COMMUNITY OUTREACH FOR CTD SCREENING IN HIGH RISK GROUPS

高危人群 CTD 筛查的社区外展

• 批准号: 6382365
• 负责人: PATRICIA Ann FRASER
• 金额: $ 31.92万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-08-01 至 2003-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6382365
• 关键词: African American; blood tests; clinical research; education evaluation /planning; environmental exposure; female; glutathione transferase; health education; human subject; hydrocarbons; mass screening; medical outreach /case finding; questionnaires; solvents; systemic lupus erythematosus; women's health

African-American women bear a disproportionate burden of systemic lupus erythematosus (SLE), an incurable, disabling, disfiguring, and potentially fatal connective tissue disease (CTD), that occurs more frequently and with greater severity among them. Inherited factors that are carried in the genes increase the tendency to develop SLE. Exposures to organic solvents and petroleum products also increase the risk of SLE and other CTD. Specific gene patterns of glutathione-S-transferase (GST) genes that control the way the body degrades many toxic substances, have been found in SLE patients. The Massachusetts Department of Environmental Protection has located 184 sites of petroleum and organic solvent contamination within Roxbury, North Dorchester and Mattapan (RDM), African-American neighborhoods in Boston. RDM residents are at high risk for SLE due to their ethnicity and their environment. Screening for CTD, exposure to hazardous waste and GST gene patterns may reveal a link between environmental toxins, GST genes, and predisposition to SLE in African-Americans in RDM. Historically, the health behavior of African-American women is to shun participation in screening programs. We hypothesize that culturally relevant health education will reduce this barrier to screening. In partnership with the Women of Courage, a community-based group of African-American women with SLE, and the Department of Public Health, Bureau of Environmental Health Assessment, we propose a two phase study of CTD in African- American women in RDM. The major focus of Phase I is the implementation of a community educational outreach program to increase awareness about CTD and exposure to toxic wastes, that will facilitate a series screening design that utilizes initial screening by environmental questionnaire and fingerstick blood sample followed by CTD questionnaire. In addition, SLE cases that are identified from hospital databases will also be enrolled for environmental screening and GST gene patterns during Phase I. In Phase II, we will perform a case-control study that compares GST gene patterns and environmental exposures between SLE cases and controls. The objectives or specific aims of this proposal are to: 1. Increase awareness of CTD and the hazards of exposure to organic solvents and petroleum products; 2. Identify all diagnosed cases of SLE in RDM by searching databases in five major teaching hospitals. 3. Determine the associations or inter- relationships between a.) risk of CTD in RDM b.) exposure to petroleum compounds and organic solvents; and c.) GST genes; by screening for environmental exposures and CTD with questionnaires and a fingerstick blood sample for anti-nuclear antibody testing and GST gene patterns.

非裔美国妇女承担了全身性红斑狼疮（SLE）的负担不成比例的负担，这是一种无法治愈的，残疾，毁容和潜在的致命结缔组织疾病（CTD），发生的频率更高，并且在其中较大的严重性。基因中携带的遗传因素增加了发展SLE的趋势。 有机溶剂和石油产品的暴露也增加了SLE和其他CTD的风险。 SLE患者发现了控制人体降解许多有毒物质方式的谷胱甘肽-S-转移酶（GST）基因的特定基因模式。 马萨诸塞州环境保护部在波士顿的非裔美国人社区，在罗克斯伯里（Roxbury），北多切斯特（North Dorchester）和马塔潘（RDM）内，在罗克斯伯里（Roxbury），北多尔切斯特（North Dorchester）和马塔潘（RDM）内找到了184个石油和有机溶剂污染。 RDM居民由于其种族和环境而受到SLE的高风险。筛查CTD，暴露于危险废物和GST基因模式可能会揭示环境毒素，GST基因和RDM中非裔美国人SLE的倾向之间的联系。从历史上看，非裔美国妇女的健康行为是避开筛查计划。 我们假设与文化相关的健康教育将减少这种筛查的障碍。 与勇气妇女（勇气妇女）合作，这是一个基于社区的非洲裔美国妇女与SLE的妇女，以及环境卫生局评估局公共卫生部，我们建议在RDM中对非裔美国妇女进行两阶段研究。 第一阶段的主要重点是实施社区教育外展计划，以提高人们对CTD和暴露于有毒废物的认识，这将有助于一系列筛查设计，该设计利用环境问卷和Fingerstick血液样本进行初步筛查，然后由CTD问卷调查。 此外，从医院数据库中鉴定出的SLE病例也将在I阶段I期间进行环境筛查和GST基因模式招募。在第二阶段，我们将进行一项病例对照研究，以比较SLE和控制案例之间的GST基因模式和环境暴露。 该提案的目标或特定目的是：1。提高对CTD的认识以及暴露于有机溶剂和石油产品的危害； 2。通过在五家主要的教学医院中搜索数据库来确定RDM中SLE的所有诊断病例。 3。确定a。）CTD风险之间的关联或相互关系。）暴露于石油化合物和有机溶剂中；和c。）GST基因；通过筛查环境暴露和CTD，并用问卷调查和针对抗核抗体测试和GST基因模式的指尖血液样本。