Peer Support for Lowering Blood Pressure among Adolescents: A Pilot, Randomized Controlled Trial

摘要 这份K 01职业发展计划是为了支持Shakia哈代博士，一位终身职位助理而制定的。 伯明翰亚拉巴马大学流行病学系教授， 成为一名独立的研究者。候选人于2017年获得流行病学博士学位， 位于查佩尔山的北卡罗来纳州大学，在以下领域发表的研究成果有很好的记录： 心血管和社会流行病学。她的目标是将她的流行病学技能与实施相结合 科学在实施和人口的交叉点开发一个独立的研究计划 科学哈代博士的研究旨在通过以下途径减少心血管疾病的健康差异： 改变生活方式行为，导致早期血压升高。培训：至 为了实现她的总体目标，哈代博士提出了一个密集的指导研究计划，包括 教学教育和经验学习，1）干预发展，2）实施科学， 干预措施的实施和评价，3）随机对照试验的设计和实施，以及4）领导 学术科学家的技能。导师制：一个由著名学者组成的跨学科团队将指导博士。 哈代，并提供持续的指导，因为她过渡到独立。她的指导团队包括一个 主要导师，Andrea Cherrington博士（UAB预防医学系），共同导师，Paul博士 Muntner（UAB流行病学系）、Nathalie Moise博士（哥伦比亚医学系 大学）和丹尼尔菲格博士（医学系，UAB）和两个内容顾问在UAB。中的每 这些导师都完全致力于这个项目和哈代博士的成功。研究：患病率 高血压，定义为收缩压（SBP）≥120 mm Hg或舒张压（DBP）≥80 mm Hg， (20在美国13-17岁的黑人与白色青少年中，的可用性 由于长途旅行，在农村社区，临床环境中降低血压的生活方式行为咨询有限 获得医疗保健的距离，共同支付的资金有限，以及提供者与患者的沟通效率低下。 拟议的K 01通过开发和测试对等体的可行性和可接受性来解决这一差距 支持干预，以降低农村黑人青少年高血压。首先，哈代博士会确认 农村环境的各个方面阻碍了生活方式行为的改变。接下来，使用行为 改变干预发展的车轮，她将开发和试点测试同伴支持干预设计 来解决这些障碍。该项目的成功完成将导致R 01赠款提交测试 在一项多中心随机分组试验中，这种同伴支持干预的有效性，并允许哈代博士 成为一名独立的调查员，为青少年的健康公平做出贡献， 这种改变可以阻止BP和心血管发病率和死亡率的种族差异的发展。

ABSTRACT This K01 career development proposal was developed to support Dr. Shakia Hardy, a tenure track Assistant Professor in the Department of Epidemiology at the University of Alabama at Birmingham (UAB), in her path towards becoming an independent researcher. The Candidate earned her PhD in Epidemiology in 2017 from the University of North Carolina at Chapel Hill and has a strong record of published research in the fields of cardiovascular and social epidemiology. Her goal is to integrate her epidemiology skills with implementation science to develop an independent research program at the intersection of implementation and population science. Dr. Hardy’s research aims to reduce health disparities in cardiovascular disease through the modification of lifestyle behaviors that contribute to increased blood pressure in early life. Training: To accomplish her overall goal, Dr. Hardy has proposed an intensive mentored research plan that includes didactic education, and experiential learning in 1) intervention development, 2) implementation science for intervention delivery and evaluation, 3) design and conduct of randomized controlled trials, and 4) leadership skills for academic scientists. Mentorship: An interdisciplinary team of renowned scholars will mentor Dr. Hardy and provide ongoing guidance as she transitions to independence. Her mentoring team includes a Primary Mentor, Dr. Andrea Cherrington (Department of Preventive Medicine, UAB), co-Mentors, Dr. Paul Muntner (Department of Epidemiology, UAB), Dr. Nathalie Moise (Department of Medicine, Columbia University) and Dr. Daniel Feig (Department of Medicine, UAB) and two content advisors at UAB. Each of these mentors are fully committed to this project and to Dr. Hardy’s success. Research: The prevalence of high BP, defined as systolic BP (SBP) ≥120 mm Hg or diastolic BP (DBP) ≥80 mm Hg, is two-times higher (20% versus 10%) among Black versus white adolescents 13-17 years of age in the US. The availability of lifestyle behavior counseling in a clinical setting to lower BP is limited in rural communities due to long travel distances to access healthcare, limited funds for co-payments, and ineffective provider-patient communication. The proposed K01 addresses this gap by developing and testing the feasibility and acceptability of a peer support intervention to lower BP among rural Black adolescents with high BP. First, Dr. Hardy will identify aspects of the rural environment that present barriers to lifestyle behavior change. Next, using the behavior change wheel for intervention development, she will develop and pilot test a peer support intervention devised to address these barriers. The successful completion of this project will lead to an R01 grant submission to test the effectiveness of this peer support intervention in a multi-site cluster-randomized trial and allow Dr. Hardy to become an independent investigator contributing to health equity among adolescents, where lifestyle behavior change could preempt the development of racial disparities in BP and cardiovascular morbidity and mortality.