The initial care of younger adults with newly diagnosed type 2 diabetes

新诊断 2 型糖尿病的年轻人的初始护理

基本信息

批准号：
9666625
负责人：
Anjali Gopalan
金额：
$ 19.4万
依托单位：
KAISER FOUNDATION RESEARCH INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-15 至 2023-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9666625
关键词：
Address Adult Affect Age Area Award California Caring Characteristics Clinical Clinical Data Complications of Diabetes Mellitus Data Data Analyses Data Reporting Development Diabetes Mellitus Diagnosis Disease Disease Management Distress Electronic Health Record Environment Face Familiarity Foundations Future Goals Health Health Sciences Healthcare Systems Hyperglycemia Hyperlipidemia Hypertension Institution Integrated Health Care Systems Internist Intervention Interview K-Series Research Career Programs Latino Learning Life Machine Learning Medical center Mentored Patient-Oriented Research Career Development Award Mentors Mentorship Methods Modeling Myocardial Infarction Newly Diagnosed Non-Insulin-Dependent Diabetes Mellitus Obesity Outcome Patient Self-Report Patient risk Patients Pharmacy facility Population Population Characteristics Provider Qualitative Research Reporting Research Research Infrastructure Research Methodology Research Personnel Research Training Resources Retrospective cohort Risk Risk Factors Risk Management Risk Reduction Role Sampling Scientist Smoke Statistical Models Stress Surveys System Testing Training Trees United Kingdom Work barrier to care base burden of illness cardiovascular disorder risk career career development cohort comparative design diabetes education diabetes management disorder control eHealth early onset ethnic diversity experience follow-up glycemic control health care delivery health literacy high risk high risk population implementation science improved improved outcome individual patient insight literacy macrovascular disease member older patient patient population patient subsets professor programs prospective protective effect racial and ethnic skills social stigma therapy design therapy development young adult

项目摘要

PROJECT SUMMARY Dr. Anjali Gopalan, MD, MSHP is a board-certified Internist at the Kaiser Permanente Northern California (KPNC) Oakland Medical Center and a Research Scientist I (equivalent to Assistant Professor) at the KPNC Division of Research (DOR). With the proposed K23 mentored career development award, Dr. Gopalan will gain the advanced training and expertise necessary to become an independent investigator who can develop and implement tailored interventions for patients with early-onset type 2 diabetes (EOT2D). By focusing on adults with EOT2D, she seeks to address the comparatively poor micro- and macrovascular outcomes in this population that may result partly from inadequate management of hyperglycemia and other cardiovascular disease risk factors. Dr. Gopalan’s research premise posits that it is particularly critical for newly diagnosed patients with EOT2D to achieve early disease control, since tighter glycemic control during the year following diagnosis confers long-lasting micro- and macrovascular benefits. In support of the premise, the Research Aims of this K23 are to: 1) use electronic health record [EHR] data to identify EOT2D patient subgroups at highest risk of inadequate early disease control, 2) identify barriers to and facilitators of initial EOT2D management, and 3) examine prospective associations between patient-reported factors (e.g., disease-related distress, health literacy) and inadequate early disease control. The proposed research will be supported by experienced mentors and advisors, as well as advanced training in the following areas: 1) the use of advanced statistical modeling, 2) qualitative data analysis to inform intervention development, 3) the role of social determinants in health, and 4) implementation science. KPNC and DOR are ideal environments for the proposed work. KPNC is an integrated learning healthcare delivery system with a diverse membership of 4.2 million people (>350,000 with diabetes). DOR has a long track record of effectively training early stage investigators and has well-established internal research programs and collaborative relationships with nearby institutions that provide the infrastructure needed for career development. This environment, along with the proposed Research and Training Plans and an outstanding mentorship team, will enable Dr. Gopalan to continue to build the skills and generate the foundational data needed to submit an R01-level proposal during the final years of the proposed award period. In this planned R01, Dr. Gopalan will refine and implement an intervention (with a design based on the results of the three K23 Research Aims) to improve early care for newly diagnosed EOT2D patients and evaluate its impact on early outcomes in this growing, high-risk population. In summary, the proposed K23 award will support the career development of Dr. Gopalan and is vital to her acquiring the skill set and expertise required to become a successful, independent investigator.

项目概要 Anjali Gopalan 博士，医学博士，MSHP 是北加州 Kaiser Permanente 的董事会认证内科医生 (KPNC) 奥克兰医学中心和 KPNC 的一级研究科学家（相当于助理教授）研究部 (DOR) 获得拟议的 K23 指导职业发展奖，Gopalan 博士将获得成为一名能够发展的独立调查员所需的高级培训和专业知识并针对早发 2 型糖尿病 (EOT2D) 患者实施量身定制的干预措施。对于患有 EOT2D 的成人，她寻求解决这一领域相对较差的微血管和大血管结果部分原因可能是由于高血糖和其他心血管疾病管理不善造成的人群戈帕兰博士的研究前提是，这对于新诊断的疾病尤其重要。 EOT2D 患者实现早期疾病控制，因为接下来的一年中血糖控制更加严格诊断可带来持久的微血管和大血管益处为了支持这一前提，该研究。该 K23 的目标是：1) 使用电子健康记录 [EHR] 数据来识别 EOT2D 患者亚组早期疾病控制不充分的风险最高，2) 确定初始 EOT2D 的障碍和促进因素管理，3) 检查患者报告因素之间的前瞻性关联（例如，与疾病相关的因素）痛苦、健康素养）和早期疾病控制不足。拟议的研究将得到以下支持。经验丰富的导师和顾问，以及以下领域的高级培训：1）使用先进的统计建模，2) 定性数据分析，为干预措施的制定提供信息，3) 社会的作用健康的决定因素，4) 实施科学 KPNC 和 DOR 是理想的环境。 KPNC 是一个具有多元化成员资格的综合学习医疗服务系统 4.2 百万人（超过 350,000 名糖尿病患者），DOR 在早期有效培训方面拥有悠久的记录。研究人员，并与附近的研究人员建立了完善的内部研究计划和合作关系提供职业发展所需基础设施的机构以及拟议的研究和培训计划以及出色的指导团队将使 Gopalan 博士能够继续培养技能并生成提交 R01 级提案所需的基础数据在拟议的奖励期的最后几年，Gopalan 博士将完善并实施一项计划中的 R01。干预（基于三个 K23 研究目标的结果进行设计），以改善早期护理新诊断的 EOT2D 患者，并评估其对这个不断增长的高风险患者的早期结果的影响总之，拟议的 K23 奖项将支持 Gopalan 博士的职业发展，并且是对于她获得成为一名成功的独立调查员所需的技能和专业知识至关重要。