Impact of Health-related Social Needs on Dialysis Outcomes

项目摘要 博士泰莎·诺维克是纽约大学肾脏病学系内科助理教授， 德克萨斯州奥斯汀戴尔医学院，是一名肾病学家，训练有素的社会工作者和健康服务研究员 他的职业目标是成为一名独立的研究者，从事以患者为导向的研究， 为患有肾病的边缘化人群提供护理。该K23奖项将为Novick博士提供培训， 在以下领域的指导研究经验：（1）利用互补的先进流行病学和 定性方法，以了解问题的范围和性质，为干预措施提供信息;（2）健康 差异和基于社区的参与性研究;（3）干预和临床试验开发， 执行和解释。为了实现这些目标，诺维克博士组建了一个指导团队， 主要共同导师：Deidra Crews博士，肾内科副教授， 约翰霍普金斯大学，谁是国际公认的领导者，在肾脏疾病的差距， 伊丽莎白·雅各布斯博士，德克萨斯大学内科学教授 她在奥斯汀戴尔医学院，因其调查医疗差距的工作而受到国际认可， 采取干预措施，解决健康的社会决定因素，并促进文化上胜任的保健， 人口。建议的指导研究的重点是了解与健康有关的社会 终末期肾病（ESKD）患者的需求会影响他们的护理以及如何解决这些需求。 ESKD影响超过70万美国人，需要大量的患者参与才能实现 最佳结果。与健康有关的社会需求是个人层面的健康社会决定因素，例如 住房不稳定、粮食不安全、交通和公用事业需要。诺维克博士假设与健康有关的 社会需求削弱了患者的参与度，并与较高的急性护理利用率和死亡率相关。博士 Novick进一步假设，透析患者将确定可接受的干预措施，以解决与健康相关的 社会需求，以及利用社区卫生工作者在一般人群中测试的干预措施， 在透析人群中，组织将患者与社区资源联系起来是可行的。诺维克医生会 使用一系列补充研究来测试这些假设，这些研究（1）利用退伍军人健康数据， 管理和美国肾脏数据系统;（2）使用 定性研究方法;（3）完善使用社区卫生工作者的干预措施， 透析患者的社区资源。

PROJECT SUMMARY Dr. Tessa Novick, an Assistant Professor of Internal Medicine in the Division of Nephrology at the University of Texas at Austin Dell Medical School, is a nephrologist, trained social worker and health services researcher whose career goal is to become an independent investigator in patient-oriented research focused on improving care for marginalized populations with kidney disease. This K23 award will provide Dr. Novick with training and mentored research experience in the following areas: (1) using complementary advanced epidemiological and qualitative methods to understand the scope and nature of a problem to inform interventions; (2) health disparities and community based participatory research; (3) intervention and clinical trial development, execution and interpretation. To achieve these goals, Dr. Novick has assembled a mentoring team comprised of primary co-mentors: Dr. Deidra Crews, Associate Professor of Medicine in the Division of Nephrology at Johns Hopkins University, who is an internationally recognized leader in kidney disease disparities and interventions to address them; Dr. Elizabeth Jacobs, Professor of Internal Medicine at the University of Texas at Austin Dell Medical School, who is internationally regarded for her work investigating health-care disparities, interventions to address social determinants of health, and advancing culturally competent care for diverse populations. The focus of the proposed mentored research is on understanding how health-related social needs of patients with end-stage kidney disease (ESKD) impact their care and how they might be addressed. ESKD affects over 700,000 Americans, and requires substantial patient engagement in order to achieve optimal outcomes. Health-related social needs are individual-level social determinants of health, such as unstable housing, food insecurity, transportation and utility needs. Dr. Novick hypothesizes that health-related social needs impair patient engagement, and are associated with higher acute care utilization and mortality. Dr. Novick further hypothesizes that dialysis patients will identify acceptable interventions to address health-related social needs, and interventions being tested in the general population using community health workers and organizations that bridge patients to community resources are feasible in the dialysis population. Dr. Novick will test these hypotheses using a series of complementary studies that (1) leverage data from the Veterans Health Administration and United States Renal Data System; (2) gain an in-depth understanding of the problem using qualitative research methods; and (3) refine an intervention that uses community health workers to connect dialysis patients with community resources.