Race, Socioeconomic Status, Diet and Chronic Kidney Disease

种族、社会经济地位、饮食和慢性肾脏病

• 批准号: 8636472
• 负责人: DEIDRA CANDICE CREWS
• 金额: $ 17.14万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 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/8636472
• 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

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）：慢性肾脏疾病（CKD）的种族差异（CKD）在低社会经济地位（SES）（SES）和饮食因素（健康食品的可用性和不健康饮食模式的有限）中最为深刻。低SES非裔美国人（AAS）更有可能遇到粮食不安全（无法负担营养充足和安全的食物），并生活在“食品沙漠”（低收入居民无法获得健康食品和快餐餐厅的地区），这可能会导致饮食方式种族差异。关于CKD发病率或进展的高风险，饮食干预措施在饮食干预措施中的稳定性有效性知之甚少。量化低SES AAS中CKD发病率和进展的差异之间的关联的研究非常需要，并确定了改善该人群中饮食习惯的有效策略，并且可能会导致CKD中的种族差异减少。该提案的总体目标是1）确定饮食模式的种族差异对在基于国家人群的研究中，低SES个体中饮食模式对种族差异的贡献； 2）检查健康食品的可用性对低SES AAS中患者，家庭和社区水平干预的有效性的影响，并通过使用已建立的措施并在AAS的房屋内开发了一种新颖的健康食品可用性量度； 3）确定可感知的健康饮食模式的障碍，并确定使用定性方法的低SES AA中被认为可以接受的潜在介入策略； 4）通过采用基于社区的参与性研究的原则，开发和试点测试对低SES AA的量身定制的饮食干预措施，对CKD的风险很高。该K23指导职业发展奖的候选人Deidra Crews博士是约翰·霍普金斯大学肾脏科学系医学助理教授，也是韦尔奇预防，流行病学和临床研究中心的副教授。她的长期目标是通过作为临床研究者的工作来改善脆弱人群的健康状况。该应用程序的总体目标是建立她成功且独立的职业研究机制，以缩小CKD的种族差异。在杰出的导师和顾问的指导下，Crews博士将通过在营养，临床试验和基于社区的参与性研究方面的进一步教学培训以及新颖，补充研究的表现，扩展其先前的培训和临床流行病学和健康差异研究。她将在韦尔奇中心的丰富培训环境，约翰·霍普金斯彭博公共卫生学院和霍普金斯中心消除心血管健康差异。 Crews博士的拟议工作不仅可以确保她成功地过渡到R01资助的独立研究人员，而且还将为CKD中的种族和社会经济差异所了解的事情做出了重大贡献。