The Discovering Healthcare Innovations to Address Disparties in Stroke (DIADS) pr

发现医疗创新以解决中风问题 (DIADS) 项目

基本信息

批准号：
8914686
负责人：
Kirsten Bibbins-Domingo
金额：
$ 197.61万
依托单位：
KAISER FOUNDATION RESEARCH INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-09-30 至 2016-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8914686
关键词：
Address Adolescent and Young Adult Adult African American Age Algorithms American Biometry Blood Blood Pressure California Cardiovascular Diseases Caucasians Cessation of life Child Childhood Clinic Clinical Clinical Trials Cohort Studies Collaborations Communities Computers County Data Diastolic blood pressure Dietary Intervention Disease Educational Intervention Elements Enrollment Epidemiology Ethnic group Etiology Future Goals Health Professional Healthcare Hypertension Incidence Institution Interdisciplinary Study Intervention Link Literature Modeling Nutritional Science Patients Policies Population Population Heterogeneity Population Study Primary Prevention Public Health Education Quality-Adjusted Life Years Race Research Research Personnel Risk Risk Factors Risk Reduction San Francisco Science Stroke Subgroup Time Training Underrepresented Minority Universities age group behavior change blood pressure reduction blood pressure regulation cardiovascular disorder epidemiology cardiovascular risk factor clinical research site design effective intervention experience health disparity hypertension control hypertension treatment innovation minority trainee novel nutritional epidemiology primary outcome programs public health relevance racial disparity randomized trial systolic hypertension treatment program trend young adult

项目摘要

DESCRIPTION (provided by applicant): African Americans experience the highest rates of stroke of all race/ethnic groups In the US. Stroke in African American occurs at younger ages than Caucasians. While racial disparities in stroke exist at all ages, disparities are greatest in young adulthood. Temporal trend data suggest that these stroke disparities in young adulthood may be widening. Hypertension is the most common and potent risk factor for stroke in the US. Blood pressure (BP) control rates are known to differ by race and may be an important contributor to racial disparities in stroke. Disparities in blood pressure control are most prominent in younger adulthood, further contributing to disparities in stroke rates in this age group. Efforts aimed at the primary prevention of stroke have generally not focused on young adulthood, despite the greatest disparities in incident disease being observed in this period and the opportunity for long-term risk reduction via interventions targeted early in adulthood. Effective intervention targeting known stroke risk factors (e.g. hypertension) have not been developed for young adults. Additionally the literature on novel risk factors present in young adulthood that may be amenable to additional risk reduction is currently lacking. DIADS is collaboration between Kaiser Permanente Northern California (KPNC) and the University of California, San Francisco (UCSF). DIADS seeks to design, implement, and evaluate a clinically-delivered hypertension control intervention that consists of both a clinical algorithm for rapid an effective blood BP control, as well as a culturally-tailored dietary Intervention aimed at more effective sustained BP control. Specific Aim 1: To conduct a cluster pragmatic randomized trial of a clinically-delivered hypertension control intervention (Shake, Rattle, and Roll) that will consist of a clinical algorithm for rapid and sustained blood pressure control, as well as a culturally tailored dietary intervention. Specific Aim 2: To conduct an observational cohort study of children, adolescents, and young adults within KPNC to identify temporal trends in traditional risk factors for stroke in the young, as well as novel factors that may Increase stroke risk in thi age group. Specific Aim 3: To implement the essential components of the Shake, Rattle, and Roll hypertension control intervention in a local community clinic serving a diverse population and then disseminate the intervention among a broad coalition of community clinics in Alameda County and San Francisco County.

描述（由申请人提供）：非裔美国人经历了美国所有种族/族裔群体中中风的最高速度。非裔美国人的中风比高加索人年轻时发生。尽管各个年龄段都存在中风的种族差异，但成年期最大的差异是最大的。时间趋势数据表明，成年年轻的这些中风差异可能正在扩大。高血压是美国中风最常见和有效的危险因素。已知血压（BP）控制率因种族而有所不同，并且可能是中风中种族差异的重要原因。血压控制的差异在年轻的成年期最大，进一步导致该年龄段的中风率差异。尽管在此期间观察到的事件疾病的差异最大，并且通过成年早期针对的干预措施，旨在降低风险的机会，但旨在主要预防中风的努力并不集中于成年。尚未针对年轻人开发有效的靶向已知中风风险因素（例如高血压）的干预措施。此外，目前缺乏有关年轻成年中存在的新危险因素的文献，目前缺乏额外的风险降低。 DIADS是Kaiser Permanente North California（KPNC）与旧金山分校（UCSF）之间的合作。 Diads试图设计，实施和评估临床上递送的高血压控制干预措施，该干预措施既包括临床算法，又是快速的有效血液BP控制的临床算法，以及旨在更有效的持续BP控制的文化研究的饮食干预措施。具体目的1：进行临床上延长的高血压控制干预措施（摇动，嘎嘎声和滚动）的集群务实的随机试验，该试验将由临床算法组成，用于快速且持续的血压控制以及饮食量身定制的饮食干预措施。具体目的2：对KPNC中儿童，青少年和年轻人进行观察队列研究，以确定年轻人中风的传统风险因素的时间趋势，以及可能增加Thi年龄段中风风险的新因素。具体目标3：在当地社区诊所中实施奶昔，嘎嘎声和滚动高血压控制干预的基本组成部分，为多样化的人群服务，然后在阿拉米达县和旧金山县的广泛社区诊所之间进行干预。