Building methods to assess and address cardiovascular health in transgender adults

项目摘要： 以当前用于解决和预防动脉粥样硬化性心血管疾病的预测模型为指导 (CVD)，拟议的项目调查性别认同和激素治疗如何与 跨性别成年人的心血管健康。该项目的三个具体目标是：1）评估一个强大的 在索赔数据中识别跨性别者的方法，并将此方法与金标准进行比较 Fenway Health是一家联邦合格的健康中心，也是跨性别者的领导者。 健康; 2）评估CVD的当前预测模型（即，合并队列风险评估方程），使用 C统计，净重新分类，和综合歧视指数的跨性别个人的会计 出生时的性别分配、性别认同和外源激素的使用。（3）检查知识 160名变性成年人对激素治疗相关潜在风险的态度， 影响心血管健康的干预措施的感知障碍、促进因素和可接受性。完成 拟议的目标将：1）提高行政数据研究的准确性; 2）加强临床 寻求激素治疗的变性成年人的决策;和3）告知风险缓解策略， 改善变性成年人的心血管健康。通过与Emelia博士一起参与指导研究 本杰明（导师）、迈克尔·帕舍-奥罗（导师）、霍华德·卡布拉尔（导师）和萨里·赖斯纳（导师），以及 合作者，完成课程，并参加研讨会，会议和定期指导 会议，我将在四个新的领域发展专业知识，这对我作为一名独立临床医生的发展至关重要- 科学家评估健康结果，以表征和减轻变性人的心血管疾病风险：1） 分析基于索赔和电子健康记录数据的定量方法; 2）定量方法， 评估预测模型; 3）跨性别内分泌学，心脏病学和预防护理的临床技能;以及4） 定性研究和社区参与技能。此外，我将延长我的赠款写作和口头 通过参加赠款写作课程和在研究会议上发表演讲， 研讨会等波士顿大学为初级学者提供他们所需的智力和实践资源， 发展成为成功的独立调查员，包括初级教师研讨会，赠款写作，编辑， 审查服务，以及与高级同事进行知识交流和合作的机会。A K01 该奖项将为我提供研究经验，技能和指导，我需要建立一个尖端的 独立的研究计划，评估和解决心血管健康的性和性别 少数群体，特别是跨性别成年人。

Project Summary: Guided by current prediction models utilized to address and prevent atherosclerotic cardiovascular disease (CVD), the proposed project investigates how gender identity and hormone therapy are related to cardiovascular health in transgender adults. The projects three specific aims are to: 1) evaluate a robust method of identifying transgender individuals within claims data and compare this method to the gold-standard of self-identification with data from Fenway Health, a federally qualified health center and leader in transgender health; 2) assess current prediction models for CVD (i.e., Pooled Cohort Risk Assessment Equation) utilizing C statistics, net reclassification, and integrated discrimination index for transgender individuals by accounting for sex assigned at birth, gender identity, and use of exogenous hormones.; and 3) examine the knowledge and attitudes of 160 transgender adult regarding potential risks associated with hormone therapy and perceived barriers, facilitators, and acceptability of interventions affecting cardiovascular health. Completing the proposed aims will 1) improve the accuracy of research with administrative data; 2) enhance clinical decision-making for transgender adults seeking hormone therapy; and 3) inform risk mitigation strategies to improve cardiovascular health of transgender adults. By engaging in mentored research with Drs. Emelia Benjamin (Mentor), Michael Paasche-Orlow (Mentor), Howard Cabral (Mentor), and Sari Reisner (Mentor), and collaborators, completing coursework, and participating in seminars, conferences, and regular mentoring meetings, I will develop expertise in four new areas critical to my development as an independent clinician- scientist evaluating health outcomes to characterize and mitigate CVD risks for transgender individuals: 1) Quantitative methods to analyze claims-based & electronic health record data; 2) Quantitative methods to assess prediction models; 3) Clinical skills in transgender endocrinology, cardiology, & preventive care; and 4) Qualitative research & community engagement skills. Moreover, I will extend my grant writing and oral presentation skills by participating in grant writing courses and presenting at research meetings and seminars. Boston University offers junior scholars with the intellectual and practical resources they need to develop into successful independent investigators, including junior faculty seminars, grant writing, editing, and review services, and opportunities for intellectual exchange and collaboration with senior colleagues. A K01 award will provide me with the research experience, skills, and mentorship I need to build a cutting-edge independent research program that assesses and addresses cardiovascular health in sexual and gender minorities, particularly transgender adults.