Increasing Eye Care Utilization in Black Americans At High Risk For Glaucoma Using A Community-Engaged and Faith-Based Intervention

通过社区参与和基于信仰的干预措施提高青光眼高危美国黑人的眼保健利用率

• 批准号: 10633232
• 负责人: Angela R Elam
• 金额: $ 16.96万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-22 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10633232
• 关键词: Academy; Address; Age; Award; Black American; Black Populations; Blindness; Caring; Chronic Disease; Church; Clinical; Communities; Community Health; Community Health Aides; Data; Detection; Diagnosis; Disease; Disparity; Education; Ethnic Origin; Ethnic Population; Etiology; Evaluation; Eye; Face; Faith; Faith-based organization; Family history of; Foundations; Geography; Glaucoma; Goals; Guidelines; Health Disparities Research; Healthcare; Individual; Intervention; Interview; Knowledge; Link; Medicine; Methods; Mission; Ophthalmologist; Outcome; Pattern; Persons; Pilot Projects; Preventive healthcare; Public Health; Race; Randomized Controlled Clinical Trials; Religion; Research; Risk; Scientist; Site; Structure; Techniques; Training; Trust; United States; United States National Institutes of Health; Visual impairment; Work; acceptability and feasibility; arm; behavior change; blind; care providers; career; caucasian American; combat; community based treatment; community engagement; design; disparity reduction; effective therapy; empowerment; evidence based guidelines; faith-based intervention; health care service; health care service utilization; health disparity; high risk; high risk population; implementation framework; implementation science; implementation strategy; improved; innovation; marginalized population; member; motivational enhancement therapy; novel; ophthalmic examination; patient-clinician communication; personalized approach; population health; programs; recruit; screening; skill acquisition; social; socioeconomics; success; tailored messaging; therapy design

PROJECT SUMMARY/ABSTRACT There are significant gaps in our understanding between well-established, evidence-based guidelines for detection and treatment of glaucoma and effectively applying those guidelines within the high-risk populations that continue to develop blindness. As outlined by the National Academy of Medicine, great opportunity exists to incorporate principles of population health and community engagement to close this observed glaucoma detection gap. The overall objective of this study is to design and implement a faith-based, community health worker-delivered (CHW) support program for individuals at high risk for glaucoma, specifically Black Americans. The central hypothesis is that a personalized faith-based support program will result in increased eye care utilization in Black Americans at high risk for glaucoma who currently underutilize eye care. The rationale is that increasing appropriate eye care utilization in high-risk individuals and beginning treatment at earlier stages of the disease will decrease the risk of unpreventable blindness. The candidate will reach the overall objective by achieving the following 2 specific aims: 1) Use implementation science framework and community-engaged methods to adapt an existing glaucoma coaching program and develop a multilevel intervention that addresses the key determinants of successfully increasing eye care utilization in Black Americans; and 2) Implement and evaluate the feasibility and acceptability of the Community-Based Treatment for Glaucoma program (ComBaT Glaucoma), for Black Americans. In Aim 1, the Tailored Implementation for Chronic Diseases (TICD) implementation science framework will be used to guide semi-structured interviews with community members, leaders, and local eye care providers to identify barriers and potential facilitators of increasing eye care utilization in Black Americans; and b) adapt the Support, Educate and Empower (SEE) Program to the needs and culture of the community to develop and the faith-based CHW-delivered program that uses implementation strategies and behavior change techniques linked to community-identified determinants for optimal success. In Aim 2, the ComBaT Glaucoma program will be implemented by conducting a single-arm pilot study with 50 Black Americans. The candidate will use mixed methods to assess the feasibility and acceptability of the ComBaT Glaucoma program. This study is significant because it addresses a gap between well-established guidelines for glaucoma and high-risk individuals that continue to go blind despite these data. It is innovative because it employs implementation science framework, a community-engaged, faith-based tailored approach to create a support program to increase eye care utilization in Black Americans at high risk for glaucoma. Dr. Elam will use the skills acquired during this training award to become one of the few ophthalmologists trained in implementation science and community-engaged health disparities research to improve glaucoma care for all people in the United States.

项目摘要/摘要 在建立良好的，基于证据的指南之间，我们的理解存在很大的差距 检测和治疗青光眼，并有效地应用这些准则 那继续发展失明。正如美国国家医学院概述的那样，存在很大的机会 纳入人口健康和社区参与原则，以结束这一观察到的青光眼 检测差距。这项研究的总体目的是设计和实施基于信仰的社区健康 工人交付（CHW）支持青光眼高风险的个人，特别是黑人美国人。 中心假设是一个个性化的基于信仰的支持计划将导致眼部护理增加 黑人美国人对目前不足眼保健的青光眼风险的利用。理由是 在高危个人中增加适当的眼部护理利用，并在早期的阶段开始治疗 该疾病将降低无法预防的失明的风险。候选人将通过 实现以下两个特定目标：1）使用实施科学框架和社区参与 适应现有青光眼教练计划并开发多层次干预的方法 在黑人美国人成功增加眼保健利用的关键决定因素； 2）实施和 评估基于社区的青光眼计划的可行性和可接受性（战斗 青光眼），适用于黑人美国人。在AIM 1中，量身定制的慢性病实施（TICD） 实施科学框架将用于指导与社区成员的半结构化访谈， 领导者和当地的眼保健提供者，以确定越来越多的眼保健利用的障碍和潜在的促进者 在黑人美国人中； b）将支持，教育和授权（请参阅）计划适应需求和文化 使用实施策略的社区和基于信仰的CHW延期计划 和行为改变技术与社区识别的决定因素有关，以获得最佳成功。在AIM 2中 战斗青光眼计划将通过进行50黑色的单臂试点研究来实施 美国人。候选人将使用混合方法来评估战斗的可行性和可接受性 青光眼计划。这项研究很重要，因为它解决了公认的准则之间的差距 尽管有这些数据，但仍继续盲目的青光眼和高风险个体。这是创新的，因为它 采用实施科学框架，一种基于社区的，基于信仰的量身定制方法来创建 支持计划的支持计划，以增加青光眼风险高风险的黑人美国人的眼部护理利用。 Elam博士将使用 在该培训奖上获得的技能，成为少数接受过实施培训的眼科医生之一 科学和社区参与的健康差异研究，以改善所有人的青光眼护理 美国。

项目成果

Michigan Screening and Intervention for Glaucoma and Eye Health Through Telemedicine Program: First-Year Outcomes and Implementation Costs.

密歇根州通过远程医疗计划进行青光眼和眼健康筛查和干预：第一年成果和实施成本。

• DOI: 10.1016/j.ajo.2023.02.026
• 发表时间: 2023
• 期刊: American journal of ophthalmology
• 影响因子: 4.2
• 作者: Newman-Casey,PaulaAnne;Niziol,LeslieM;Elam,AngelaR;Bicket,AmandaK;Killeen,Olivia;John,Denise;Wood,SarahDougherty;Musch,DavidC;Zhang,Jason;Johnson,Leroy;Kershaw,Martha;Woodward,MariaA
• 通讯作者: Woodward,MariaA