Building methods to assess and address cardiovascular health in transgender adults

建立评估和解决跨性别成人心血管健康的方法

• 批准号: 10392856
• 负责人: Carl G Streed
• 金额: $ 16.63万
• 依托单位: BOSTON MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-15 至 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10392856
• 关键词: Accounting; Address; Adult; Affect; Algorithms; Area; Atherosclerosis; Attitude; Birth; Boston; Cardiology; Cardiovascular Diseases; Caring; Cessation of life; Clinical Skills; Code; Collaborations; Consolidated Framework for Implementation Research; Data; Data Analyses; Data Collection; Development; Diabetes Mellitus; Diagnosis; Discrimination; Disease Outcome; Disease model; Electronic Health Record; Endocrinology; Equation; Exogenous Hormone Therapy; Faculty Workshop; Federally Qualified Health Center; Female; Future; Gender; Gender Identity; Goals; Gold; Grant; Health; Hormone use; Hormones; Hyperlipidemia; Hypertension; Individual; Institutes; Intervention; Intramuscular; K-Series Research Career Programs; Knowledge; Mentored Research Scientist Development Award; Mentors; Mentorship; Methods; Modeling; Morbidity - disease rate; Myocardial Infarction; National Heart, Lung, and Blood Institute; Oral; Outcome; Patients; Persons; Play; Population; Preventive care; Primary Prevention; Procedures; Qualitative Research; Recommendation; Records; Research; Research Personnel; Resources; Review Literature; Risk; Risk Assessment; Risk Factors; Risk Management; Role; Route; Scientist; Sensitivity and Specificity; Services; Sexual and Gender Minorities; Site; Statistical Models; Stroke; Surveys; Tobacco; Tobacco use; Training; United States National Institutes of Health; Universities; Writing; base; cardiovascular disorder risk; cardiovascular health; cis-female; cis-male; cisgender; clinical decision-making; cohort; community engagement; comorbidity; data warehouse; experience; follow-up; gender minority; hormone therapy; implementation science; improved; indexing; male; meetings; mortality; multidisciplinary; novel; predictive modeling; prevent; programs; recruit; risk mitigation; risk prediction model; sex; skills; statistics; success; symposium; transgender; transgender men; transgender women

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.

项目概要： 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），拟议项目调查性别认同和激素治疗如何与 跨性别成人的心血管健康。该项目的三个具体目标是：1）评估稳健的 在索赔数据中识别变性人的方法，并将该方法与黄金标准进行比较 使用 Fenway Health 的数据进行自我认同，Fenway Health 是一家联邦合格的健康中心，也是变性人领域的领导者 健康; 2) 利用以下方法评估当前的 CVD 预测模型（即合并队列风险评估方程） C 跨性别者的统计、净重分类和综合歧视指数 出生时指定的性别、性别认同和外源激素的使用。 3）检查知识 160 名跨性别成人对激素治疗和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。正在完成 拟议的目标将 1) 提高行政数据研究的准确性； 2）加强临床 寻求激素治疗的跨性别成年人的决策； 3) 告知风险缓解策略 改善跨性别成年人的心血管健康。通过与博士一起参与指导研究。埃米莉亚 本杰明（导师）、Michael Paasche-Orlow（导师）、Howard Cabral（导师）和 Sari Reisner（导师），以及 合作者、完成课程作业、参加研讨会、会议和定期指导 在会议上，我将在四个新领域发展专业知识，这对我作为独立临床医生的发展至关重要- 科学家评估健康结果，以描述和减轻跨性别者的 CVD 风险：1) 分析基于索赔的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、心脏病学和预防保健方面的临床技能；和 4) 定性研究和社区参与技能。此外，我将扩展我的资助写作和口头 通过参加资助写作课程和在研究会议上演讲来提高演讲技巧 研讨会。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研究者，包括初级教师研讨会、资助写作、编辑和 评审服务以及与资深同事进行知识交流和合作的机会。一个K01 该奖项将为我提供建立尖端研究所需的研究经验、技能和指导 评估和解决性和性别心血管健康问题的独立研究计划 少数群体，特别是跨性别成年人。