Predictors of Medication Adherence Among African Americans With Hypertension

非裔美国人高血压患者服药依从性的预测因素

基本信息

项目摘要

DESCRIPTION (provided by applicant): My overarching goal is to elucidate the root causes of poor hypertension control in the African American population. Working in the Cooper Green Health System (CGHS), an urban, inner-city setting in Birmingham, Alabama, we found that approximately 80% of African Americans diagnosed with hypertension did not have their blood pressure adequately controlled. Perceived discrimination and lack of trust in the medical system may be important determinants of hypertension medication adherence, greatly contributing to these alarming health disparities. These factors also influence how African Americans cope with stress and are linked to the reliance on home remedies instead of appropriate medication management. This cross-sectional study will examine the association of sociocultural factors with medication adherence among African Americans using existing data (2007-8) from the TRUST project, funded by the National Heart Lung and Blood Institute. The TRUST Principal Investigators, Drs. Jeroan Allison and Sandral Hullett will serve as mentors for this research. An internship with Dr. Hullett will provide an opportunity to work with the patients of CGHS, the same population from which the TRUST participants were recruited. The specific aims of this dissertation are to: (1) evaluate the association of self-reported discrimination with medication adherence, and to determine if trust in the medical system mediates this association; (2) examine the relationship of coping with adversity and medication adherence; and (3) determine if the use of home remedies is associated with lower adherence. This study supports AHRQ's mission to improve the quality, safety, efficiency and effectiveness of health care for priority populations. Our analyses will use the advanced statistical techniques of mediation analysis and structural equation modeling. As such, we will generate new knowledge and practical insights that will be easily translated into innovative disparity-reducing interventions. In addition to the substantive work that I am proposing, I have developed a solid mentorship plan with Drs Allison and Hullett. My dissertation advisory committee brings additional expertise in advanced quantitative methods, the application of sociocultural constructs to health services research, and the development of culturally sensitive interventions for reducing health disparities. After completing my dissertation, I will apply for a career development award that draws on quantitative and qualitative techniques to develop and pilot interventions that promote medication adherence among African Americans. I am committed to a career in health services research, with a focus on health disparities. In addition to pursuing my own line of independent research, it is my long-term goal to serve as a positive force attracting new talent to health services research, mentoring minority students for success in academic medicine, and building strong community-academic partnerships. PUBLIC HEALTH RELEVANCE: This project will generate new knowledge about the root causes of cardiovascular health disparities, which is a topic of urgent public health need. In addition, this work will lay the foundation for new research that will deliver new culturally relevant interventions to improve health outcomes for African Americans. Such interventions may operate at the level of the patient, clinical encounter, health system, local community, and beyond.
描述(由申请人提供):我的总体目标是阐明非洲裔美国人口中高血压控制不良的根本原因。在阿拉巴马州伯明翰的城市内城市环境中,在库珀绿色卫生系统(CGHS)工作,我们发现大约80%被诊断出患有高血压的非洲裔美国人没有充分控制血压。感知的歧视和对医疗系统缺乏信任可能是高血压药物依从性的重要决定因素,这极大地导致了这些令人震惊的健康差异。这些因素还影响非洲裔美国人如何应对压力,并与对家庭疗法的依赖而不是适当的药物管理有关。这项横断面研究将使用现有数据(2007-8)(2007-8)的《信托项目》(2007 - 8年)的药物依从性研究,由国家心脏肺和血液研究所资助。信托主要调查员博士。 Jeroan Allison和Sandral Hullett将担任这项研究的导师。与赫拉特博士的实习将提供与CGHS患者合作的机会,CGHS的患者是招募信托参与者的同一人群。本论文的具体目的是:(1)评估自我报告的歧视与药物依从性的关联,并确定对医疗系统的信任是否介导了这种关联; (2)检查应对与逆境和药物依从性的关系; (3)确定使用家庭疗法是否与较低的依从性有关。这项研究支持AHRQ提高优先人群医疗保健的质量,安全性,效率和有效性的使命。我们的分析将使用中介分析和结构方程建模的先进统计技术。因此,我们将产生新的知识和实用见解,这些知识和实用见解将很容易转化为创新的减少差异干预措施。除了我提出的实质性工作外,我还与艾莉森(Allison)和赫拉特(Hullett)博士制定了坚实的指导计划。我的论文咨询委员会为高级定量方法,社会文化结构应用于卫生服务研究的应用以及对降低健康差异的文化敏感干预措施的发展提供了更多专业知识。完成论文后,我将申请一项职业发展奖,该奖项借鉴了定量和定性技术,以开发和试点干预措施,以促进非裔美国人的药物依从性。我致力于从事卫生服务研究职业,重点是健康差异。除了追求自己的独立研究系列外,我的长期目标是作为吸引卫生服务研究的新人才,指导少数民族学生在学术医学方面取得成功并建立强大社区学术伙伴关系的积极目标。 公共卫生相关性:该项目将产生有关心血管健康差异的根本原因的新知识,这是紧急公共卫生需要的话题。此外,这项工作将为新研究奠定基础,这些研究将提供新的与文化相关的干预措施,以改善非裔美国人的健康状况。这种干预措施可能会在患者,临床遭遇,卫生系统,当地社区等水平上进行。

项目成果

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Yendelela Levana Cuffee其他文献

Yendelela Levana Cuffee的其他文献

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{{ truncateString('Yendelela Levana Cuffee', 18)}}的其他基金

Examining the Feasibility of Implementing a Hypertension Storytelling among African Americans with Hypertension
检查在患有高血压的非裔美国人中实施高血压故事的可行性
  • 批准号:
    10570545
  • 财政年份:
    2023
  • 资助金额:
    $ 2.93万
  • 项目类别:

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