Hypertension Self-management in Refugees Living in San Diego

居住在圣地亚哥的难民的高血压自我管理

基本信息

批准号：
10449102
负责人：
Tala Al-Rousan
金额：
$ 17.64万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN DIEGO
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-06-01 至 2025-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10449102
关键词：
Address Affect Age Antihypertensive Agents Awareness Biometry Blood Pressure Cardiovascular Diseases Cardiovascular system Caring Clinical Research Clinical Trials Communities Complex Country County Data Deterioration Development Diagnosis Disadvantaged minority Educational workshop Epidemiology Evaluation Evidence based intervention Face Feasibility Studies Foundations Future Gender Goals Health Health Expenditures Health Knowledge Attitudes Practice Health Personnel Home Home Blood Pressure Monitoring Hypertension Immigrant Instruction Intervention Intervention Studies Iraq Knowledge Language Learning Literature Location Mentored Patient-Oriented Research Career Development Award Mentors Mentorship Methods Migrant Minority Groups Modeling Monitor Myocardial Infarction National Heart, Lung, and Blood Institute Outcome Outcome Measure Pathway Analysis Patients Pharmaceutical Preparations Population Positioning Attribute Prevention Protocols documentation Quality of life Randomized Clinical Trials Reading Refugee Camp Refugees Religion Research Research Infrastructure Research Personnel Research Priority Research Project Grants Rest Science Self Management Self Medication Social Network Somalia Specific qualifier value Stress Stroke Structure Time Titrations Training Training Activity Treatment Cost Treatment Efficacy Trust Ursidae Family Vulnerable Populations Work acceptability and feasibility base blood pressure control cardiovascular disorder risk cardiovascular health cardiovascular risk factor career community intervention cost effective design disease disparity effectiveness research empowered empowerment epidemiology study ethnic minority evidence base experience health care availability health disparity health inequalities health literacy hypertension control implementation research improved migration multilevel analysis novel patient oriented research patient population perceived discrimination preservation racial minority responsible research conduct satisfaction skills social determinants social health determinants success theories tool

项目摘要

Project Summary The proposed Mentored Patient-Oriented Research Career Development Award (K23) is to provide the candidate with training and research experiences that will promote her development as an independent clinician-researcher, with particular emphasis in the field of intervention research addressing hypertension control, specifically self-management (home blood pressure monitoring and self-titration of medications) as a tool to deal with cardiovascular disparities related to displacement in refugees. This training will provide her with the opportunity to develop knowledge and skills in: 1) hypertension epidemiology and disparities focusing on migration as a social determinant of health,; 2) acquire knowledge in the theory, development, implementation, and adaptation of theoretically driven community-based interventions to improve blood pressure (BP) control through self-management; 3) acquire skills in qualitative (social network analysis) multilevel modeling of longitudinal data to assess the efficacy of interventions and hypertension self- management clinical trials. Training activities will include didactic coursework and specific workshops, directed readings, one-on-one tutorials with mentors, and instructions in the responsible conduct of research that focuses on vulnerable populations. The candidate will capitalize on her previous clinical and research experience with refugees, and leverage mentorship from a Training Committee comprised of globally renowned experts in the fields of CVD disparities, community interventions, hypertension trials, social determinants of immigrant health, and advanced biostatistics. The present K23 research project emerges from the existing research infrastructure and extensive experience of her mentors’ self-management trials in CVD disparities, epidemiological research and clinical trials, to carve out a niche for me to specialize in CVD clinical trials and prevention in refugees and vulnerable immigrants. The specific aims are to conduct a structured feasibility study through: 1) Understanding knowledge, attitudes and behaviors related to self-management of hypertension among refugees; 2) Developing, adapting and implementing a culturally-sensitive hypertension self-management intervention in refugees in San Diego; and 3) Identifying factors affecting the feasibility and acceptability of such an intervention to estimate effect sizes and outcome measures to be used in a future powered trial. This work will lay strong foundations for the first powered randomized clinical trial of refugee hypertension self-management ever conducted. While the specified initial goal of this work is to adapt an evidence-based hypertension self-management intervention model adapted from recent large clinical trials, we hypothesize that this intervention will be feasible in refugees; they can do it, accept it and give us leads on designing a future clinical trial to learn more about CVD disparities science and implementation research. The candidate’s longer-term goal is to develop expertise necessary to become a leading trialist in understanding and addressing cardiovascular health disparities.

项目概要拟议的以患者为导向的研究职业发展奖（K23）旨在提供具有培训和研究经验的候选人将促进她作为独立的发展临床医生兼研究员，特别侧重于高血压干预研究领域控制，特别是自我管理（家庭血压监测和自我滴定药物）作为这次培训将为她提供解决与难民流离失所有关的心血管差异的工具。有机会发展以下方面的知识和技能：1）高血压流行病学和差异重点关于移徙作为健康的社会决定因素；2) 获取理论、发展方面的知识，实施和调整理论上驱动的基于社区的干预措施以改善血液通过自我管理控制压力（BP）；3）获得定性（社交网络分析）技能纵向数据的多级建模，以评估干预措施和高血压自我评估的效果管理临床试验。培训活动将包括指导性课程和具体研讨会。阅读材料、与导师一对一的辅导以及负责任地进行研究的指导候选人将重点关注弱势群体。与难民打交道的经验，并利用由全球成员组成的培训委员会的指导 CVD 差异、社区干预、高血压试验、社会干预等领域的知名专家目前的 K23 研究项目源于移民健康的决定因素和先进的生物统计学。现有的研究基础设施和导师在心血管疾病自我管理试验中的丰富经验差异、流行病学研究和临床试验，为我专门从事心血管疾病临床研究开辟了一个利基对难民和弱势移民进行审判和预防的具体目标是开展结构化的工作。可行性研究通过： 1) 了解与自我管理相关的知识、态度和行为难民高血压；2) 制定、调整和实施文化敏感的高血压对圣地亚哥难民进行自我管理干预；以及 3) 确定影响可行性的因素和这种干预措施的可接受性，以估计未来使用的效果大小和结果衡量标准这项工作将为难民的首次动力随机临床试验奠定坚实的基础。虽然这项工作的具体初始目标是适应高血压自我管理。基于证据的高血压自我管理干预模型改编自最近的大型临床试验，我们坚持这种干预措施对难民是可行的；他们可以做到、接受并为我们提供线索；设计未来的临床试验，以了解有关 CVD 差异科学和实施研究的更多信息。候选人的长期目标是发展成为理解领域领先试用者所需的专业知识并解决心血管健康差异问题。