Diet Counseling Intervention for Black Americans with CKD

对患有 CKD 的美国黑人进行饮食咨询干预

• 批准号: 10848506
• 负责人: Crystal C Tyson
• 金额: $ 5.45万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10848506
• 关键词: Address; Adult; Adverse effects; Affect; Ambulatory Blood Pressure Monitoring; Antihypertensive Agents; Award; Behavior Therapy; Behavioral; Behavioral Research; Biological Markers; Biometry; Black American; Black Populations; Black race; Blood Pressure; Carbohydrates; Cardiovascular Diseases; Caring; Chronic Kidney Failure; Clinical Research; Clinical Trials; Complex; Conduct Clinical Trials; Control Groups; Counseling; DASH diet; Data; Data Collection; Death Rate; Dialysis procedure; Diet; Diet Modification; Dietary Assessment; Dietary Intervention; Dietary Practices; Disease; Disease Outcome; Doctor of Philosophy; Environmental Risk Factor; Faculty; Feasibility Studies; Feedback; Fishes; Focus Groups; Fruit; Future; Glomerular Filtration Rate; Goals; Health; Hour; Hypertension; Institution; International; Intervention; Intervention Studies; Interview; K-Series Research Career Programs; Kidney; Kidney Diseases; Kidney Failure; Kidney Transplantation; Lead; Leadership; Life; Mentors; Mentorship; Metabolic; Metabolic Marker; Mind; Minority; Minority Health Research; Outcome; Participant; Pattern; Perception; Phenotype; Phosphorus; Pilot Projects; Population; Potassium; Public Health; Qualitative Research; Randomized; Research; Research Methodology; Resistance; Safety; Serum; Sodium; Specialist; Structure; Testing; Training; Urea; Urine; Vegetables; Work; acceptability and feasibility; behavior change; behavioral clinical trial; black patient; blood pressure control; blood pressure reduction; cardiovascular disorder risk; career; clinically relevant; design; dietary; dietary adherence; dissemination research; evidence base; feasibility testing; feeding; health disparity; hypertension control; hypertensive; improved; intervention effect; minority health; mortality; multidisciplinary; pilot test; premature; racial disparity; racial diversity; recruit; saturated fat; skills; sociocultural determinant; standard of care; treatment arm

Project Summary/Abstract: Excess cardiovascular disease (CVD) mortality among Black Americans with chronic kidney disease (CKD) is a significant US public health disparity. Compared to their White counterparts, Blacks with CKD develop kidney disease earlier in life, are 3 times more likely to develop kidney failure necessitating dialysis or kidney transplantation, and are 1.5 times more likely to die prematurely from CVD. Hypertension, which is also more prevalent, more severe, and less often controlled in Blacks with CKD compared to Whites, is a leading cause of CKD and CVD, and a major contributor to the racial disparity in CVD mortality. Therefore, improving hypertension in Blacks with CKD could have a profound positive impact on an important minority health issue. The long-term career goal of Dr. Crystal Tyson, who is a nephrologist and hypertension specialist, is to develop sustainable interventions that improve hypertension and eliminate racial disparities in CVD among adults with CKD. In her formative work, Dr. Tyson conducted a pilot metabolic feeding study which demonstrated that the Dietary Approaches to Stop Hypertension diet (DASH) lowers BP in Black adults with CKD without having adverse effects on metabolic markers of safety. For her career development award, Dr. Tyson is advancing her research by modifying an existing DASH counseling intervention that was previously demonstrated by her mentors (Svetkey, Lin) to improve DASH adherence and BP in racially diverse, non-CKD populations, to now specifically address cultural and disease-specific considerations of Black adults with CKD. For Aim 1, she will conducted formative qualitative research involving focus group discussions with Black adults with hypertension and CKD to identify barriers and facilitators of DASH adherence. For Aim 2, she is conducting a randomized controlled pilot study to test feasibility, acceptability, and the preliminary effect on DASH adherence and BP of the newly-modified intervention in 50 Black patients with hypertension and CKD. During the award period, Dr. Tyson has been training to develop (1) new skills in qualitative research methods, (2) new skills to conduct behavioral and diet interventions in minority and CKD populations, and (3) enhanced skills in health disparities and minority health research methods. Her highly-accomplished, multi-disciplinary mentorship team is be led by Laura Svetkey, MD, MHS, an internationally recognized hypertension and clinical trial expert who has received several institutional awards for her leadership in faculty diversity and mentoring. Dr. Tyson’s team also includes national leaders in CKD-related health disparities (L. Ebony Boulware, MD, MPH), behavioral intervention and dissemination research (Gary Bennett, PhD, MPH), qualitative research methods (Laura Fish, PhD), and biostatistics (Stephen Grambow, PhD). By accomplishing the research aims and training objectives of this career development award, Dr. Tyson will be prepared to successfully transition to research independence and develop broadly implementable interventions that help eliminate racial disparities in CVD among CKD populations.

项目摘要/摘要： 患有慢性肾脏疾病（CKD）的黑人美国人的心血管疾病过多（CVD）是 与他们的白人相比，美国的公共卫生差异很大 生命早期疾病，需要透析或肾脏的肾衰竭3倍 移植，过早死亡的1.5倍。 与白人相比，普遍存在，更严重，较少的CKD黑人控制是一个主要原因 CKD和CVD，以及CVD死亡率种族差异的主要贡献者。 患有CKD的黑人的高血压在重要的次要问题上可能具有很高的积极性。 肾脏科医生和高血压专家Crystal Tyson博士的长期职业目标是发展 可持续的IntevuatuationNTIT改善高血压并消除患有CVD的CVD的种族差异 泰森博士在她的形成性工作中进行了代谢研究 停止高血压饮食（DASH）的饮食方法可降低CKD黑人成年人的BP 泰森博士对她的职业发展奖的不利影响 通过修改她以前证明的现有DASH咨询干预措施的研究 到目前 特别针对CKD的黑人成年人的文化和疾病特定审议。 与黑人成年人进行了形成性定性研究互动焦点小组讨论 CKD识别符合AIM 2的障碍和促进者。 受控的试点研究以测试频率，以及对破折号依从性和bp的预后作用 在奖励期间，新的改性为50例黑人患者。 泰森（Tyson）一直在培训（1）定性研究方法的新技能，（2）新技能 少数民族和CKD人群的行为和饮食干预措施，以及（3）健康差异的技能提高 和少数族裔健康研究方法。 由MHS劳拉·斯维特基（Laura Svetky），国际公认的高血压和临床试验专家 她在教师多样性和指导方面获得了严重的机构奖项 还包括与CKD相关的健康差异（L. Ebony Boulware，MD，MPH）的国家领导者，行为 间隔和传播研究（Gary Bennett，PhD，MPH），定性研究方法（Laura Fish， 博士学位）和生物统计学（Stephen Grambow，PhD）。 在这个职业发展奖中，泰森博士将准备成功过渡到研究 独立和发展在CVD中可广泛可实现的实施差异 在CKD人群中。