Building methods to assess and address cardiovascular health in transgender adults

建立评估和解决跨性别成人心血管健康的方法

• 批准号: 10596603
• 负责人: Carl G Streed
• 金额: $ 16.63万
• 依托单位: BOSTON MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-15 至 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10596603
• 关键词: Accounting; Address; Adult; Affect; Algorithms; Area; Atherosclerosis; Attitude; Boston; Cardiology; Cardiovascular Diseases; Cessation of life; Classification; Clinical Skills; Code; Collaborations; Consolidated Framework for Implementation Research; Data; Data Analyses; Data Collection; Development; Diabetes Mellitus; Diagnosis; Discrimination; Disease Outcome; Disease model; Electronic Health Record; Endocrinology; Equation; Exogenous Hormone Therapy; Faculty Workshop; Federally Qualified Health Center; Female; Future; Gender; Gender Identity; Goals; Grant; Health; Hormone use; Hormones; Hyperlipidemia; Hypertension; Individual; Intervention; Intramuscular; K-Series Research Career Programs; Knowledge; Mentored Research Scientist Development Award; Mentors; Mentorship; Methods; Modeling; Morbidity - disease rate; Myocardial Infarction; National Heart, Lung, and Blood Institute; Oral; Outcome; Patients; Persons; Play; Population; Preventive care; Primary Prevention; Procedures; Qualitative Research; Recommendation; Records; Research; Research Personnel; Resources; Review Literature; Risk; Risk Assessment; Risk Factors; Risk Management; Role; Route; Scientist; Sensitivity and Specificity; Services; Sexual and Gender Minorities; Site; Statistical Models; Stroke; Surveys; Tobacco; Tobacco use; Training; United States National Institutes of Health; Universities; Writing; cardiovascular disorder risk; cardiovascular health; cis-female; cis-male; cisgender; clinical decision-making; cohort; community engagement; comorbidity; data warehouse; experience; follow-up; gender affirming care; gender minority; hormone therapy; implementation science; improved; indexing; male; meetings; mortality; multidisciplinary; novel; predictive modeling; prevent; programs; recruit; risk mitigation; risk prediction model; sex; sex assigned at birth; skills; statistics; success; symposium; transgender; transgender men; transgender women

Project Summary: Guided by current prediction models utilized to address and prevent atherosclerotic cardiovascular disease (CVD), the proposed project investigates how gender identity and hormone therapy are related to cardiovascular health in transgender adults. The projects three specific aims are to: 1) evaluate a robust method of identifying transgender individuals within claims data and compare this method to the gold-standard of self-identification with data from Fenway Health, a federally qualified health center and leader in transgender health; 2) assess current prediction models for CVD (i.e., Pooled Cohort Risk Assessment Equation) utilizing C statistics, net reclassification, and integrated discrimination index for transgender individuals by accounting for sex assigned at birth, gender identity, and use of exogenous hormones.; and 3) examine the knowledge and attitudes of 160 transgender adult regarding potential risks associated with hormone therapy and perceived barriers, facilitators, and acceptability of interventions affecting cardiovascular health. Completing the proposed aims will 1) improve the accuracy of research with administrative data; 2) enhance clinical decision-making for transgender adults seeking hormone therapy; and 3) inform risk mitigation strategies to improve cardiovascular health of transgender adults. By engaging in mentored research with Drs. Emelia Benjamin (Mentor), Michael Paasche-Orlow (Mentor), Howard Cabral (Mentor), and Sari Reisner (Mentor), and collaborators, completing coursework, and participating in seminars, conferences, and regular mentoring meetings, I will develop expertise in four new areas critical to my development as an independent clinician- scientist evaluating health outcomes to characterize and mitigate CVD risks for transgender individuals: 1) Quantitative methods to analyze claims-based & electronic health record data; 2) Quantitative methods to assess prediction models; 3) Clinical skills in transgender endocrinology, cardiology, & preventive care; and 4) Qualitative research & community engagement skills. Moreover, I will extend my grant writing and oral presentation skills by participating in grant writing courses and presenting at research meetings and seminars. Boston University offers junior scholars with the intellectual and practical resources they need to develop into successful independent investigators, including junior faculty seminars, grant writing, editing, and review services, and opportunities for intellectual exchange and collaboration with senior colleagues. A K01 award will provide me with the research experience, skills, and mentorship I need to build a cutting-edge independent research program that assesses and addresses cardiovascular health in sexual and gender minorities, particularly transgender adults.

项目摘要： 在当前用于解决和预防动脉粥样硬化心血管疾病的预测模型的指导下 （CVD），拟议的项目调查了性别认同和激素治疗与 跨性别成年人的心血管健康。这些项目的三个具体目标是：1）评估强大的 在索赔数据中识别跨性别者并将此方法与金标准进行比较的方法 与Fenway Health的数据，Fenway Health，Federmedsmentimpersmited Health Center和Transgender的领导者的自我认同 健康; 2）评估使用CVD的当前预测模型（即使用合并的队列风险评估方程） C统计，净重新分类和跨性别者的综合歧视指数通过会计 出生时分配的性别，性别认同和外源激素的使用。 3）检查知识 160名变性成年人对激素治疗和激素治疗和 感知的障碍，促进者以及影响心血管健康的干预措施的可接受性。完成 拟议的目标将通过行政数据提高研究的准确性； 2）增强临床 跨性别成年人寻求激素治疗的决策； 3）告知风险缓解策略 改善跨性别成年人的心血管健康。通过与DRS进行指导研究。艾米莉亚 本杰明（导师），迈克尔·帕斯奇·奥洛（Michael Paasche-Orlow）（导师），霍华德·卡布拉尔（Mentor）（导师）和萨里·瑞斯纳（Sari Reisner）（导师）和 合作者，完成课程工作，参加研讨会，会议和定期指导 会议，我将在我作为独立临床医生发展至关重要的四个新领域中发展专业知识 - 科学家评估健康结果以表征和减轻跨性别者的CVD风险：1） 定量方法来分析基于索赔的和电子健康记录数据； 2）定量方法 评估预测模型； 3）跨性别内分泌，心脏病学和预防保健的临床技能；和4） 定性研究与社区参与技能。而且，我将扩展我的赠款写作和口头 通过参加赠款写作课程并在研究会议上介绍，演讲技巧 研讨会。波士顿大学为初级学者提供了他们需要的智力和实践资源 发展成为成功的独立研究人员，包括初级教师研讨会，赠款写作，编辑和 审查服务，以及与高级同事进行智力交流和合作的机会。一个K01 奖项将为我提供研究经验，技能和指导，我需要建立尖端 评估和解决性别和性别心血管健康的独立研究计划 少数民族，特别是跨性别成年人。