ASSIST - Address Self-Management Strategies to Improve and Sustain T2D outcomes for adults with comorbid chronic pain and type 2 diabetes in the South

ASSIST - 制定自我管理策略，以改善和维持南方患有慢性疼痛和 2 型糖尿病共病的成年人的 T2D 结局

• 批准号: 10809124
• 负责人: Suzanne E Judd
• 金额: $ 22.95万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCIENCE CENTER
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-05-15 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10809124
• 关键词: Accelerometer; Address; Adherence; Adult; Alabama; American; Appalachian Region; Attitude; Behavior; Belief; Black race; Blood Glucose; Blood Vessels; Cessation of life; Cholesterol; Chronic; Chronic Disease; Communities; Community Health Aides; Complex; Complications of Diabetes Mellitus; County; Data; Development; Diabetes Mellitus; Diet; Disease; Economic Burden; Education; Ensure; Etiology; Exercise; Eye; Feedback; Foundations; Funding; Goals; Green space; Guidelines; Health; Health Promotion; Heart; Heart Diseases; Heart Rate; High Prevalence; Home; Housing; Hypertension; Income; Individual; Intervention; Interview; Kidney; Knowledge; Life Style; Mental Depression; Metabolic Diseases; Mississippi; Monitor; Morbidity - disease rate; Nerve; Non-Insulin-Dependent Diabetes Mellitus; Not Hispanic or Latino; Outcome; Pain; Participant; Patients; Perception; Persistent pain; Personal Satisfaction; Persons; Pharmaceutical Preparations; Physical Function; Physical activity; Population; Psychological Factors; Psychological Impact; Psychosocial Factor; Quality of life; Questionnaires; Recommendation; Recording of previous events; Recurrent pain; Reduce health disparities; Resources; Risk; Risk Factors; Rural; Rural Community; Self Management; Sleep; Social support; Stroke; Structure; Technology; Underserved Population; burden of illness; chronic pain; chronic pain management; community partnership; comorbidity; design; diabetes self-management; electronic consent; emotional functioning; feasibility testing; food desert; glucose monitor; glycemic control; improved; insight; mHealth; mortality; multiphase optimization strategy; parent grant; perceived stress; pharmacologic; premature; prevent; primary health service; psychosocial; recruit; resilience; resilience factor; rural dwellers; rural health disparities; smartphone application; social; social cognitive theory; syndemic; theories; treatment planning; usability

PROJECT SUMMARY Rural communities are laden with high rates of multiple syndemic health conditions, contributing to an excess burden of disease. This is particularly salient in the Southern regions of the Appalachia and Mississippi Delta regions, where there is a high proportion of underserved groups (e.g., rural dwellers), and underlying social (e.g., income, education, housing), and environmental (e.g., food deserts, green space/safe spaces, access to primary health care services) risk factors, which may increase the likelihood of developing chronic diseases, such as diabetes and other health conditions. Chronic pain, a persistent or recurring pain that lasts more than three months, is a common condition among U.S. adults that negatively impacts quality of life, wellbeing, and causes considerable economic burdens. This condition has a complex etiology, impacts physical and emotional function, and has a varied approach to treatment and management. Approximately 34 million Americans have diabetes, and approximately 50-70% of the U.S. adult population with diabetes also suffer from chronic pain. Diabetes, a metabolic disorder characterized by high levels of blood glucose, may cause serious damage to the heart, blood vessels, eyes, kidneys, and nerves. The co-occurrence of chronic pain and type 2 diabetes is marked by decreased physical function, lower quality of life, and depression, which may increase the onset of heart disease, stroke, as well as exacerbate other risk factors such as high blood pressure or high cholesterol. Ample evidence suggests treatment and self-management strategies (e.g., glucose monitoring, diet, exercise) for diabetes are effective with proper adherence to recommended guidelines. However, managing chronic pain and diabetes can undermine a person's ability to engage in recommended diabetes self-management activities as it often leads to elevated blood glucose levels. Technology has the potential to support self-management strategies and reduce health disparities for rural dwellers, but only if designed for the specific and unique needs of the community. Therefore, the proposed project will examine the psychological factors, psychosocial risk, and resilience factors associated with premature morbidity and mortality of comorbid diabetes and chronic pain in the rural South, with the goal of improving type 2 diabetes outcomes (e.g., glycemic control, quality of life, and preventing or reducing diabetes complications). Additionally, we will examine the utility and the potential leveraging power of technology (i.e., wearable activity monitors) to further examine barriers and facilitators to self-management strategies and general health promoting behaviors among rural dwellers in the South.

项目摘要 农村社区载有高度综合健康状况的高率，导致了多余的 疾病负担。这在阿巴拉契亚州和密西西比三角洲的南部地区尤为重要 在服务不足的群体（例如农村居民）和基本社会的地区（例如， 收入，教育，住房）和环境（例如，食品沙漠，绿色空间/安全空间，进入主要的空间 医疗保健服务）风险因素，这可能会增加发展慢性疾病的可能性，例如 糖尿病和其他健康状况。 慢性疼痛，一种持续超过三个月的持续或经常性疼痛，是一个普遍的状况 负面影响生活质量，福祉并造成巨大经济负担的美国成年人。这 病学具有复杂的病因，影响身体和情感功能，并且具有多样的方法 治疗和管理。大约有3400万美国人患有糖尿病，约占50-70％ 美国成年人糖尿病人群也患有慢性疼痛。糖尿病，一种代谢障碍 以高水平的血糖为特征，可能对心脏，血管，眼睛， 肾脏和神经。慢性疼痛和2型糖尿病的同时出现以降低的身体标志 功能，较低的生活质量和抑郁症，可能会增加心脏病的发作，中风以及 加剧其他危险因素，例如高血压或高胆固醇。 充分的证据表明治疗和自我管理策略（例如，葡萄糖监测，饮食，运动） 对于糖尿病，有效地遵守建议的准则。但是，管理慢性疼痛 糖尿病可能会破坏一个人从事推荐糖尿病自我管理活动的能力 由于它通常会导致血糖水平升高。技术有可能支持自我管理 策略并减少农村居民的健康差异，但只有在为特定和独特的需求设计时才 社区。因此，拟议的项目将检查心理因素，社会心理风险和 与合并症糖尿病和慢性疼痛过早发病率和死亡率相关的弹性因素 南方农村，目的是改善2型糖尿病结果（例如，血糖控制，生活质量和 预防或减少糖尿病并发症）。此外，我们将检查效用和潜力 利用技术的力量（即可穿戴活动监视器）进一步检查障碍和促进者 南方农村居民之间的自我管理策略和一般健康促进行为。

项目成果

The Molecular Basis of Predicting Atherosclerotic Cardiovascular Disease Risk.

• DOI: 10.1161/circresaha.120.315890
• 发表时间: 2021-01-22
• 期刊: Circulation research
• 影响因子: 20.1
• 作者: Nayor M;Brown KJ;Vasan RS
• 通讯作者: Vasan RS

The southern rural health and mortality penalty: A review of regional health inequities in the United States.

• DOI: 10.1016/j.socscimed.2020.113443
• 发表时间: 2021-01
• 期刊: Social science & medicine (1982)
• 作者: Miller CE;Vasan RS
• 通讯作者: Vasan RS

Differences in estimates for 10-year risk of cardiovascular disease in Black versus White individuals with identical risk factor profiles using pooled cohort equations: an in silico cohort study.

• DOI: 10.1016/s2589-7500(21)00236-3
• 发表时间: 2022-01
• 期刊: The Lancet. Digital health
• 作者: Vasan RS;van den Heuvel E
• 通讯作者: van den Heuvel E

Closing the Last Mile Gap in Access to Multimodality Imaging in Rural Settings: Design of the Imaging Core of the Risk Underlying Rural Areas Longitudinal Study.

缩小农村环境中获得多模态成像的最后一英里差距：农村地区纵向研究风险的成像核心设计。

• DOI: 10.1161/circimaging.123.015496
• 发表时间: 2024
• 期刊: Circulation. Cardiovascular imaging
• 作者: Fazlalizadeh,Hooman;Khan,MuhammadShahzeb;Fox,ErvinR;Douglas,PamelaS;Adams,David;Blaha,MichaelJ;Daubert,MelissaA;Dunn,Gary;vandenHeuvel,Edwin;Kelsey,MichelleD;Martin,RandolphP;Thomas,JamesD;Thomas,Yngvil;Judd,SuzanneE

Life Course Developmental Approach to Cardiovascular Health and Cardiovascular Disease Prevention: Opportunities and Unanswered Questions.

• DOI: 10.1016/j.jacc.2020.10.011
• 发表时间: 2020-12-08
• 期刊: Journal of the American College of Cardiology
• 影响因子: 24
• 作者: Vasan RS;Zachariah JP;Xanthakis V
• 通讯作者: Xanthakis V