Latinos Using Cardio Health Actions to Reduce Risk

拉丁美洲人利用心脏健康行动来降低风险

• 批准号: 6862050
• 负责人: JOHN F STEINER
• 金额: $ 59.59万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-30 至 2009-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6862050
• 关键词: Hispanic Americans; antihypercholesterolemic agent; cardiovascular disorder education; cardiovascular disorder prevention; cardiovascular disorder risk; cardiovascular disorder therapy; clinical research; clinical trials; cooperative study; diabetes mellitus; educational resource design /development; health care service utilization; health disparity; health science research potential; health services research tag; human subject; human therapy evaluation; hyperlipidemia; hypertension; interactive multimedia; medical outreach /case finding; nursing intervention; patient oriented research; racial /ethnic difference; self care; tobacco abuse

DESCRIPTION (provided by applicant): Cardiovascular disease is the leading cause of mortality in U.S. Hispanics. The prevalence of risk factors for cardiovascular disease is higher for Hispanics than for non-Hispanic whites and is increasing. Hispanics face unique social, cultural, and language barriers gaining access to care. These barriers are a major reason that Hispanics are less likely to receive treatment for cardiovascular disease risk factors. For these reasons, improving the primary prevention of cardiovascular disease in Hispanics is the broad, long-term objective of the proposed research. In response to NHLBI RFA HL-04-002, this project will develop a partnership between Denver Health (DH), a minority-serving healthcare system, and the University of Colorado Health Sciences Center (UCHSC), a research-intensive medical center. The first Specific Aim of the project is to develop and evaluate an interactive computer-based tool to improve community-based recognition of cardiovascular risk factors and to improve self-management skills, including adherence with clinic visits. The tool will be culturally-sensitive and bilingual. The second Specific Aim is to test the ability of a nurse-based disease management program to improve control of risk factors. Under this aim, DH's unique computerized information system will be used to develop a registry of patients with hypertension, and to characterize patients' overall risk for cardiovascular disease and their risk for non-adherent behavior. A randomized clinical trial will be used to assess the impact of a nurse-based disease management intervention in those at highest risk and with a history of non-adherence. The intervention will be based on programs already in place at DH but will be modified in response to input from community-based focus groups. Specific Aims 3 and 4 will seek to refine current cardiovascular risk profiling in ways specific to Hispanics. Specific Aim 3 will assess ethnic differences in the relationship between traditional risk factors (diabetes, hypertension, smoking, hyperlipidemia) and pre-clinical markers of cardiovascular disease (left ventricular mass, carotid intima media thickness, and brachial artery reactivity) over time. Specific Aim 4 will assess the relationship among the traditional risk factors, pre-clinical markers, and a panel of circulating inflammatory markers. Also under Specific Aim 4, a randomized, placebo controlled trial will assess the efficacy of "statin" medications to reduce circulating levels of these inflammatory markers. Specific Aims 5 and 6 will develop educational programs to increase the cultural proficiency of clinical researchers, increase minority researcher participation in cardiovascular prevention research, and assist junior DH physicians in developing research careers in cardiovascular prevention.

描述(由申请人提供)： 心血管疾病是美国拉美裔美国人死亡的主要原因。拉美裔美国人心血管疾病风险因素的患病率高于非西班牙裔白人，而且还在增加。拉美裔美国人在获得护理方面面临着独特的社会、文化和语言障碍。这些障碍是拉美裔美国人不太可能接受心血管疾病风险因素治疗的一个主要原因。出于这些原因，改善拉美裔美国人心血管疾病的初级预防是拟议研究的广泛、长期目标。 为了响应NHLBI RFA HL-04-002，该项目将在为少数族裔服务的医疗保健系统丹佛健康(DH)和研究密集型医疗中心科罗拉多大学健康科学中心(UCHSC)之间建立合作伙伴关系。 该项目的第一个具体目标是开发和评价一种基于计算机的互动工具，以改善社区对心血管风险因素的认识，并提高自我管理技能，包括坚持就诊。该工具将是对文化敏感的双语工具。 第二个具体目标是测试以护士为基础的疾病管理计划改善风险因素控制的能力。在这个目标下，卫生署独特的电脑化资讯系统将被用来建立高血压病人登记册，以及分析病人患心血管疾病的整体风险，以及他们不遵守规定的行为风险。一项随机临床试验将被用来评估以护士为基础的疾病管理干预对那些风险最高和有不遵守病史的人的影响。干预措施将基于卫生署已有的计划，但将根据社区焦点小组的意见进行修改。 具体目标3和4将寻求以拉美裔美国人特有的方式完善当前的心血管风险概况。具体目标3将评估传统危险因素(糖尿病、高血压、吸烟、高脂血症)和临床前心血管疾病标记物(左心室质量、颈动脉内膜中层厚度和臂动脉反应性)之间的种族差异。具体目标4将评估传统危险因素、临床前标记物和一组循环炎症标记物之间的关系。同样在特定目标4下，一项随机的安慰剂对照试验将评估“他汀类”药物降低这些炎症循环水平的疗效。 记号笔。 具体目标5和6将制定教育计划，以提高临床研究人员的文化熟练程度，增加少数族裔研究人员对心血管预防研究的参与，并帮助初级卫生署医生发展心血管预防研究事业。