differences in patient composition and organizational structure. The Aims will use detailed data from the RICH LIFE Project, a cluster randomized trial of collaborative, stepped care to reduce disparities in hypertension control (the multilevel intervention), along with a retrospective cohort of patients from the Johns Hopkins Community Physicians primary care network (the target institution). This study will lay the groundwork for a theory-informed research program that blends causal inference and systems science methods to guide the translation of disparities-focused interventions to new settings.

项目摘要高血压控制的差异是心血管疾病的主要决定因素，是由汇合驱动的在患者，提供者，医疗机构和社区层面上运作的障碍。开发多级克服这些障碍的干预措施可能需要数年，高水平的资金和基础设施。服务差异人群的医疗机构可能缺乏这些资源，无法严格制定和评估这种复杂的干预措施。那么，问题是如何最好地适应基于证据的高血压控制的干预措施，以便机构可以实施和维持它们？约翰·W·杰克逊（John W. Jackson）博士是约翰·霍普金斯（Johns Hopkins）流行病学系的助理教授彭博公共卫生学院。杰克逊博士寻求K01指导的职业发展奖以获得独立，以方法为中心的研究计划所需的技能，经验和初步数据转化健康差异研究。通过该奖项概述的培训和研究经验，杰克逊博士将整合他的背景关于捕获医疗保健系统生态复杂性的方法和理论的因果关系和患者护理。职业发展计划包括（a）系统科学培训（b）实施科学（c）社会生态理论和（d）通过指导的心血管疾病流行病学，课程工作以及参与工作组，专业发展计划和科学会议。使用此培训，杰克逊博士将建立微仿真模型，以解决三个关键阶段转化健康差异研究。 AIM 1从经验上识别出多级的患者级因素干预必须解决，以减少目标机构的差异。 AIM 2经验识别活动必须将多层次干预的组成部分转化为目标机构。 AIM 3估计在考虑患者组成的差异之后，多层次干预对目标机构的影响和组织结构。目的将使用Rich Life Project的详细数据，这是一个随机的群集协作，逐步谨慎的试验，以减少高血压控制的差异（多层次干预），以及来自约翰·霍普金斯社区医生初级保健的患者的回顾性队列网络（目标机构）。这项研究将为理论知识的研究计划奠定基础混合因果推理和系统科学方法指导以差异为中心的翻译新设置的干预措施。