REDUCING DISPARITIES IN URINARY CONTROL SYMPTOMS FOR MINORITY WOMEN

减少少数族裔女性排尿控制症状的差异

基本信息

批准号：
10908915
负责人：
James William Griffith
金额：
$ 28.16万
依托单位：
UNIVERSITY OF CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-08-17 至 2025-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10908915
关键词：
Adherence Anxiety Behavior Therapy Behavioral Bladder Control Body Weight decreased Chicago Client satisfaction Clinical Cognitive Therapy Communication Communities Community Health Community Health Aides Data Diet Modification Disease Disparity Educational Curriculum Epidemiologist Funding Future Health Services Accessibility Healthcare Home Hospitals Human Incontinence Insurance Coverage Intervention Interview Knowledge Lead Left Low income Manipulative Therapies Measures Mediating Medicaid Medicare Mental Depression Mental Health Minority Minority Health Research Minority Women National Institute of Diabetes and Digestive and Kidney Diseases Observational Study Operative Surgical Procedures Outcome Participant Patient-Focused Outcomes Patients Pelvic floor structure Persons Physical Exercise Physical therapy Physical therapy exercises Population Study Post-Traumatic Stress Disorders Private Practice Process Psychologist Psychology Quality of life Questionnaires Recommendation Reporting Research Research Design Research Personnel Sampling Self Administration Self Direction Self Management Symptoms Therapeutic Intervention Time Training Travel Treatment Efficacy Treatment Protocols Urinary Incontinence Urology Woman Writing barrier to care behavioral health care burden care seeking community based treatment copayment cost disparity reduction efficacy evaluation efficacy study efficacy testing efficacy trial evidence base feasibility testing feasibility trial handbook health literacy human centered design improved incontinence symptom innovation lifetime risk lower urinary tract symptoms micturition urgency physical therapist programs prospective response sexual trauma standard care urologic

项目摘要

Urinary incontinence and lower urinary tract symptoms (UI/LUTS) are a major healthcare burden. Unfortunately, there are large disparities in knowledge, access to treatment and inclusion in research for minority women with UI/LUTS. One important disparity is the lack of access to evidence-based, non-surgical treatment options (e.g., diet and behavioral modification, weight loss and physical therapy (PT)). Minority women often to not have access to safer, conservative interventions due to poor access and insurance coverage. Additionally, UI/LUTS lead to anxiety and depression, which our preliminary studies have shown, exacerbate organic UI/LUTS symptoms. Given the barriers to accessing PT and the behavioral and mental health impacts on UI/LUTS, this project will evaluate the feasibility and efficacy of a culturally-specific, home- based, community health-worker (CHW) supported, conservative intervention for UI/LUTS. The SUPPORT intervention will include self-managed cognitive behavioral therapy (CBT), behavioral modifications and self-directed physical therapy exercises. We propose to adapt our clinician-guided CBT for UI/LUTS to a self-managed CBT curriculum supplemented with self-directed PT and behavioral retraining and support from a CHW. Our intervention will test the feasibility, efficacy, adherence and acceptability of an intervention like this is in a large, publicly funded hospital in Chicago. Over 4 years, we aim to 1) write a home CBT and PT handbook that is sensitive to patient culture and health literacy and can be followed by the patient at home over 8 weeks to improve UI/LUTS; 2) to determine the efficacy of this intervention in treating UI/LUTS and the acceptability and adherence to this program of our participants. We hypothesize that SUPPORT therapy will significantly improve UI/LUTS and will be satisfying and feasible for patients to complete.

尿失禁和较低的尿路症状（UI/LUTS）是主要的医疗负担。不幸的是，知识的差异很大，可以接受UI/LUTS的少数族裔女性的研究。一个重要的差异是缺乏获得基于证据的非手术治疗方案（例如饮食和行为修改，体重减轻和物理治疗（PT））的机会。少数族裔妇女通常由于获得不良和保险范围而无法获得更安全，保守的干预措施。此外，UI/LUTS导致焦虑和抑郁症，我们的初步研究表明，有机UI/LUTS症状加剧。鉴于访问PT的障碍以及对UI/LUTS的行为和心理健康的影响，该项目将评估对UI/LUTS的文化特异性，基于家庭的，社区健康工人（CHW）支持，保守的干预的可行性和功效。支持干预措施将包括自我管理的认知行为疗法（CBT），行为修改和自我指导的物理疗法练习。我们建议将我们的临床医生指导的CBT适应UI/LUTS，以补充有自我指导的PT以及CHW的行为重新培训和支持的自我管理的CBT课程。我们的干预措施将测试这样的干预措施的可行性，功效，依从性和可接受性。在4年的时间里，我们的目标是1）写一本对患者文化和健康素养敏感的家庭CBT和PT手册，可以在8周内患者在家中遵循以改善UI/LUTS； 2）确定这种干预措施在治疗UI/LUTS以及对参与者计划的可接受性和遵守性方面的功效。我们假设支持疗法将显着改善UI/LUTS，并且可以使患者满足和可行。