Race, Socioeconomic Status, Diet and Chronic Kidney Disease

种族、社会经济地位、饮食和慢性肾脏病

基本信息

批准号：
8424489
负责人：
DEIDRA CANDICE CREWS
金额：
$ 17.2万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-07-22 至 2017-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8424489
关键词：
Accounting Address Affect African American Ancillary Study Area Behavior Therapy Blood Pressure Cardiovascular system Cessation of life Chronic Kidney Failure Clinical Clinical Investigator Clinical Research Clinical Trials Communities DASH diet Data Diabetes Mellitus Diet Diet Habits Dietary Factors Dietary Intervention Dietary Practices Disadvantaged Effectiveness End stage renal failure Enrollment Environment Epidemiologic Studies Epidemiology Faculty Family Family history of Focus Groups Food Fruit Funding Goals Health Health Food Home environment Hypertension Incidence Individual Intervention K-Series Research Career Programs Kidney Lead Life Link Low income Measures Medicine Mentors Methodology National Health and Nutrition Examination Survey National Heart, Lung, and Blood Institute Nephrology Outcome Participant Patients Performance Persons Population Prevention Prevention Research Public Health Schools Race Randomized Controlled Trials Reporting Research Research Personnel Restaurants Risk Socioeconomic Status Study Subject Testing Training United States United States National Center for Health Statistics Universities Vulnerable Populations Work cardiovascular risk factor career clinical epidemiology community based participatory research design experience fast food fruits and vegetables health disparity high risk hypertension control improved low socioeconomic status medical schools member novel nutrition patient oriented population based professor public health relevance racial difference socioeconomics

项目摘要

DESCRIPTION (provided by applicant): Racial disparities in chronic kidney disease (CKD) are most profound among persons of low socioeconomic status (SES), and dietary factors (limited availability of healthy foods and unhealthy dietary patterns) likely underlie much of this disparit. Low SES African Americans (AAs) are more likely to experience food insecurity (the inability to afford nutritionally adequate and safe foods) and live in "food deserts" (areas where low-income residents do not have access to healthy food and fast food restaurants predominate) which likely contributes to racial differences in dietary patterns. Little is known regarding the potentil effectiveness of dietary interventions among low SES AAs at high risk for CKD incidence or progression. Studies quantifying the association between poor diet and disparities in CKD incidence and progression among low SES AAs and identifying effective strategies to improve dietary habits in this population are critically needed, and could lead to reduced racial disparitis in CKD. The overall objectives of this proposal are to 1) determine the contribution of racial differences in dietary patterns to racial disparities in progression to end stage renal disease (ESRD) among low SES individuals in a national population-based study; 2) examine the impact of availability of healthy foods on the effectiveness of a patient, family and community level intervention among low SES AAs with uncontrolled hypertension by using established measures and developing a novel measure of healthy food availability within AAs' homes; 3) identify perceived barriers to healthy dietary patterns and identify potential interventional strategies deemed acceptable among low SES AAs at very high risk for CKD using qualitative methodology; and 4) develop and pilot-test a tailored dietary intervention for low SES AAs at very high risk for CKD by employing the principles of community-based participatory research. The candidate for this K23 Mentored Career Development Award, Dr. Deidra Crews, is an Assistant Professor of Medicine in the Division of Nephrology at Johns Hopkins University and an Associate Faculty Member at the Welch Center for Prevention, Epidemiology and Clinical Research. Her long term goal is to improve health outcomes among vulnerable populations through her work as a clinical investigator. The overarching goal of this application is to establish her successful and independent career studying mechanisms to narrow racial disparities in CKD. Under the guidance of exceptional mentors and advisors, Dr. Crews will extend her prior training and work in clinical epidemiology and health disparities research through further didactic training in nutrition, clinical trials and community-based participatory research, and through the performance of novel, complementary studies. She will conduct this work in the rich training environment of the Welch Center, the Johns Hopkins Bloomberg School of Public Health, and the Hopkins Center to Eliminate Cardiovascular Health Disparities. Dr. Crews' proposed work will not only assure her successful transition to an R01-funded independent investigator, but will also contribute substantially to what is known about racial and socioeconomic disparities in CKD.

描述（由申请人提供）：慢性肾病（CKD）的种族差异在社会经济地位（SES）较低的人群中最为明显，而饮食因素（健康食品的供应有限和不健康的饮食模式）可能是造成这种差异的主要原因。社会经济地位低的非洲裔美国人 (AA) 更有可能经历粮食不安全（无法负担营养充足且安全的食品）并生活在“食品沙漠”（低收入居民无法获得健康食品和快餐店的地区）占主导地位），这可能导致饮食模式的种族差异。对于 CKD 发病或进展高风险的低 SES AA 人群中饮食干预的潜在有效性知之甚少。迫切需要研究量化不良饮食与低 SES AA 中 CKD 发病率和进展差异之间的关系，并确定改善该人群饮食习惯的有效策略，这可能会减少 CKD 的种族差异。该提案的总体目标是 1) 在一项基于全国人口的研究中，确定低 SES 个体中饮食模式的种族差异对进展为终末期肾病 (ESRD) 的种族差异的影响； 2) 通过使用既定措施并制定一种新的衡量健康食品供应情况的新措施，研究健康食品的供应对患有未控制高血压的低 SES AA 患者、家庭和社区层面干预效果的影响； 3) 使用定性方法确定健康饮食模式的障碍，并确定在 CKD 风险极高的低 SES AA 中可接受的潜在干预策略； 4) 采用基于社区的参与性研究原则，针对 CKD 风险极高的低 SES AA 制定并试点测试定制饮食干预措施。 K23 指导职业发展奖的候选人 Deidra Crews 博士是约翰·霍普金斯大学肾内科医学助理教授，也是韦尔奇预防、流行病学和临床研究中心的副教员。她的长期目标是通过临床研究人员的工作来改善弱势群体的健康状况。该申请的总体目标是建立她成功且独立的职业学习机制，以缩小 CKD 的种族差异。在杰出导师和顾问的指导下，克鲁斯博士将通过营养学、临床试验和社区参与性研究方面的进一步教学培训，并通过新颖、互补的表现，扩展她之前在临床流行病学和健康差异研究方面的培训和工作。研究。她将在韦尔奇中心、约翰霍普金斯大学彭博公共卫生学院和霍普金斯大学消除心血管健康差异中心丰富的培训环境中开展这项工作。 Crews 博士提出的工作不仅将确保她成功过渡为 R01 资助的独立研究者，而且还将为了解 CKD 中的种族和社会经济差异做出重大贡献。