EVALUATION OF STROKE DISPARITIES IN NATIVE HAWAIIANS AND OTHER PACIFIC ISLANDERS

夏威夷原住民和其他太平洋岛民的中风差异评估

• 批准号: 9369108
• 负责人: Marjorie K. Leimomi Mala Mau
• 金额: $ 14.54万
• 依托单位: UNIVERSITY OF HAWAII AT MANOA
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-11-01 至 2017-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9369108
• 关键词: Accounting; Acute; Admission activity; Age; Blood Vessels; Brain hemorrhage; Cardiovascular Diseases; Cerebral hemisphere hemorrhage; Clinical; Clinical Research; Communities; Diabetes Mellitus; Disease; Ethnic group; Etiology; Evaluation; Filipino; Focus Groups; Future; Hawaii; Hawaiian population; High Density Lipoprotein Cholesterol; High Prevalence; Hospitals; Hypertension; Incidence; Intervention Studies; Japanese Population; Lead; Measures; Medical center; Mental Health; Metabolic syndrome; Methamphetamine; Minority Groups; Morbidity - disease rate; Neuronal Injury; Obesity; Outcome; Pacific Island Americans; Patients; Pilot Projects; Population; Primary Prevention; Quality of life; Race; Randomized; Reporting; Research; Risk Factors; Secondary Prevention; Services; Stroke; Survivors; Sympathomimetics; Testing; United States; Universities; Work; base; burden of illness; disability; functional outcomes; health disparity; health related quality of life; high risk; improved; methamphetamine abuse; mortality; post stroke depression; programs; racial and ethnic; racial disparity; racial minority

Intracerebral hemorrhage (ICH) is a devastating hemorrhagic stroke that accounts for 10-15% of the approximately 700,000 annual strokes in the Unites States and results in disproportionately high morbidity and mortality. To date, there is no definitive treatment that results in reversal of neuronal injury and improvement in outcome after ICH. Therefore, it is important to identify the high-risk group and focus on primary and secondary prevention to reduce the incidence and burden of ICH. Recent evidence suggests that the burden of ICH is not borne equally by all, with racial minority groups reported to have a higher incidence and poorer outcomes than whites. Although Native Hawaiians and other Pacific Islanders (NHPI) have been reported to have higher burden of cardiovascular diseases compared to other major racial-ethnic groups, the burden of vascular risk factors related to ICH in this population has not been adequately studied. Furthermore, long-term functional outcome and quality-of-life measures after ICH among NHPI have not been studied. The overall strategy for this project will be to build on the findings from our preliminary work on ICH disparities, utilizing the clinical and research expertise at The Queen's Medical Center, a university-affiliated hospital that is the primary tertiary referral center in the Pacific and has the largest stroke service in the state. We plan to prospectively identify patients who are hospitalized at The Queen's Medical Center for acute ICH, and assess racial disparities in clinical and sociodemographic risk factors and long-term disease-specific health-related quality of life and functional outcomes, which will be measured at 3-, 6-, and 12-month from admission. We hypothesize that NHPI race is associated with younger age of presentation with ICH, better quality of life and less disability at 3 months after ICH compared to other major racial-ethnic groups in Hawaii. In addition, we will develop and test, in a randomized controlled pilot study, the impact of a culturally-informed, stroke-specific Patient Navigation program on psychological health-related quality of life and post-stroke depression among the ICH survivors.

脑出血 (ICH) 是一种毁灭性的出血性中风，占所有疾病的 10-15% 美国每年约有 700,000 例中风，导致发病率极高 和死亡率。迄今为止，尚无明确的治疗方法可以逆转神经元损伤和 ICH 后结果的改善。因此，识别高危人群并重点关注非常重要。 一级和二级预防，以减少脑出血的发生率和负担。最近的证据表明 非物质文化遗产的负担并非由所有人平等承担，据报道少数族裔群体的负担更高 发病率和结果比白人差。尽管夏威夷原住民和其他太平洋岛民 (NHPI) 据报道，与其他主要种族相比，他们的心血管疾病负担更高 对于该人群，与 ICH 相关的血管危险因素的负担尚未得到充分研究。 此外，NHPI 中 ICH 后的长期功能结果和生活质量指标尚未得到证实。 被研究过。 该项目的总体策略将建立在我们 ICH 前期工作的结果之上 利用大学附属女王医疗中心的临床和研究专业知识来消除差异 该医院是太平洋地区主要的三级转诊中心，拥有该州最大的中风服务。 我们计划前瞻性地识别因急性脑出血而在女王医疗中心住院的患者， 并评估临床和社会人口学危险因素以及长期疾病特异性的种族差异 与健康相关的生活质量和功能结果，将在 3、6 和 12 个月后进行测量 入场。我们假设 NHPI 种族与 ICH 发病年龄较小相关，更好 与其他主要种族群体相比，ICH 后 3 个月的生活质量更高，残疾更少 夏威夷。此外，我们将在一项随机对照试点研究中开发和测试具有文化背景的、 针对心理健康相关生活质量和中风后的中风患者导航计划 ICH 幸存者的抑郁症。