Impact of Health-related Social Needs on Dialysis Outcomes

健康相关的社会需求对透析结果的影响

基本信息

批准号：
10450063
负责人：
Tessa Novick
金额：
$ 18.51万
依托单位：
UNIVERSITY OF TEXAS AT AUSTIN
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-01 至 2026-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10450063
关键词：
Address Affect American Applications Grants Area Behavioral Caring Chronic Disease Clinical Trials Communities Community Health Aides Computerized Medical Record Data Development Dialysis patients Dialysis procedure Economically Deprived Population Emergency department visit End stage renal failure Enrollment Epidemiologic Methods Food General Population Goals Health Health Services Hemodialysis Impairment Individual Information Systems Internal Medicine International Intervention Intervention Trial Interview Kidney Kidney Diseases Lead Length of Stay Link Medical Medicine Mentored Patient-Oriented Research Career Development Award Mentors Methods Modality Modeling Nature Nephrology Outcome Patients Performance Pharmaceutical Preparations Population Population Heterogeneity Population Intervention Qualitative Methods Qualitative Research Regimen Research Research Methodology Research Personnel Resources Role Secure Series Social Work Social Workers Structure System Testing Texas Time Training Transportation United States Universities Veterans Health Administration Work acceptability and feasibility acute care austin barrier to care career clinical epidemiology cohort community based participatory research cultural competence design dietary restriction disease disparity experience food insecurity health care disparity health disparity hospitalization rates housing instability improved large datasets marginalized population medical schools mid-career faculty mortality patient engagement patient oriented patient oriented research personalized management professor public health relevance social social health determinants socioeconomics therapy design therapy development

项目摘要

PROJECT SUMMARY Dr. Tessa Novick, an Assistant Professor of Internal Medicine in the Division of Nephrology at the University of Texas at Austin Dell Medical School, is a nephrologist, trained social worker and health services researcher whose career goal is to become an independent investigator in patient-oriented research focused on improving care for marginalized populations with kidney disease. This K23 award will provide Dr. Novick with training and mentored research experience in the following areas: (1) using complementary advanced epidemiological and qualitative methods to understand the scope and nature of a problem to inform interventions; (2) health disparities and community based participatory research; (3) intervention and clinical trial development, execution and interpretation. To achieve these goals, Dr. Novick has assembled a mentoring team comprised of primary co-mentors: Dr. Deidra Crews, Associate Professor of Medicine in the Division of Nephrology at Johns Hopkins University, who is an internationally recognized leader in kidney disease disparities and interventions to address them; Dr. Elizabeth Jacobs, Professor of Internal Medicine at the University of Texas at Austin Dell Medical School, who is internationally regarded for her work investigating health-care disparities, interventions to address social determinants of health, and advancing culturally competent care for diverse populations. The focus of the proposed mentored research is on understanding how health-related social needs of patients with end-stage kidney disease (ESKD) impact their care and how they might be addressed. ESKD affects over 700,000 Americans, and requires substantial patient engagement in order to achieve optimal outcomes. Health-related social needs are individual-level social determinants of health, such as unstable housing, food insecurity, transportation and utility needs. Dr. Novick hypothesizes that health-related social needs impair patient engagement, and are associated with higher acute care utilization and mortality. Dr. Novick further hypothesizes that dialysis patients will identify acceptable interventions to address health-related social needs, and interventions being tested in the general population using community health workers and organizations that bridge patients to community resources are feasible in the dialysis population. Dr. Novick will test these hypotheses using a series of complementary studies that (1) leverage data from the Veterans Health Administration and United States Renal Data System; (2) gain an in-depth understanding of the problem using qualitative research methods; and (3) refine an intervention that uses community health workers to connect dialysis patients with community resources.

项目摘要 Tessa Novick博士，大学内科学助理教授德克萨斯州奥斯汀·戴尔医学院（Austin Dell Medical School）是肾脏科医生，经过培训的社会工作者和卫生服务研究员其职业目标是成为以患者为导向研究的独立研究者的重点护理边缘化肾脏疾病的人群。该K23奖将为Novick博士提供培训和在以下领域的指导研究经验：（1）使用互补的高级流行病学和理解问题的范围和性质以告知干预措施的定性方法；（2）健康差异和基于社区的参与性研究；（3）干预和临床试验开发，执行和解释。为了实现这些目标，诺维克博士组成了一个指导团队主要院长：Deidra Crews博士，肾脏科学副教授约翰·霍普金斯大学（Johns Hopkins University）是肾脏疾病差异的国际公认领导者干预措施以解决这些问题；德克萨斯大学内科教授伊丽莎白·雅各布斯博士在奥斯汀·戴尔医学院（Austin Dell），她因调查医疗保健差异的工作而受到国际视为解决社会决定因素的干预措施，并推进具有多种多样的文化胜任的护理人群。拟议的指导研究的重点是了解与健康相关的社会终阶段肾脏疾病（ESKD）的患者的需求会影响他们的护理以及如何解决。 ESKD影响超过70万美国人，需要大量的患者参与才能实现最佳结果。与健康相关的社会需求是健康的个人社会决定因素，例如不稳定的住房，粮食不安全，运输和公用事业需求。诺维克博士假设与健康有关社会需求会损害患者的参与，并与更高的急性护理利用和死亡率有关。博士诺维克进一步假设透析患者将确定可接受的干预措施以解决与健康有关的问题社会需求以及使用社区卫生工作者和在透析人群中，将患者桥接到社区资源的组织是可行的。诺维克·威尔博士使用一系列互补研究来检验这些假设，这些研究（1）利用退伍军人健康的数据管理和美国肾脏数据系统；（2）使用定性研究方法；（3）完善一种使用社区卫生工作者联系的干预措施透析患者具有社区资源。