Stroke Disparities Program

中风差异计划

• 批准号: 7932850
• 负责人: CHELSEA S KIDWELL
• 金额: $ 201.18万
• 依托单位: GEORGETOWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-30 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7932850
• 关键词: Stroke; Disparities; Program

Acute stroke is the third leading cause of death and the leading cause of adult disability in the US. A disproportionate amount of morbidity and mortality falls on underserved populations. Reduction of health disparities has become a significant public health challenge and is a major goal of the Healthy People 2010 initiative. The programmatic goal of this proposal is to identify biological and socioeconomic factors contributing to ethnic disparities and to develop innovative approaches to reduce these disparities for ischemic and hemorrhagic stroke. Three research projects are proposed. Project 1, Acute Stroke Program of Interventions addressing Racial and Ethnic disparities (ASPIRE), is an intervention study designed to investigate whether implementation of a multilevel intervention can significantly increase the number of ischemic stroke patients appropriately treated with intravenous tissue plasminogen activator (IV tPA) in a predominantly underserved community. The primary outcome measure will be the percentage of all ischemic stroke patients appropriately treated with IV tPA. Project 2, Preventing Recurrence of Thromboembolic Events through Coordinated Treatment in the District of Columbia (PROTECT DC) is a randomized phase II clinical trial of the PROTECT DC intervention (hospital-based initiation of aggressive secondary prevention combined with navigator case management) vs. standard management in ischemic stroke patients from two underserved hospitals in the District of Columbia. The primary aims are 1) to refine the PROTECT DC design in preparation for a phase INI trial and, 2) to assess the effect of the intervention on 4 medication goals as defined by normalization of objective measures of secondary risk factor control. Project 3, DiffErenCes in the Imaging of Primary Hemorrhage based on Ethnicity or Race (DECIPHER) is a longitudinal, MR imaging, prospective, observational, cohort study designed to evaluate the prevalence and significance by race/ethnicity of chronic cerebral microbleeds in patients with primary intracerebral hemorrhage. Three cores will support the projects: A) Administration B) Participant Recruitment, Retention, Intervention and Outcomes, and C) Biostatistics / Data Management. This application is designed not only to define factors leading to racial/ethnic disparities in stroke treatment and outcomes, but also to demonstrate the efficacy of programs specifically designed to reduce these disparities.

急性中风是死亡的第三大主要原因，也是美国成人残疾的主要原因。不成比例的发病率和死亡率属于服务不足的人群。降低健康差异已成为一项重大的公共卫生挑战，并且是《健康人》 2010年倡议的主要目标。该提案的程序化目标是确定导致种族差异的生物学和社会经济因素，并开发创新的方法来减少缺血性和出血性中风的这些差异。提出了三个研究项目。项目1，解决种族和种族差异的急性中风计划（ASPIRE）是一项干预研究，旨在调查多层次干预的实施是否可以显着增加静脉内组织纤溶酶原激活剂（IV TPA）在主要未加工的社区中适当治疗的缺血性中风患者的数量。主要结局指标将是所有使用IV TPA治疗的所有缺血性中风患者的百分比。项目2，通过哥伦比亚特区（Protect DC）在哥伦比亚特区进行协调的治疗来防止血栓栓塞事件复发，这是一项针对Protect DC干预措施的随机II期临床试验（基于医院的促进性二级预防与导航案例管理相结合）与来自哥伦比亚山区的两名不受欢迎医院的标准患者的积极预防相结合）。主要目的是1）精炼保护直流设计以准备一项INI试验，以及2）评估干预措施对4种药物目标的影响，这些因素通过临床化的二级风险因素控制的客观度量定义。项目3，基于种族或种族的原发性出血成像的差异是一种纵向，MR成像，前瞻性，观察性的，同类的研究，旨在评估原发性脑内血液中慢性脑部微生物的种族/族裔的普遍性和意义。三个核心将支持这些项目：a）管理b）参与者招募，保留，干预和结果，以及c）生物统计学 /数据管理。该应用不仅旨在定义导致中风治疗和结果中种族/族裔差异的因素，而且还旨在证明专门旨在减少这些差异的计划的功效。