ACHIEVE P3 - CHD

实现 P3 - CHD

• 批准号: 10494208
• 负责人: Sanjay Rajagopalan
• 金额: $ 58.51万
• 依托单位: WAYNE STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-24 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10494208
• 关键词: Address; Great Lakes Region; Prevention; cardiometabolism; health inequalities

ABSTRACT The substantial improvement in lifespan and health span in the United States, attributable to improvements in awareness, detection and treatment of risk factors have not translated into Black individuals. Life expectancy among Black males remains recalcitrantly low and comparable to the developing world. Socio-economic status, education, neighborhood, built environment, community context and behavioral factors or social determinants of health (SDoH) account for ~80% of variance in health outcomes and cluster geographically. Strategies to address health inequities in Black individuals must acknowledge and address SDoH. Precision health technologies, access to care coordination and guidance on lifestyle, diet and pharmacotherapy have traditionally been the prerogative of the privileged, but offer value, by virtue of their accuracy and co-benefits of engagement, education and empowerment. The overall hypothesis of PROJECT 3 is that a visionary free precision medicine approach to identify “at-risk” Blacks. and linkage to care using a pragmatic reimbursable HUB-facilitated, community health worker (CHW) led, personalized, adaptable approach to lifestyle and life circumstance (PAL2) intervention, will improve the triple goal of optimal blood pressure, lipids and glucose targets. PAL2 will incorporate proven interventions including CHW care coordination, motivational interviewing, lifestyle coaching, home blood pressure monitoring and importantly will be tunable to address high risk patients (CAC≥100) with a nurse-dietician-pharmacist. We will partner with the Cuyahoga Metropolitan Housing Authority (CMHA), one of the nation’s largest subsidized housing programs and Better Health Partnerships (BHP), a Cleveland based non-profit, that offers a CHW-HUB model of care. Utilizing a Practical Robust Implementation and Sustainability Model (PRISM) framework to address RE-AIM domains (Reach x Efficacy: Adoption, Implementation, Maintenance) and contextual factors, our multi-disciplinary team will test the benefits of a tunable PAL2 intervention to achieve guideline driven targets while exploring contextual factors that may determine the success of our intervention.

抽象的 美国的寿命和健康范围的重大改善，归因于改善 意识，检测和治疗危险因素尚未转化为黑人个体。预期寿命 在黑人男性中，顽固的顽固性和与发展中国家相当。社会经济 地位，教育，邻里，建筑环境，社区环境和行为因素或社会 确定健康状况（SDOH）占健康成果差异的约80％，并且在地理位置上占了群集。 解决黑人个人健康不平等的策略必须承认并解决SDOH。精确 健康技术，获得护理协调以及有关生活方式的指导，饮食和药物治疗 传统上，由于其准确性和共同利益，传统上是特权的特权，但具有价值 参与，教育和授权。项目3的总体假设是一个有远见的人 精密医学方法以识别“处于危险的黑人”。并使用务实的报销与护理联系 枢纽实力，社区卫生工作者（CHW）LED，个性化，适应性的生活方式和生活方法 情况（PAL2）干预将改善最佳血压，脂质和葡萄糖的三个目标 目标。 PAL2将纳入经过验证的干预措施，包括CHW护理协调，动机面试， 生活方式指导，家庭血压监测以及重要的是可调用高风险 患者（CAC≥100）与护士 - 抑郁症患者。我们将与Cuyahoga Metropolitan合作 住房管理局（CMHA），美国最大的补贴住房计划之一，改善健康 合作伙伴关系（BHP）是一家基于克利夫兰的非营利组织，它提供了CHW-HUB的护理模型。利用一个实用 强大的实施和可持续性模型（PRISM）框架以解决RE-AIM域（达到X 功效：采用，实施，维护）和上下文因素，我们的多学科团队将测试 可调PAL 2干预的好处是实现指导驱动目标的同时探索上下文 可能决定我们干预成功的因素。