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: 10596603
• 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/10596603
• 关键词: Accounting; Address; Adult; Affect; Algorithms; Area; Atherosclerosis; Attitude; Boston; Cardiology; Cardiovascular Diseases; Cessation of life; Classification; 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; Grant; Health; Hormone use; Hormones; Hyperlipidemia; Hypertension; Individual; 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; cardiovascular disorder risk; cardiovascular health; cis-female; cis-male; cisgender; clinical decision-making; cohort; community engagement; comorbidity; data warehouse; experience; follow-up; gender affirming care; gender minority; hormone therapy; implementation science; improved; indexing; male; meetings; mortality; multidisciplinary; novel; predictive modeling; prevent; programs; recruit; risk mitigation; risk prediction model; sex; sex assigned at birth; 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.

项目总结： 以目前用于处理和预防动脉粥样硬化性心血管疾病的预测模型为指导 (心血管疾病)，拟议的项目调查性别认同和激素治疗如何与 变性人成年人的心血管健康。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 使用芬威健康公司的数据进行自我认同，芬威健康公司是一家获得联邦资格的健康中心，也是变性人领域的领导者 健康；2)评估当前的心血管疾病预测模型(即，合并队列风险评估方程)使用 C按会计分列的跨性别者统计、净重新分类和综合歧视指数 对于出生时的性别分配、性别认同和外源激素的使用；以及3)检查知识 和160名变性人对激素治疗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、促进者和可接受性。正在完成 拟议的目标将1)提高管理数据研究的准确性；2)加强临床 寻求激素治疗的变性人成年人的决策；以及3)提供风险缓解战略，以 改善变性人成年人的心血管健康。通过与Emelia博士一起从事有指导的研究 本杰明(导师)、迈克尔·帕斯基-奥洛(导师)、霍华德·卡布拉尔(导师)和萨里·赖斯纳(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，这对我作为一名独立临床医生的发展至关重要- 评估健康结果以确定和减轻变性人心血管疾病风险的科学家：1) 分析基于索赔和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、心脏病学和预防护理方面的临床技能；以及4) 定性研究和社区参与技能。此外，我将延长我的助学金的书面和口头 通过参加赠款撰写课程和在研究会议和 研讨会。波士顿大学为初级学者提供他们需要的智力和实践资源 发展成为成功的独立调查人员，包括初级教员研讨会、拨款撰写、编辑和 审查服务，以及与资深同事进行智力交流和合作的机会。A K01 该奖项将为我提供我所需的研究经验、技能和指导，以建立一个尖端的 在性和性别方面评估和解决心血管健康的独立研究计划 少数群体，特别是变性人成年人。