Improving Outcomes Among Mexican and Central-American Patients with Nonalcoholic Fatty Liver Disease

项目概要/摘要 非酒精性脂肪肝（NAFLD）是一种高度流行的公共卫生问题， 墨西哥人和中美洲人（M/CA）。通过饮食和身体方面的行为改变来减肥 活性可导致肝脏脂肪、损伤和纤维化的减少，但很少成功实现。针对性 行为减肥干预可能改善M/CA伴NAFLD患者的结局。不过小 已知的个人，认知和社会因素，如果改变，可能会导致改善减肥 率和避免并发症。该提案的目的是确定健康行为的障碍 M/CA NAFLD患者经历的变化，并调整和测试减肥干预，以解决 他们的需求 博士Maya Balakrishnan是一名临床研究者，在临床肝病学方面有着坚实的基础， 流行病学，使她能够朝着改善NAFLD结局的目标前进， 少数民族社区。通过这个NIMHD K23指导病人导向的职业发展奖，博士。 Balakrishnan将获得开发，实施和测试行为干预措施的经验， 特别关注患有NAFLD的M/CA患者的体重减轻。她将接受定性方法的培训， 深入了解患者的减肥行为体验。她将获得经验， 在健康差距的背景下，调整、实施和测试行为干预措施。 Balakrishnan博士打算与她的跨学科导师团队一起使用哈里斯县NAFLD队列， 一个独特的以M/CA为主的NAFLD患者队列，作为她的数据和参与者的来源。 提出的目标。在患有NAFLD的M/CA患者中，她将1）识别个人，认知和社会- 减肥行为改变的结构性障碍（目标1），2）适应展望未来的生活方式干预， 使用生态有效性模型（目标2），通过患者和专家利益相关者的反馈满足他们的需求 评估适应性干预在M/CA伴NAFLD患者中的可行性和可接受性 (Aim 3）。 博士Balakrishnan在贝勒医学院及其充满活力的领导人的充分制度支持， 培育研究环境。K23应用的培训计划和研究策略将为博士提供。 Balakrishnan的时间，指导，和必要的基础数据，成功地过渡到一个 独立资助的调查员。

Project Summary/Abstract Nonalcoholic fatty liver disease (NAFLD) is a highly prevalent public health problem that disproportionately hurts Mexican and Central Americans (M/CA). Weight loss through behavioral changes in diet and physical activity can lead to reductions in liver fat, injury, and fibrosis, but is rarely successfully achieved. Targeted behavioral weight loss interventions may improve the outcomes of M/CA patients with NAFLD. However, little is known about the personal, cognitive, and social factors that, if changed, may lead to improved weight loss rates and avert complications. The objective of this proposal is to identify the barriers to health behavior change experienced by M/CA patients with NAFLD and to adapt and test a weight loss intervention to address their needs. Dr. Maya Balakrishnan is a clinician investigator with a strong foundation in clinical hepatology and epidemiology that has positioned her to advance toward her goal of improving NAFLD outcomes among minority communities. Through this NIMHD K23 Mentored Patient Oriented Career Development Award, Dr. Balakrishnan will obtain experience in developing, implementing, and testing behavioral interventions, with a special focus on weight loss among M/CA patients with NAFLD. She will train in qualitative methods to gain an in-depth understanding of patients’ experience with weight loss behaviors. She will gain experience in the adaptation, implementation, and testing of behavioral interventions in the context of health disparities. With her inter-disciplinary team of mentors, Dr. Balakrishnan intends to use the Harris County NAFLD Cohort, a unique cohort of predominantly M/CA patients with NAFLD, as the source of data and participants for her proposed aims. Among M/CA patients with NAFLD, she will 1) identify the personal, cognitive and socio- structural barriers to weight loss behavioral change (Aim 1), 2) adapt the Look AHEAD lifestyle intervention for their needs through feedback from patients and expert stakeholders using an Ecological Validity Model (Aim 2) and 3) assess the feasibility and acceptability of the adapted intervention among M/CA patients with NAFLD (Aim 3). Dr. Balakrishnan has the full institutional support of leaders at Baylor College of Medicine and its vibrant and nurturing research environment. The training plan and research strategy in this K23 application will afford Dr. Balakrishnan the time, mentorship, and foundational data necessary to successfully transition into an independently funded investigator.