Community Health Worker-Led Church-Based Intervention for Eliminating Cardiovascular Health Disparities in African Americans

社区卫生工作者主导的教会干预措施，旨在消除非裔美国人的心血管健康差异

• 批准号: 10414464
• 负责人: Jiang He
• 金额: $ 19.81万
• 依托单位: TULANE UNIVERSITY OF LOUISIANA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-10 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10414464
• 关键词: Address; Adherence; Administrative Supplement; African American; Appointment; Church; Communities; Community Health Aides; Community Health Systems; Data; Development; Effectiveness of Interventions; Focus Groups; Guidelines; Health Personnel; Intervention; Louisiana; Measurement; Measures; Patients; Phase; Physicians; Primary Prevention; Process; Provider; Randomized; Recommendation; Research; Research Personnel; Review Literature; Risk Factors; Role; Sociology; Testing; Time; Trust; Underserved Population; Visit; base; cardiometabolic risk; cardiovascular disorder prevention; cardiovascular health; clinical care; control trial; effectiveness evaluation; health disparity; implementation strategy; improved; member; psychologic; systematic review; therapy design; tool; trustworthiness

PROJECT SUMMARY The “Community Health Worker-Led (CHW) Church-Based Intervention for Eliminating Cardiovascular Health Disparities in African Americans” (CHERISH) study is a clustered randomized control trial to test whether a community health worker-led church-based multifaceted implementation strategy for applying the 2019 ACC/AHA Guidelines on the Primary Prevention of Cardiovascular Disease will reduce cardiovascular health disparities in African Americans in New Orleans and Bogalusa, Louisiana. However, low levels of trust in doctors and researchers among African Americans is often a barrier to participation in research and clinical care. CHWs offer an opportunity to understand how trust is built between communities and health systems, but there is little empirical evidence. The process by which CHWs engender trust among community members is largely anecdotal and theoretical. It is unknown how trust-building occurs, develops, grows, or terminates over time, particularly in interventions to address CVD disparities. Research is needed to understand how CHWs build trust among African Americans and other underserved groups to maximize the effectiveness of interventions to reduce cardiometabolic risk factors for CVD. The purpose of this PA-21-071 Administrative Supplement is to leverage the planning phase of the CHERISH study to identify the role of CHWs in developing trust in providers and researchers. Our central hypothesis is that CHWs can be used to improve trust in providers and researchers. The rationale for the proposed research is that CHWs act as trust intermediaries that increase the likelihood of cooperation (e.g., adherence to physician visit appointments and treatment recommendations) between African Americans and their providers. To test our central hypothesis and, thereby, attain the overall objective, we will pursue the following objectives in parallel with the UH3 planning phase of the CHERISH study: (1) Identify community health worker-led trust-building interventions through a systematic review of the literature. (2) Identify the factors that influence the perceived trustworthiness of community health workers through CHERISH study focus groups. (3) Develop a measurement tool to assess the level of trust between patients and community health workers. The project will provide preliminary data for an application for an R01 to assess the effectiveness of a CHW-led trust-building intervention among African Americans with risk factors for CVD. The design of the intervention will be informed by the systematic review of the literature, focus groups, and the CHW trust measure.

项目概要 “社区卫生工作者主导 (CHW)、基于教会的消除心血管健康干预措施 非裔美国人的差异”（CHERISH）研究是一项集群随机对照试验，旨在测试是否 社区卫生工作者主导的、基于教会的多方面实施战略，以应用 2019 年 ACC/AHA 心血管疾病一级预防指南将降低心血管健康 然而，新奥尔良和路易斯安那州博加卢萨的非裔美国人的信任度较低。 非裔美国人的医生和研究人员往往是参与研究和临床的障碍 社区卫生工作者提供了了解社区和卫生系统之间如何建立信任的机会，但是 社区卫生工作者在社区成员之间建立信任的过程几乎没有经验证据。 目前尚不清楚信任的建立是如何发生、发展、增长或终止的。 需要时间，特别是在解决 CVD 差异的干预措施方面，需要进行研究以了解社区卫生工作者如何做到这一点。 在非裔美国人和其他服务不足的群体之间建立信任，以最大限度地提高服务的有效性 减少 CVD 心脏代谢危险因素的干预措施 本 PA-21-071 管理的目的。 补充是利用 CHERISH 研究的规划阶段来确定社区卫生工作者在 我们的中心假设是社区卫生工作者可以用来改进。 对提供者和研究人员的信任 拟议研究的理由是社区卫生工作者充当信任的角色。 增加合作可能性的中介机构（例如，遵守医生就诊预约和 非裔美国人及其提供者之间的治疗建议）。 因此，为了实现总体目标，我们将与 UH3 并行地追求以下目标： CHERISH 研究的规划阶段：(1) 确定社区卫生工作者主导的信任建立干预措施 (2) 通过对文献的系统回顾，确定影响感知可信度的因素。 通过 CHERISH 研究焦点小组来评估社区卫生工作者的能力 (3) 开发衡量工具 该项目将提供初步评估患者和社区卫生工作者之间的信任程度。 R01 申请的数据，以评估社区卫生工作者主导的信任建立干预措施的有效性 具有 CVD 危险因素的非裔美国人将根据系统的信息设计干预措施。 文献回顾、焦点小组和 CHW 信任措施。