Partnership Program to Reduce Cardiovascular Disparities

减少心血管差异的合作伙伴计划

• 批准号: 7339435
• 负责人: ELIJAH SAUNDERS
• 金额: $ 1.71万
• 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/7339435
• 关键词: Accounting; Acute; Address; Adherence; Administrator; Adopted; African American; Ally; Area; Attention; Awareness; Baltimore; Blood Glucose; Blood Pressure; Build-it; Cardiovascular Diseases; Cardiovascular system; Caring; Caucasians; Caucasoid Race; Characteristics; Cholesterol; Chronic; Cities; Classification; Clinical; Clinical Research; Clinical Trials; Collaborations; Communication; Communities; Community Healthcare; Comorbidity; Condition; Cost Savings; Counseling; Count; Data; Detection; Diabetes Mellitus; Diagnosis; Direct Costs; Disadvantaged; Disease; Doctor of Philosophy; Economic Burden; Economics; Education; Educational Intervention; Effectiveness; Effectiveness of Interventions; Enrollment; Ensure; Environment; Evaluation; Event; Expenditure; Facilities and Administrative Costs; Goals; Grant; Guideline Adherence; Guidelines; Health; Health Care Seeking Behavior; Health Fairs; Health education; Health system; Healthcare; Healthcare Systems; Heart Diseases; Hemoglobin; 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Cardiovascular Diseases; Cardiovascular system; Caring; Caucasians; Caucasoid Race; Characteristics; Cholesterol; Chronic; Cities; Classification; Clinical; Clinical Research; Clinical Trials; Collaborations; Communication; Communities; Community Healthcare; Comorbidity; Condition; Cost Savings; Counseling; Count; Data; Detection; Diabetes Mellitus; Diagnosis; Direct Costs; Disadvantaged; Disease; Doctor of Philosophy; Economic Burden; Economics; Education; Educational Intervention; Effectiveness; Effectiveness of Interventions; Enrollment; Ensure; Environment; Evaluation; Event; Expenditure; Facilities and Administrative Costs; Goals; Grant; Guideline Adherence; Guidelines; Health; Health Care Seeking Behavior; Health Fairs; Health education; Health system; Healthcare; Healthcare Systems; Heart Diseases; Hemoglobin; High Blood Pressure; Hospitals; Hypertension; Immersion Investigative Technique; Individual; Inferior; Institution; Integrated Delivery Systems; International; Intervention; Joints; Knowledge; Learning; Life; Linear Regressions; Logistic Regressions; Maryland; Measures; Medical; Medical center; Medicine; Mentors; Methodology; Methods; Minority; Minority Groups; Minority-Serving Institution; Missionary; Modeling; Monitor; National Health and Nutrition Examination Survey; National Institute of Diabetes and Digestive and Kidney Diseases; Non-Insulin-Dependent Diabetes Mellitus; Numbers; Nurses; Outcome; Ownership; Patients; Perception; Physician-Patient Relations; Physicians; Plant Roots; Population; Positioning Attribute; Prevalence; Prevention; Primary Health Care; Principal Investigator; Probability; Prospective Studies; Provider; Quality of life; Race; Randomized Controlled Trials; Rate; Recommendation; Relative (related person); Reporting; Research; Research Personnel; Resources; Rest; Risk Factors; Score; Services; Societies; Solid; Source; Staging; Stress; Stroke; Structure; Surveys; Survival Analysis; System; Systems Analysis; Targeted Research; Testing; Time; Trainers Training; Training; Training Programs; Translating; Treatment Factor; Underserved Population; Universities; Update; Upper arm; Visit; Vital Statistics; Work; age group; base; blood pressure regulation; cardiovascular risk factor; care delivery; care seeking; compliance behavior; concept; cost; cost effectiveness; design; diabetes management; diabetic; expectation; health care delivery; hypertension treatment; improved; innovation; interest; member; middle age; mortality; prescription document; prescription procedure; prevent; programs; response; sensitivity training; skills; statistics; treatment effect; treatment planning; willingness

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 )atient adherence to treatment plans. Through didactic training, UMB aims to build a sustainable research )rogram 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.

背景：高血压和糖尿病是心血管疾病的主要危险因素 少数民族和非裔美国人负担不成比例的负担。有证据表明干预措施 提高控制率将大大降低心血管差异。目的：该提议基于 Bon Secours巴尔的摩卫生系统（BSBHS）与大学之间的合作伙伴关系 马里兰州巴尔的摩（UMB）。针对UMB和BSBH的研究特定目标是互补的，并寻求 分别改善提供者和患者方法分别治疗高血压和糖尿病。 UMB 还旨在修改医师在临床试验中与少数群体入学的障碍，并改善BSBHS ）遵守治疗计划。通过教学培训，UMB旨在建立可持续的研究 ）在BSBHS的ROGRAM；通过文化敏感性培训，BSBHS希望增强差异计划 在UMB。方法：医师和/或患者干预对控制高血压的相对影响 评估糖尿病。这是一项假设测试，前瞻性研究，具有实验2x2阶乘 设计;这是一项四臂随机对照试验。结果包括依从性和改善 （患者及其医生）的知识/意识以及患者的临床和质量 生活措施。该研究适用于目标患者的比例。我们针对的是 800名患者（每个患有高血压和糖尿病），可提供80％（高达90％）的功率，允许25％ 损耗。我们将使用逻辑回归来达到目标​​的概率，多个线性回归 MMHG（高血压）和HBALC（糖尿病）的相对变化以及生存分析以建模时间到达 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；以及由于患者愿意参加临床试验的意愿而变化 针对医师的教育。讨论：我们试图根据一个 合作伙伴关系，并在BSBHS建立自我维持的研究计划 UMB的心血管差异计划。社区实体将在两者中都可以完全访问资源 机构又可以访问社区群体的宝贵意见和支持。我们 强烈期望在服务的少数族裔患者中提高结果/心血管健康的意识 BSBHS和UMB均为。