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

摘要 这份K01职业发展提案是为了支持终身教职助理Shakia Hardy博士 阿拉巴马大学伯明翰分校流行病学系教授，在她的道路上 成为一名独立的研究人员。这位候选人在2017年获得了流行病学博士学位， 位于教堂山的北卡罗来纳大学，在以下领域的已发表研究方面有着良好的记录 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 科学将在实施和人口的交汇点制定独立的研究计划 科学。哈迪博士的研究旨在通过以下方式减少心血管疾病的健康差距 改变导致早年血压升高的生活方式。培训：至 为了实现她的总体目标，哈迪博士提出了一个密集的有指导的研究计划，包括 教学教育和体验式学习1)干预开发，2)实施科学 干预措施的提供和评估，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。指导：一个由知名学者组成的跨学科团队将指导Dr。 并在她过渡到独立的过程中提供持续的指导。她的指导团队包括一个 主要导师安德里亚·切林顿博士(预防医学系，UAB)，共同导师保罗博士 Muntner(UAB流行病学系)，Nathalie Moise博士(哥伦比亚医学部 和Daniel Feig博士(UAB医学系)和UAB的两名内容顾问。每一个 这些导师完全致力于这个项目和哈代博士的成功。研究：艾滋病的流行率 高血压，定义为收缩压≥120 mm Hg或舒张压≥80 mm Hg，是正常血压的两倍 (20%比10%)在美国13-17岁的黑人和白人青少年中。是否可以使用 在农村社区，由于长途旅行，临床环境中降低血压的生活方式行为咨询受到限制 获得医疗保健的距离很远，共同支付的资金有限，提供者与患者之间的沟通效率低下。 建议的K01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 支持在患有高血压的农村黑人青少年中进行降血压干预。首先，哈迪博士将确定 阻碍生活方式行为改变的农村环境方面。接下来，使用行为 换个轮子进行干预开发，她将开发和试行一种同伴支持干预设计 来解决这些障碍。该项目的成功完成将导致R01拨款提交以进行测试 在一项多站点集群随机试验中，这种同行支持干预的有效性，并允许Hardy博士 成为促进青少年健康公平的独立调查者，生活方式行为 变化可能会先发制人，在BP和心血管疾病发病率和死亡率方面出现种族差异。

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.