RESEARCH CORE

研究核心

• 批准号: 7305046
• 负责人: JEANNE MIRANDA
• 金额: $ 7.16万
• 依托单位: CHARLES R. DREW UNIVERSITY OF MED & SCI
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-01 至 2012-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7305046
• 关键词: AIDS prevention; AIDS/HIV problem; Accounting; Address; African American; Alcohols; Anxiety; Area; Assertiveness; Attitude; Behavior; Caring; Case Study; Cessation of life; Chronic Disease; Clinical Trials; Cognitive Therapy; Communities; Community Health; Complications of Diabetes Mellitus; Condition; Conflict (Psychology); Depressed mood; Development; Diabetes Mellitus; Diagnosis; Disease; Endocrinologist; Environment; Epidemiologist; Evidence based intervention; Faculty; Funding; Gender Role; Goals; HIV; HIV Infections; Health; Health Campaign; Health Professional; Health Promotion; Health behavior; Healthcare; High Prevalence; Hispanics; Hour; Income; Indigent Care; Internist; Intervention; K-Series Research Career Programs; Latino; Lead; Longevity; Low income; Mediator of activation protein; Mental Depression; Mental Health; Mentors; Mentorship; Methods; Minority; Modeling; Monitor; Moods; Motivation; Outcome; Paper; Patients; Pharmaceutical Preparations; Pilot Projects; Population; Process; Psychiatrist; Psychiatry; Research; Research Infrastructure; Research Personnel; Research Project Grants; Research Training; Resources; Risk; Risk Behaviors; Risk Factors; Risk Reduction; Science; Self Care; Statistical Methods; Stigmata; Surveys; Testing; Time; Training; Universities; Week; Woman; Work; base; behavioral health; biobehavior; career; depressive symptoms; diabetic; experience; health disparity; high risk behavior; high risk sexual behavior; improved; innovation; interest; member; men; novel; professor; psychological distress; psychosocial; research and development; research study; sex; social stigma; therapy design

Research Core Nearly half of all preventable deaths in the U.S. are related to high-risk behaviors. Community health campaigns aimed at reducing those risks have been successful primarily among those with higher incomes. Evidenced-based behavioral health promotion strategies need to be adapted, tested, and disseminated within low-income and minority communities to eliminate health disparities. The Research Core includes two full research projects covering: (1) diabetes and depression and (2) HIV/AIDS. Since Drew opted to include the optional Research Training and Pilot Core, Drew placed the "active mentorship of the pilot projects and pilot investigators" within that core. The Research Training and Pilot Core will fund innovative health disparities pilot projects for junior and established faculty members at Drew University and UCLA in an enriched training environment. An important goal of the Research Core is to develop infrastructure that will support the development of research capacity at Drew, as well as minority junior faculty interested in disparities research. This core will provide methodological and infrastructure support and monitoring for the research and pilot projects, and will develop new methods to address health disparity problems such as the use of improved survey instruments and statistical methods and modeling. The two research projects, briefly described below, will provide the active environment for training in the setting of improving health outcomes for key health disparity areas. These are challenging studies, but they seek to have an impact on important areas of health disparities. The Center proposes to devote substantial resources to these research efforts. The two studies take different, but complementary approaches to building research capacity. The diabetes and depressive symptoms study brings together accomplished senior investigators in these substantive areas. They will merge interventions in an effort to improve care for both conditions. Junior investigators will participate in the study with the goal of moving them toward career development award funding. The HIV prevention study is being led by two relatively junior investigators, one of whom is a Project EXPORT product (having previously had pilot project funding). They will be mentored and supported by several senior investigators who have extensive experience in addressing the issues upon which the study is focused. Both approaches should serve the goal of making important contributions to disparities research, while advancing the career development of investigators in the field. Diabetes and Depression Study The complications from diabetes are particularly severe among older Latinos, a rapidly growing population with a high prevalence of the disease. Recently, Dr. Mangione (project co-leader) demonstrated that a self-care intervention improves diabetes outcomes for older Latinos. However, 30 percent of these older Latinos were depressed, and the intervention did not result in improved diabetes outcomes for this subset of depressed diabetics. This finding is not surprising given that depression results in lack of motivation, negative attitudes towards change, and lack of assertiveness necessary to garner support for good diabetes self care. Dr. Miranda (project co-leader) has demonstrated that Cognitive Behavioral Therapy is highly effective for treating depression in low-income Latinos and has recently modified this depression intervention so that it can be given by non-mental health professionals. In this project, Drew examines the impact of a mood treatment enhanced diabetes self-care intervention for depressed, low-income Latino diabetics. Drew hypothesizes that the mood treatment enhancement will lead to significant improvement in both diabetes and depression outcomes as compared with the self-care intervention alone. The specific aims of this project are: 1. To improve diabetes and depression outcomes for older Latinos through development of a self-care diabetes intervention combined with a depression treatment intervention. 2. To support dissemination of positive findings from our intervention to the community through our ongoing participation in the Community Core with the "Witness for Wellness and Building Bridges to Optimum Health - Diabetes Throughout the Lifespan" community dissemination projects. Diana Echeverry, MPH, MD, (Hispanic endocrinologist and assistant professor, Drew) and Kenrik Duru, MD, MSHS (African American internist and assistant professor, UCLA) will serve as emerging junior research faculty for the diabetes and depression study. The study will be led by accomplished senior investigators in the areas of depression care (Jeanne Miranda), diabetes self-care (Carol Mangione), clinical investigation in diabetes (Mayer Davidson), and quality improvement for the treatment of diabetes and other chronic diseases in indigent care settings (Michael Rodriguez and Mohsen Bazargan). HIV Prevention Study HIV directly or indirectly related to men having sex with men is the single largest contributor to HIV infection among Blacks.55 In states with long-term HIV reporting, cases attributed to sex between men account for an estimated 49 percent of US HIV/AIDS cases diagnosed among Black men and a substantial but unknown percentage of cases diagnosed among Black women between 2001 and 2004.56 No other single risk factor accounts for a larger proportion of cases. Drew proposes to test the efficacy of the Men of African American Legacy Empowering Self (MAALES) Project, a newly developed, novel, and culturally congruent intervention designed to reduce HIV risk-related behaviors and improve psychosocial outcomes. The MAALES intervention was developed through an extensive formative research process and involves six two-hour group sessions held over three weeks with six men and lead by two ethnically matched co-facilitators. This project will be among the first to develop and test a HIV risk-reduction intervention designed specifically for African American MSMW. The Primary Aims include: 1) Determine the impact of the MAALES intervention on: (a) HIV-related sexual risk behaviors and (b) sex under the influence of drugs and alcohol among African American MSMW, and 2) Determine the impact of the MAALES intervention condition on psychosocial outcomes, including reducing HIV stigma and increasing racial/cultural pride among African American MSMW. The Exploratory Aims are to: 1) Examine whether reductions in internalized homophobia and gender role conflicts act as mediators of the sex under the influence of drugs. 2) Examine whether psychological distress (i.e., depression and anxiety) predicts for risky sexual behaviors and moderates the MAALES intervention condition's efficacy. Nina T. Harawa, MPH, PhD, (African American epidemiologist and newly appointed as an assistant professor, Department of Research, Drew) will serve as the PI for the HIV prevention study. Dr. Harawa was initially involved with Drew/UCLA as a pilot project investigator. She has since become a full-time faculty member at Drew, and due to the potential for innovative advances in health disparities in HIV/AIDS among African Americans, her pilot project has evolved into a full project for the Drew/UCLA EXPORT Center. The Co-Pi on the project is John Williams, MD, an African American psychiatrist, and an assistant professor, Department of Psychiatry and Biobehavioral Sciences, UCLA. The mentors include senior faculty with expertise in HIV prevention Drs. Thomas Coates and Hector Myers, and other senior faculty with research studies of HIV behaviors and health care by Drs. Martin Shapiro and William Cunningham (primary project mentor). The products of these two research projects will include new evidenced-based strategies to improve outcomes for (1) patients with diabetes and depression and (2) populations at high risk for HIV/AIDS. Additional outcomes will include scientific papers and transferable experience working with the community in designing interventions that are evidence-based, acceptable to the community and have the potential of decreasing additional health disparities in the population.

研究核心 在美国所有可预防的死亡中，几乎一半与高风险行为有关。社区健康 旨在降低这些风险的运动主要在收入较高的运动中取得了成功。 需要对基于证据的行为健康促进策略进行调整，测试和传播 低收入和少数民族社区以消除健康差异。研究核心包括两个完整 研究项目涵盖：（1）糖尿病和抑郁症以及（2）HIV/AIDS。由于Drew选择包括 可选的研究培训和飞行员核心，Drew放置了“飞行员项目和飞行员的积极指导 调查人员“在该核心内。研究培训和飞行员核心将在Drew University和UCLA的初级和成熟的教职员工中资助创新的健康差异项目，并在丰富的培训中为 环境。研究核心的一个重要目标是开发将支持该基础架构 Drew的研究能力以及对差距研究感兴趣的少数族裔初级教师的发展。 该核心将为研究和试点项目提供方法论和基础设施的支持和监控，并将开发新的方法来解决健康差异问题，例如使用改进 调查工具和统计方法和建模。 在下面简要介绍的两个研究项目将为培训提供积极的环境，以改善关键健康差异领域的健康状况。这些是具有挑战性的研究，但他们试图 对健康差异的重要领域产生影响。该中心建议将大量资源投入到这些研究工作中。这两项研究采用不同但互补的方法来建立研究能力。糖尿病和抑郁症状研究汇集了成熟的高级研究人员 这些实体领域。他们将合并干预措施，以改善两种情况的护理。初级调查人员将参加该研究，目的是将其转向职业发展奖 资金。艾滋病毒预防研究由两名相对较小的研究人员领导，其中一项是项目出口产品（以前有试点项目资金）。他们将得到几位高级调查人员的指导和支持，他们在解决研究的问题方面具有丰富的经验。 两种方法都应实现为差异研究做出重要贡献的目标，而 推进该领域调查人员的职业发展。 糖尿病和抑郁研究 糖尿病的并发症在较老的拉丁裔中尤其严重，这是一个迅速增长的人口 疾病的高流行。最近，Mangione博士（项目共同领导者）证明，自我保健干预措施改善了较老的拉丁美洲裔糖尿病结果。但是，这些较旧的拉丁美洲人中有30％沮丧，干预措施并未导致抑郁症子集改善糖尿病结果 糖尿病患者。鉴于抑郁症导致动力缺乏动力，对变革的负面态度以及缺乏对良好糖尿病的支持所需的自信，这一发现就不足为奇了。博士 Miranda（项目共同领导者）表明，认知行为疗法对于治疗低收入拉丁裔的抑郁症非常有效，最近对这种抑郁症进行了修改，以便由非精美卫生专业人员提供。在这个项目中，Drew检查了情绪治疗的影响 抑郁，低收入拉丁裔糖尿病患者的糖尿病自我护理干预。 Drew假设心情 治疗增强将导致糖尿病和抑郁症结果的显着改善，因为 与仅自我保健干预相比。 该项目的具体目的是： 1。通过发展自我保健来改善较老的拉丁裔糖尿病和抑郁症状 糖尿病干预结合抑郁治疗干预措施。 2。支持通过我们的干预措施传播积极的发现 持续参与社区核心，并与“见证健康和建造桥梁的见证人 最佳健康 - 整个寿命中的糖尿病”社区传播项目。 戴安娜·埃希弗里 MSHS（非裔美国人内科医生和加州大学洛杉矶分校助理教授）将担任新兴的初级研究 糖尿病和抑郁研究的教师。这项研究将由成熟的高级研究人员领导 抑郁症护理（Jeanne Miranda），糖尿病自我护理（Carol Mangione），临床研究 糖尿病（Mayer Davidson），以及治疗糖尿病和其他慢性疾病的质量改善 在贫困的护理环境中（迈克尔·罗德里格斯和莫森·巴扎尔根）。 HIV预防研究 HIV直接或间接与男性与男性发生性关系是艾滋病毒感染的最大贡献者 在黑人中。55在有长期艾滋病毒报告的州中，男性之间的性别归因于 估计在黑人男性中诊断出的美国艾滋病毒/艾滋病案件中有49％和一个未知的案件 2001年至2004年之间，黑人妇女诊断的病例百分比百分比没有其他单一风险因素 占更大比例的案件。 Drew提议测试非裔美国人人士的功效 遗产增强自我（MAALES）项目，这是一个新开发，新颖和文化的干预措施 旨在减少与艾滋病毒风险相关的行为并改善社会心理结局。 MAALES干预 是通过广泛的形成性研究过程开发的，涉及六个两个小时的小组会议 与六名男子一起举行了三个星期，并由两个种族匹配的共同利益人领导。这个项目将是 在第一个开发和测试专门为非裔美国人设计的艾滋病毒风险干预措施的人 MSMW。主要目的包括： 1）确定MAALES干预对：（a）与HIV相关的性风险行为和（b）性别的影响 在非裔美国人MSMW中毒品和酒精的影响下， 2）确定Maales干预条件对社会心理结局的影响，包括 减少非裔美国人MSMW中的艾滋病毒污名并增加种族/文化自豪感。 探索目的是： 1）检查降低内在恐同症和性别角色冲突是否作为调解人 在毒品影响下的性别。 2）检查心理困扰（即抑郁和焦虑）是否预测了风险性的性行为 行为和调节MAALES干预条件的功效。 Nina T. Harawa，MPH，博士学位（非裔美国人流行病学家，新任命为助理教授， Drew研究部将作为HIV预防研究的PI。哈拉瓦博士最初是 与DREW/UCLA有关试点项目调查员。从那以后，她已成为 Drew，并且由于非洲艾滋病毒/艾滋病健康差异的创新进展 她的飞行员项目美国人已经发展成为Drew/UCLA出口中心的完整项目。 Co-Pi On 该项目是医学博士约翰·威廉姆斯（John Williams） 加州大学洛杉矶分校的精神病学和生物行为科学。导师包括具有艾滋病毒专业知识的高级教师 预防博士。托马斯·科茨（Thomas Coates）和赫克托·迈尔斯（Hector Myers），以及其他高级教师艾滋病毒研究 博士的行为和医疗保健。马丁·夏皮罗（Martin Shapiro）和威廉·坎宁安（William Cunningham）（主要项目导师）。 这两个研究项目的产品将包括新的基于证据的策略来改善结果 （1）患有糖尿病和抑郁症的患者以及（2）艾滋病毒/艾滋病风险高的人群。额外的 成果将包括科学论文和与社区一起设计的可转移经验 干预措施是基于证据的，可以被社区接受，并且有可能减少的干预措施 人口的额外健康差异。