Partnership Program to Reduce Cardiovascular Disparities

减少心血管差异的合作伙伴计划

• 批准号: 7087602
• 负责人: ELIJAH SAUNDERS
• 金额: $ 4.31万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-30 至 2009-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7087602
• 关键词: behavioral /social science research tag; cardiovascular disorder therapy; clinical research; clinical trials; cooperative study; diabetes mellitus; diabetes mellitus therapy; health disparity; health education; human subject; hypertension; longitudinal human study; nurses; patient care personnel relations; patient oriented research; physicians; quality of life; self care; therapy compliance; training

DESCRIPTION (provided by applicant): Background: Hypertension and diabetes represent major risk factors for cardiovascular disease, placing a disproportionate burden on minorities and African Americans. Evidence suggests that interventions that improve control rates would significantly reduce cardiovascular disparities. Aims: This proposal is based on a collaborative partnership between the Bon Secours Baltimore Health System (BSBHS) and the University of Maryland Baltimore (UMB). The research-specific aims at UMB and BSBHS are complementary and seek to improve provider and patient approaches to treatment of hypertension and diabetes, respectively. UMB also aims to modify physician related barriers to minority enrollment in clinical trials, and BSBHS to improve patient adherence to treatment plans. Through didactic training, UMB aims to build a sustainable research program at BSBHS; through cultural sensitivity training, BSBHS expects to enhance the disparities program at UMB. Methods: The relative impact of physician and/or patient interventions for controlling hypertension and diabetes is assessed. This is a hypothesis-testing, prospective study, with an experimental 2X2 factorial design; it is a four-arm randomized controlled trial. Outcomes include adherence and improved knowledge/awareness of guidelines (of patients and their physicians), as well as patient clinical and quality of life measures. The study is powered for the proportion of patients who get to goal. We target enrollment of 800 patients (each for hypertension and diabetes), to afford 80% (up to 90%) power and allow for 25% attrition. We will use logistic regression for the probability of reaching goal, multiple linear regression for relative changes in mmHg (hypertension) and HbAlc (diabetes), and survival analysis to model time to reach goal. We will also measure improved adherence of diabetes patients as a result of BSBHS actively identifying access barriers; and changes in the willingness of patients to enroll in clinical trials as a result of physician-targeted education. Discussion: We seek to demonstrate a best practice model, based on a collaborative partnership, and build a self-sustained research program at BSBHS and an enhanced cardiovascular disparities program at UMB. Community entities will have full access to resources at both institutions, which in turn will have access to invaluable input and support from community groups. We strongly expect improved outcomes/awareness of cardiovascular health among minority patients serviced by both BSBHS and UMB.

描述（由申请人提供）： 背景：高血压和糖尿病是心血管疾病的主要危险因素，给少数民族和非裔美国人带来了不成比例的负担。 有证据表明，提高控制率的干预措施将大大减少心血管差异。 AIMS：该提案基于Bon Secours Baltimore Health System（BSBHS）和马里兰州巴尔的摩大学（UMB）之间的合作伙伴关系。 针对UMB和BSBHS的研究特定目标是互补的，并寻求改善提供者和患者的治疗高血压和糖尿病的方法。 UMB还旨在在临床试验中修改医师与少数群体入学率相关的障碍，而BSBH则可以改善患者对治疗计划的遵守。 通过教学培训，UMB旨在在BSBHS建立可持续的研究计划；通过文化敏感性培训，BSBHS希望增强UMB的差异计划。 方法：评估医师和/或患者干预对控制高血压和糖尿病的相对影响。这是一项实验2x2阶乘设计的假设检验，前瞻性研究。这是一项四臂随机对照试验。 结果包括（患者及其医生）的依从性和提高的知识/意识，以及患者的临床和生活质量措施。 该研究适用于目标患者的比例。 我们针对800名患者（每名高血压和糖尿病）的入学率，可提供80％（最高90％）的功率，并允许25％的损耗。 我们将使用逻辑回归来达到目标​​的概率，MMHG（高血压）和HBALC（糖尿病）的相对变化的多个线性回归以及生存分析以建模时间以达到时间 目标。 我们还将由于BSBH的积极衡量糖尿病患者的依从性提高 确定访问障碍；以及因靶向医师的教育而导致患者参加临床试验的意愿的变化。 讨论：我们试图根据协作伙伴关系展示一个最佳实践模型，并在BSBHS建立自我维持的研究计划，并在UMB进行增强的心血管差异计划。 社区实体将在这两个机构中完全访问资源，进而可以访问社区团体的宝贵意见和支持。 我们强烈期望在BSBHS和UMB服务的少数族裔患者中，心血管健康的结局/意识提高/意识。