Problem Solving & CVD Risk Management in Diabetic Blacks

解决问题

• 批准号: 6771328
• 负责人: FELICIA HILL-BRIGGS
• 金额: $ 15.04万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-07-15 至 2009-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6771328
• 关键词: African American; adult human (21+); behavior modification; behavior test; cardiovascular disorder education; cardiovascular disorder prevention; cardiovascular disorder risk; clinical research; human therapy evaluation; hyperglycemia; hyperlipidemia; hypertension; noninsulin dependent diabetes mellitus; problem solving; self care

DESCRIPTION (provided by applicant): African Americans with type 2 diabetes carry high burden of cardiovascular disease risk and adverse vascular events such as stroke and peripheral vascular disease. CVD risk factors of suboptimal blood pressure, lipids, and glycemic control are controllable through medical management and lifestyle behavior modification. The traditional primary care medical management model for these chronic CVD risks is inadequate, and models are shifting toward increased disease-related decision-making and self-management on the part of the patient. Yet, precise methods for: 1) identifying patients with ineffective disease-related problem-solving skills, and 2) providing patients with disease-related education that incorporates problem-solving and decision-making skills, have yet to be determined. The proposed study will address this limitation in the literature by testing a measurement tool and a novel training intervention for problem solving as applied to self-management of high CVD risk in African Americans with type 2 diabetes. The specific aims are to: 1) assess the validity and reliability of an empirically-derived assessment tool of effective vs. ineffective CVD risk-related problem solving ability (the Health Problem Solving Scale, HPSS), 2) develop a novel intervention to teach CVD risk-related problem-solving skills to ineffective problem solvers, and 3) conduct a pilot study with a sample of African Americans with type 2 diabetes who have a high CVD risk profile (suboptimal blood pressure, lipids, and/or HbA1c) AND ineffective CVD risk-related problem-solving skills, as measured by the HPSS. The candidate's career goal is to become an independent researcher in self-management of CVD risk in high-risk African American populations, and to be a leader in the development and translation into practice of novel, theory-driven and empirically based interventions to improve patient self-management of CVD risks. Therefore, the candidate proposes the following two areas of career enhancement training to prepare her for this task: 1) formal coursework and training in cardiovascular epidemiology, research methodology, biostatistics, and behavioral science and health promotion; and 2) research in problem-solving training interventions for high CVD risk African Americans with type 2 diabetes. Results of this intervention will lead to development of a pilot project in year 04 and an R01 proposal in year 05 to investigate the efficacy of a problem-solving intervention in this high-risk population.

描述（由申请人提供）： 患有 2 型糖尿病的非裔美国人承受着较高的心血管疾病风险和不良血管事件（如中风和周围血管疾病）的负担。血压、血脂和血糖控制不佳等 CVD 危险因素可以通过医疗管理和生活方式行为改变来控制。针对这些慢性心血管疾病风险的传统初级保健医疗管理模式是不够的，模式正在转向增加患者的疾病相关决策和自我管理。然而，以下方面的精确方法尚未确定：1）识别疾病相关问题解决技能无效的患者，2）为患者提供包含问题解决和决策技能的疾病相关教育。拟议的研究将通过测试测量工具和新颖的解决问题的培训干预措施来解决文献中的这一局限性，并将其应用于患有 2 型糖尿病的非裔美国人的高 CVD 风险的自我管理。具体目标是：1) 评估有效与无效 CVD 风险相关问题解决能力（健康问题解决量表，HPSS）的经验派生评估工具的有效性和可靠性，2) 开发一种新颖的干预措施来教授向无效的问题解决者提供与 CVD 风险相关的问题解决技能，以及 3) 对患有 2 型糖尿病的非裔美国人样本进行试点研究，这些人具有高 CVD 风险特征（血压、血脂和/或HbA1c) 以及 CVD 风险相关问题解决技能无效（由 HPSS 衡量）。候选人的职业目标是成为高危非裔美国人人群心血管疾病风险自我管理的独立研究员，并成为开发新颖、理论驱动和基于经验的干预措施并将其转化为实践的领导者，以改善患者的健康状况CVD风险的自我管理。因此，候选人提出以下两个领域的职业提升培训，为她完成这项任务做好准备：1）心血管流行病学、研究方法、生物统计学、行为科学和健康促进方面的正式课程和培训； 2) 针对患有 2 型糖尿病的高 CVD 风险非裔美国人的问题解决培训干预研究。 这项干预措施的结果将导致在 04 年制定一个试点项目，并在 05 年制定 R01 提案，以调查解决问题的干预措施对这一高危人群的有效性。