Understanding and Addressing Racial Disparities in Guideline-Indicated Management of Symptomatic Peripheral Artery Disease

理解和解决症状性外周动脉疾病指南指示治疗中的种族差异

• 批准号: 10327698
• 负责人: Corey Andrew Kalbaugh
• 金额: $ 13.6万
• 依托单位: CLEMSON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-01-15 至 2022-09-01
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10327698
• 关键词: Abdomen; Address; Advisory Committees; Affect; Appendicitis; Area; Attenuated; Award; Biomedical Engineering; Black Populations; Black race; Blood Vessels; Bypass; Cardiovascular system; Caring; Clinical; Data; Databases; Development; Diabetes Mellitus; Diagnosis; Diagnostic tests; Doctor of Philosophy; Educational workshop; Epidemiologic Methods; Epidemiologist; Epidemiology; Event; Funding; Future; Goals; Guidelines; Health; Healthcare; Implicit Association Test; Inferior; Institution; International; Intervention; Intervention Studies; K-Series Research Career Programs; Limb structure; Link; Literature; Location; Measures; Medicine; Mentored Research Scientist Development Award; Mentors; Mentorship; Methods; Midwestern United States; Morbidity - disease rate; North Carolina; Operative Surgical Procedures; Outcome; Patient Care; Patient-Focused Outcomes; Patients; Pelvic Inflammatory Disease; Peripheral arterial disease; Persons; Pharmaceutical Preparations; Physician' s Role; Physicians; Procedures; Provider; Race; Recommendation; Recording of previous events; Registries; Research; Research Personnel; Research Project Grants; Risk; Role; Sampling; Scholarship; Scientist; Severity of illness; Site; Smoking; Societies; Surgeon; Surveys; System; Test Result; Testing; Time; Training; Treatment outcome; Unconscious State; Universities; Work; acute care; base; black patient; black women; cancer care; cancer health disparity; care delivery; care outcomes; care providers; career; career development; clinical decision support; design; disparity reduction; epidemiology study; experience; health equity; implicit bias; improved; innovation; mortality; pilot test; professor; provider behavior; racial bias; racial disparity; success; successful intervention; support tools; surgery outcome; symposium; tenure track; therapy design

PROJECT SUMMARY AND ABSTRACT I am an Epidemiologist and a tenure-track Assistant Professor in the Department of Surgery at the University of North Carolina at Chapel Hill (UNC). Through scholarship, I will devote my professional career to improving the care and outcomes for people with symptomatic peripheral artery disease (PAD). I have graduate training in Bioengineering (MS, ’03), Medicine, Health and Society (MA, ’10), and Epidemiology (PhD, ’16). While I have exceptional training in epidemiology methods and have a long background of conducting epidemiologic research, the majority of my previous work was in a support role and I want to pivot into areas where I lack training and expertise. The overall goal of this K01 award, therefore, is to provide me with the training and mentorship in disparities and in intervention research aimed at reducing disparities that are critical to becoming an independent scientist. To accomplish this overall goal, I have assembled a team of internationally renowned scholars with expertise in the topics and methods described in my application. My primary mentor is Dr. Samuel Cykert, an expert in health care-related racial disparities and an R01-funded investigator with experience in designing and implementing successful interventions to reduce these disparities. My co-mentor is Dr. Adil Haider, an expert in the role of implicit bias in health care-related racial disparities, and an investigator with a significant history of R-level funding. Dr. Phillip Goodney will lend his expertise and credibility as a senior-level, practicing vascular surgeon and as the Chair of the Vascular Quality Initiative Research Advisory Committee. Each of the three are fully committed to this project and to my success. The research plan is designed to first identify the presence of racial disparities in the delivery of guideline- recommended care using the nationally representative vascular quality initiative registry, a database of vascular procedures performed across 536 locations in the US. Second, I will administer the implicit association test to vascular surgeons to examine implicit racial bias and determine if those biases are correlated with actual clinical results. Finally, I will incorporate the findings from these first components of the research plan into the design of an intervention aimed at reducing disparities in the delivery of PAD-related health care. I will pilot test the intervention by assessing acceptability and utility among surgeons who care for patients with symptomatic PAD. I have recommended coursework, workshops, conferences, and other educational opportunities to round out my training. I have set up five objectives regarding career development and each of these activities is directly related to one or more of those five objectives. The successful completion of this project will lead to an R01 submission designed to test a multi-site intervention and allow me to become an independent investigator who can contribute to health equity in an area where optimal care can attenuate substantial morbidity and mortality.

项目摘要和摘要 我是一名流行病学家，也是加州大学外科系终身教职助理教授。 北卡罗来纳州教堂山(北卡罗来纳州)。通过奖学金，我将把我的职业生涯奉献给提高 对有症状的外周动脉疾病(PAD)患者的护理和预后。我曾接受过研究生培训 生物工程(硕士，‘03)、医学、健康与社会(硕士，’10)和流行病学(博士，‘16)。趁着我有 接受过特殊的流行病学方法培训，并具有长期从事流行病学工作的背景 研究，我之前的大部分工作都是支持角色，我想转移到我缺乏的领域 培训和专业知识。因此，这个K01奖项的总体目标是为我提供培训和 指导差异和旨在减少差异的干预研究，这些差异对实现 一个独立的科学家。为了实现这一总体目标，我组建了一支国际知名的团队 在我的申请中描述的课题和方法方面具有专业知识的学者。我的主要导师是Dr。 塞缪尔·塞克特，医疗保健相关种族差距专家，R01资助的调查员， 在设计和实施成功的干预措施以缩小这些差距方面的经验。我的合作导师 阿迪尔·海德尔博士是一位研究隐性偏见在医疗保健相关种族差异中的作用的专家，也是一位 具有重要的R级资助历史的调查员。菲利普·古德尼博士将提供他的专业知识和 作为一名高级执业血管外科医生和血管质量倡议主席的信誉 研究咨询委员会。这三个人中的每一个都完全致力于这个项目和我的成功。这个 研究计划旨在首先确定在交付指南时存在的种族差异- 使用具有全国代表性的血管质量倡议登记数据库进行推荐护理 在美国的536个地点进行了血管手术。第二，我会管理隐含的 血管外科医生的关联测试，以检查隐含的种族偏见，并确定这些偏见是否 与实际临床结果相关。最后，我将结合来自以下第一部分的发现 旨在减少与PAD相关的分娩差异的干预措施设计研究计划 医疗保健。我将通过评估关心的外科医生的可接受性和实用性来试行干预措施 有症状性PAD的患者。我推荐了课程作业、研讨会、会议和其他 接受教育的机会使我的训练更加充实。关于职业发展，我设定了五个目标 这些活动中的每一项都与这五个目标中的一个或多个直接相关。成功者 这个项目的完成将导致R01提交旨在测试多站点干预并允许我 成为一名独立的调查员，能够在最佳医疗保健领域为卫生公平做出贡献 减少大量的发病率和死亡率。