Gender Race and Ethnic Disparities Research in Cardiovascular Disease Prevention

心血管疾病预防中的性别种族和民族差异研究

• 批准号: 8143359
• 负责人: LORI J MOSCA
• 金额: $ 19.17万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-15 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8143359
• 关键词: Academic Medical Centers; Acculturation; Address; Adherence; Admission activity; Alternative Therapies; Award; Awareness; Behavior; Behavioral; Blood Pressure; Cardiac; Cardiovascular Diseases; Cardiovascular system; Caregivers; Caring; Cause of Death; Clinical; Clinical Research; Clinical Trials; Clinical Trials Design; Coronary heart disease; Data; Data Set; Demographic Factors; Disease Outcome; Education; Educational Background; Educational Intervention; Effectiveness; Electronics; Emergency Situation; Ethnic Origin; Ethnic group; Etiology; Exposure to; Family member; Female; Friends; Funding; Future; Gender; Goals; Health; Heart; Hospitalization; Hospitals; Income; Informatics; Intervention; Intervention Trial; Knowledge; LDL Cholesterol Lipoproteins; Learning; Life; Link; Market Research; Medical center; Medicine; Mid-Career Clinical Scientist Award (K24); Minority; Minority Groups; Myocardial Infarction; National Heart, Lung, and Blood Institute; Outcome; Participant; Patients; Perception; Population; Population Heterogeneity; Prevention; Prevention Guidelines; Prevention program; Preventive; Preventive Intervention; Procedures; Program Effectiveness; Protocols documentation; Psychosocial Factor; Race; Randomized Controlled Trials; Research; Research Personnel; Risk; Risk Factors; Risk Reduction; Sampling; Screening procedure; Services; Social Marketing; Staging; Surveys; Symptoms; Testing; Time; Ursidae Family; Weight; Woman; Work; acute coronary syndrome; base; cardiovascular disorder prevention; cardiovascular disorder risk; career development; caregiving; design; effective intervention; experience; follow-up; health disparity; heart disease risk; high risk; human subject; improved; innovation; interest; lifestyle factors; loris; medication compliance; mortality; multidisciplinary; novel; patient oriented; professor; programs; psychosocial; public health relevance; racial and ethnic; racial and ethnic disparities; therapy design

DESCRIPTION (provided by applicant): Gender and racial/ethnic disparities in cardiovascular disease (CVD) have been well documented over the past decade of research. The applicant for renewal of a Midcareer Research Award, Dr. Lori Mosca, and many of her mentees, have contributed substantially to advancement of our knowledge in this field as a result of the initial K24 award, during which time Dr. Mosca was promoted to Professor of Medicine at Columbia University Medical Center. Substantial questions remain regarding the reasons for discrepancies in care and outcomes, a critical scientific gap that could inform interventions designed to reduce gender and racial/disparities in the prevention and treatment of CVD. The goal of this award is to provide the applicant with protected time to increase the pool of high quality multidisciplinary patient oriented researchers dedicated to a) understanding the independent contributions of gender and race/ethnicity to CVD outcomes and b) developing novel interventions targeted to modifiable factors that may reduce disparities. The award will also support the applicant's time to interact with and learn from other senior investigators with an interest in CVD disparities research, an appropriate and important commitment for her stage of career development. Extensive preliminary data by the applicant and her mentees has documented disparities in CVD awareness, risk factor control, and barriers to prevention. The proposed research provides a timely scientific opportunity to garner data from existing and ongoing studies uniquely suited to evaluate independent contributors to disparities and inform the design of future clinical trials and interventions aimed to reduce CVD disparities. The specific aims of the research include: 1) To examine the association between race/ethnic group and a) awareness of coronary heart disease as the leading cause of death in women, b) knowledge of heart attack symptoms and actions to take when experiencing heart attack symptoms, and c) perceptions of preventive/alternative therapies for coronary heart disease risk reduction, among nationally representative samples of women surveyed triennially from 1997-2009, 2) To determine whether the effectiveness of a screening and education program for family members of patients hospitalized with CVD to improve lifestyle factors over one year varies by race/ethnic group and to examine acculturation, baseline risk, and psychosocial factors as potential confounders/effect modifiers of program effectiveness and 3) To ascertain whether control of CVD risk factors is independently associated with race/ethnic group among consecutive patients admitted to the cardiovascular disease service line of a major medical center, and to determine whether the association with medication adherence and having a paid or non-paid (family member/friend) caregiver prior to hospitalization. The significance and impact of this research is that it will extend our knowledge about health disparities and will address the etiology of differential outcomes with the goal of developing effective interventions to optimize cardiovascular health among populations that bear a disproportionate burden of CVD risk. PUBLIC HEALTH RELEVANCE: This purpose of this research is to contribute to a reduction in gender, racial, and ethnic disparities in cardiovascular disease prevention through innovative approaches to study the causes of health disparities and to use the knowledge gained to inform targeted educational programs and to design future clinical studies aimed to reduce disparities and improve cardiovascular health for all.

描述（由申请人提供）：在过去十年的研究中，心血管疾病（CVD）的性别和种族/民族差异已得到充分记录。中期职业研究奖续签申请人洛里·莫斯卡 (Lori Mosca) 博士和她的许多学员，通过最初的 K24 奖项，为我们在这一领域的知识进步做出了重大贡献，在此期间，莫斯卡 (Mosca) 博士被晋升为哥伦比亚大学医学中心医学教授。关于护理和结果差异的原因仍然存在实质性问题，这是一个关键的科学差距，可以为旨在减少心血管疾病预防和治疗方面的性别和种族/差异的干预措施提供信息。该奖项的目标是为申请人提供受保护的时间，以增加以患者为中心的高质量多学科研究人员队伍，致力于 a) 了解性别和种族/民族对 CVD 结果的独立贡献，b) 开发针对可修改的新颖干预措施可能缩小差距的因素。该奖项还将支持申请人有时间与其他对 CVD 差异研究感兴趣的高级研究人员互动并向他们学习，这对于她的职业发展阶段来说是适当且重要的承诺。申请人及其受训者提供的大量初步数据记录了 CVD 意识、风险因素控制和预防障碍方面的差异。拟议的研究提供了一个及时的科学机会，可以从现有和正在进行的研究中收集数据，这些数据特别适合评估差异的独立因素，并为未来旨在减少心血管疾病差异的临床试验和干预措施的设计提供信息。该研究的具体目标包括：1) 检查种族/族裔群体与 a) 对冠心病作为女性死亡主要原因的认识，b) 对心脏病发作症状和心脏病发作时应采取的行动的了解c) 1997-2009 年每三年调查一次的全国代表性女性样本中对降低冠心病风险的预防/替代疗法的看法，2) 确定针对患者家属的筛查和教育计划是否有效因 CVD 住院一年内改善生活方式因素因种族/族裔群体而异，并检查文化适应、基线风险和心理社会因素作为计划有效性的潜在混杂因素/效应调节因素，以及 3) 确定 CVD 风险因素的控制是否独立相关对连续入住大型医疗中心心血管疾病服务线的患者进行种族/族裔群体分析，并确定其与药物依从性以及住院前有付费或无付费（家庭成员/朋友）护理人员是否相关。这项研究的意义和影响在于，它将扩展我们对健康差异的认识，并解决差异结果的病因学问题，目标是制定有效的干预措施，以优化心血管疾病风险负担过重的人群的心血管健康。 公共卫生相关性：本研究的目的是通过创新方法研究健康差异的原因，并利用获得的知识为有针对性的教育计划提供信息，从而有助于减少心血管疾病预防方面的性别、种族和民族差异。设计未来的临床研究，旨在减少差异并改善所有人的心血管健康。