Developing and testing Collaborative Quality ImProvement initiative (C-QIP) for prevention of cardiovascular disease in India

制定和测试印度预防心血管疾病的协作质量改进计划 (C-QIP)

• 批准号: 10160984
• 负责人: Kavita Singh
• 金额: $ 6.87万
• 依托单位: PUBLIC HEALTH FOUNDATION OF INDIA
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-27 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10160984
• 关键词: Adherence; Administrator; Adrenergic beta-Antagonists; Age; Angiotensin-Converting Enzyme Inhibitors; Asia; Aspirin; Award; Cardiovascular Agents; Cardiovascular Diseases; Cardiovascular system; Caring; Case Manager; Cause of Death; Cessation of life; Characteristics; Chronic; Chronic Care; Clinic; Clinical; Clinical Decision Support Systems; Clinical Research; Collaborations; Complement; Complex; Computer software; Country; Decision Aid; Development; Disease Outcome; Economics; Educational workshop; Effectiveness; Enrollment; Epidemic; Europe; European; Evaluation; Event; Feedback; Foundations; Future; Goals; Government; Grant; Growth; Guidelines; Health; Health Care Costs; Health Personnel; Health Services Research; Health system; Healthcare; Healthcare Systems; Heart failure; Heterogeneity; Income; India; Individual; Infrastructure; Infrastructure Activities; Institution; International; Intervention; Knowledge; Lead; Learning; Life Style; Measures; Medical Research; Mentors; Mission; Modeling; Morbidity - disease rate; Myocardial Infarction; Myocardial Ischemia; Online Systems; Outcome; Outpatients; Participant; Patient Care; Patients; Pharmaceutical Preparations; Physical activity; Pilot Projects; Premature Mortality; Prevention; Prevention program; Privatization; Process; Process Measure; Program Evaluation; Provider; Quality of Care; Quality of life; Recurrence; Reporting; Research; Research Ethics; Research Personnel; Research Training; Resources; Risk; Rural; Secondary Prevention; Source; South Asian; Southeastern Asia; Standardization; Stroke; Testing; Text Messaging; Time; Training; United Kingdom; United States; United States National Institutes of Health; World Health Organization; adherence rate; base; burden of illness; cardiovascular disorder epidemiology; cardiovascular disorder prevention; cardiovascular disorder therapy; cardiovascular health; care costs; care delivery; career; career development; chronic care model; cost; disability; effective intervention; efficacy trial; epidemiology study; experience; feasibility testing; global health; good diet; group intervention; health care delivery; health related quality of life; healthy lifestyle; implementation fidelity; implementation science; improved; improved outcome; innovation; international center; knowledge translation; lifestyle intervention; literacy; low and middle-income countries; mHealth; mortality; multidisciplinary; novel; productivity loss; programs; prospective; smoking cessation; social; stress management; treatment as usual; trial comparing

PROJECT SUMMARY/ABSTRACT The proposed K43 application aims to develop, implement, and evaluate a Collaborative Quality ImProvement (C-QIP) intervention (non-physician health worker, text messages for healthy lifestyle and clinical decision-support system) effect on processes of care measures and clinical outcomes among individuals with existing CVD in India using United Kingdom Medical Research Council (MRC) framework for developing and evaluating complex interventions. A growing body of research suggests several factors at the level of the patient, provider, and health system may effectively lower the impact of CVD in India, such as literacy, increased time spent with patients, and integrated health care. Maximizing CVD treatment in India must involve a cascade of processes from appropriate prescribing to longer-term adherence as well as low(er)-cost health service delivery innovations such as non-physician health workers and interactive web-based or mHealth-based clinical decision-support system for providers and patients. Multifaceted quality improvement intervention (including but not limited to non-physician health worker/case managers, team-based care, SMS reminders, interactive decision-aids for patients and providers, audit-and feedback mechanisms) have been successful in high-income countries for improving care among individuals with existing CVD, but have not been extensively evaluated in India. These interventions could be sources of innovation in CVD prevention, treatment, and control through implementation science research. During the career development period of this award, I will take courses in research ethics, program evaluation, and health services research to complement my prior training. I will participate in training, or workshops organized by the World Health Organization SEARO (South-East Asia Regional Office), to learn about the development of evidence-informed clinical standards and guidelines adapted to local country settings and healthcare systems. My unique background and training will serve as a strong foundation for the present proposal and for future career development as an independent, innovative investigator and leader in global CVD research. In 10 years, I envision myself as an India-based clinical researcher in global CVD epidemiology and prevention, with a focus in South Asia. My current and future training, institution, and mentoring team provide me excellent platform to discover novel ideas about improving cardiovascular health and ultimately disseminate and deliver them globally, including in the US. The NIH K43 grant can provide me the mentored clinical research training and research opportunities to pursue my career goals. Relevance Development of local solutions to improving CVD care by Indian practitioners may provide innovative ideas that are relevant to and applicable in the US. As such, this proposal aims to improve the delivery of chronic care for patients with CVD in India and capture the innovative potential of global health, a thematic goal of the NIH and part of the strategic mission of the Fogarty International Centre.

项目总结/文摘