Improving Gastrointestinal Disease Outcomes in Vulnerable Populations

改善弱势群体胃肠道疾病的治疗效果

• 批准号: 7448822
• 负责人: JOHN MATTHEW INADOMI
• 金额: $ 17.8万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-07-01 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7448822
• 关键词: Adherence; Biometry; Chi-Square Tests; Clinical; Clinical Research; Clinical Trials; Cohort Studies; Colonoscopy; Colorectal Neoplasms; Counseling; Data; Data Analyses; Data Collection; Decision Modeling; Development; Disease Outcome; Educational process of instructing; Effectiveness; Environment; Epidemiology; Fecal occult blood; Funding; Gastrointestinal Diseases; Gender; Goals; Grant; Health; Institutes; International; Intervention; Journals; K-Series Research Career Programs; Linear Models; Mentors; Mentorship; Methods; Modeling; Outcome; Outcomes and Health Services Research; Patients; Peer Review; Polyps; Premalignant; Program Development; Public Health; Publishing; Rate; Recruitment Activity; Research; Research Design; Research Infrastructure; Research Methodology; Research Personnel; Research Project Grants; Research Technics; Risk; Screening procedure; Surveys; Testing; Training; Translational Research; United States National Institutes of Health; Vulnerable Populations; base; design; health belief; health economics; improved; interest; patient oriented research; programs; prospective; racial and ethnic; theories

DESCRIPTION (provided by applicant): Objectives: The objective of this K24 proposal is to enable the candidate to mentor young investigators to successfully integrate clinical, outcomes and health services research methods to optimize management strategies for gastrointestinal disease. Background: The candidate has a successful program of patientoriented research in gastrointestinal disease. He has obtained independent NIH funding for his research, and has an established record of mentoring young investigators who have been successful in conducting patientoriented research, publishing in peer-reviewed journals and obtaining NIH support in the form of K-awards. The candidate has been invited to teach patient-oriented research design to national and international audiences, and publish reviews of research techniques in leading journals. Methods: Mentoring plan: The candidate's environment allows new investigators to obtain formal training in clinical study design, epidemiology and biostatistics. Specific goals for the candidate include formal coursework in health economic theory and participation in the UCSF Clinical and Translational Science Institute Mentor Development Program. The candidate proposes to teach quantitative analysis in order to generate hypotheses, which can be tested through properly designed prospective clinical trials. Data derived from these studies can be integrated into revised decision models to identify the optimal competing strategies of management, which can then be prospectively tested. An example testing this hypothesis is presented as a research project, which uses the infrastructure established by the candidate's R01 project to recruit and follow subjects. Research plan: The effectiveness of strategies to screen for colorectal neoplasia depends heavily on the rate of adherence between screening tests. This study aims to identify factors associated with non-adherence to colorectal neoplasia screening in a vulnerable population at high-risk for poor health outcomes. We are conducting a prospective cohort study of patients at average risk for development of polyps in which subjects receive counseling about screening using fecal occult blood testing or colonoscopy or their choice of either test. This proposal adds a survey to identify factors based on the Health Belief Model, including sociodemographic variables that predict non-adherence to screening. Data Collection: 1. The primary outcome is identification of variables associated with non-adherence. Data Analysis: Chi-square testing of proportions and generalized linear models. Public health: This grant will support mentorship of new investigators interested in patient-oriented research in gastrointestinal disease. We aim to identify important questions through quantitative analysis and then definitively answer these questions through prospective clinical trials. The research project will provide targets for intervention to increase screening adherence for pre-malignant colorectal neoplasia, focusing on vulnerable populations.

描述（由申请人提供）： 目标：该 K24 提案的目标是使候选人能够指导年轻研究人员成功整合临床、结果和健康服务研究方法，以优化胃肠道疾病的管理策略。背景：候选人在胃肠道疾病方面拥有一个成功的以患者为导向的研究项目。他的研究获得了独立的 NIH 资助，并在指导年轻研究人员方面取得了良好的记录，这些研究人员成功地进行了以患者为导向的研究，在同行评审的期刊上发表文章，并以 K 奖的形式获得 NIH 的支持。该候选人已受邀向国内和国际受众教授以患者为导向的研究设计，并在领先期刊上发表研究技术评论。方法： 指导计划：候选人的环境允许新研究者获得临床研究设计、流行病学和生物统计学方面的正式培训。候选人的具体目标包括健康经济理论的正式课程以及参与加州大学旧金山分校临床和转化科学研究所导师发展计划。候选人建议教授定量分析以产生假设，这些假设可以通过正确设计的前瞻性临床试验进行测试。从这些研究中获得的数据可以整合到修订后的决策模型中，以确定最佳的管理竞争策略，然后可以对其进行前瞻性测试。测试该假设的示例作为一个研究项目提供，该项目使用候选人的 R01 项目建立的基础设施来招募和跟踪受试者。研究计划：结直肠肿瘤筛查策略的有效性在很大程度上取决于筛查测试之间的依从率。本研究旨在确定与健康状况不佳高风险人群中不遵守结直肠肿瘤筛查相关的因素。我们正在对患有息肉平均风险的患者进行一项前瞻性队列研究，其中受试者接受有关使用粪便隐血测试或结肠镜检查或他们选择任一测试进行筛查的咨询。该提案增加了一项调查，以根据健康信念模型确定因素，包括预测不遵守筛查的社会人口统计学变量。数据收集： 1. 主要结果是识别与不依从性相关的变量。数据分析：比例和广义线性模型的卡方检验。公共卫生：这笔赠款将支持指导对以患者为导向的胃肠疾病研究感兴趣的新研究人员。我们的目标是通过定量分析确定重要问题，然后通过前瞻性临床试验明确回答这些问题。该研究项目将提供干预目标，以提高对癌前结直肠肿瘤的筛查依从性，重点关注弱势群体。