Adapting Hypertension and Diabetes Guides for Hard-to-Reach African American Men

为难以接触到的非洲裔美国男性调整高血压和糖尿病指南

• 批准号: 8009006
• 负责人: JENNIFER L LAUBY
• 金额: $ 149.9万
• 依托单位: PUBLIC HEALTH MANAGEMENT CORPORATION
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-30 至 2013-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8009006
• 关键词: Adapting; Hypertension; Diabetes; Guides; Hard

DESCRIPTION (provided by applicant): Researchers from Philadelphia Health Management Corporation in collaboration with the Health Promotion Council propose to adapt, evaluate and disseminate Comparative Effectiveness Research Summary Guides (CERSGs) on hypertension and type 2 diabetes for hard-to-reach and underserved African American men, including men who are homeless or living in public housing, men in the correctional system and men who participate in faith-based organizations.. The three consumer guides that will adapted are: Comparing Two Kinds of Blood Pressures Pills: ACEIs and ARBs: A Guide for Adults; Pills for Type 2 Diabetes: A Guide for Adults; Premixed Insulin for Type 2 Diabetes: A Guide for Adults. African American men are disproportionately impacted by hypertension and diabetes while also lacking access to needed health information due to low health literacy and other information barriers. Informed by concepts of social marketing and behavioral theory, we will adapt the language and format of printed CERSGs to be culturally appropriate, relevant, and easily understood and will develop video versions of the guides. Both qualitative and quantitative data will be collected to assess the efficacy of the adapted materials and dissemination strategies. The specific aims of the proposed project are to: 1)Assess the informational and communication needs and preferences of hard-to-reach African American men who have been diagnosed with hypertension and/or type 2 diabetes by conducting focus groups with consumers and key informant interviews with health care providers ; 2) Adapt print and video versions of CERSGs on hypertension and type 2 diabetes to be appropriate, culturally relevant, and easily understood by African American men; 3) Use a repeated measures randomized control trial to test the efficacy of the adapted guides on health outcomes including improving men's knowledge of medications for their condition, self-efficacy for health management, appropriate use of medication, and communication with health care providers, as well as changes in biomarkers such as blood pressure and blood glucose level. 420 men will be randomly assigned to one of three groups-those receiving both the adapted printed CERSG and the video, those receiving only the adapted printed material, and the control group who will receive the current version of the CERSG. 4) Develop and assess methods of disseminating the adapted guides to men in community health centers, the correctional system and in faith- based organizations and examine adoption, reach, economic cost and sustainability of the use of these materials in community settings; and 5) Provide a plan for future dissemination of the adapted guides to settings in other communities, thereby ensuring that the results from comparative effectiveness research will have a greater impact on health outcomes of hard-to-reach populations. PUBLIC HEALTH RELEVANCE: The proposed project will have a significant impact on improving chronic disease management through 1) focusing on a hard-to-reach population of African American men with high rates of chronic illness, 2) collecting qualitative and quantitative data on the health information needs of African American men, 3) employing behavior change theory to adapt CERGS in print and video form for use with persons with low health literacy, 4) rigorously testing the effectiveness of both the print and video versions of the CERSGs in comparison to the current versions, and 5) assessing the feasibility and sustainability of disseminating this information in a range of community settings.

描述（由申请人提供）：费城健康管理公司的研究人员与健康促进委员会合作，提议为难以接触和服务不足的非洲地区改编、评估和传播高血压和 2 型糖尿病的比较有效性研究摘要指南 (CERSG)美国男性，包括无家可归或住在公共住房中的男性、惩教系统中的男性以及参加信仰组织的男性。将改编的三份消费者指南是：比较两种血压药丸：ACEI 和 ARB：成人指南； 2 型糖尿病药丸：成人指南；治疗 2 型糖尿病的预混合胰岛素：成人指南。非裔美国男性受到高血压和糖尿病的影响尤为严重，同时由于健康素养低和其他信息障碍，他们也无法获得所需的健康信息。根据社会营销和行为理论的概念，我们将调整印刷版 CERSG 的语言和格式，使其适合文化、相关且易于理解，并将开发指南的视频版本。将收集定性和定量数据，以评估改编材料和传播策略的有效性。拟议项目的具体目标是： 1）通过与消费者和关键信息提供者进行焦点小组讨论，评估难以接触到的被诊断患有高血压和/或 2 型糖尿病的非裔美国男性的信息和沟通需求和偏好与医疗保健提供者访谈； 2) 调整关于高血压和 2 型糖尿病的 CERSG 的印刷版和视频版，使其适合、文化相关且易于非裔美国男性理解； 3) 使用重复测量随机对照试验来测试改编后的指南对健康结果的有效性，包括提高男性对其病情的药物知识、健康管理的自我效能、适当使用药物以及与医疗保健提供者的沟通，如以及血压和血糖水平等生物标志物的变化。 420 名男子将被随机分配到三组中的一组：同时接收改编的印刷版 CERSG 和视频的组、仅接收改编版印刷材料的组以及将接收当前版本 CERSG 的对照组。 4) 制定和评估在社区卫生中心、惩教系统和信仰组织中向男性传播改编指南的方法，并审查在社区环境中使用这些材料的采用情况、覆盖范围、经济成本和可持续性； 5) 制定一项计划，以便将来向其他社区传播改编后的指南，从而确保比较有效性研究的结果将对难以接触人群的健康结果产生更大的影响。 公共卫生相关性：拟议项目将通过以下方式对改善慢性病管理产生重大影响：1）重点关注慢性病发病率高的难以接触到的非洲裔美国男性人群，2）收集有关健康的定性和定量数据非洲裔美国男性的信息需求，3) 采用行为改变理论以印刷版和视频形式改编 CERGS，以供健康素养较低的人使用，4) 严格测试 CERSG 印刷版和视频版的有效性与当前版本进行比较，以及 5) 评估在一系列社区环境中传播此信息的可行性和可持续性。