RESEARCH CORE

研究核心

• 批准号: 8266277
• 负责人: Joseph Neil Henderson
• 金额: $ 0.21万
• 依托单位: UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至 2012-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8266277
• 关键词: Abate; Adherence; American Indians; Area; Behavior; Behavioral; Belief; Caring; Categories; Choctaw Nation of Oklahoma; Clinical Research; Collaborations; Communication; Communication Barriers; Community Health; Community Health Education; Diabetes Mellitus; Discipline; Disease; Education; Etiology; Gestational Diabetes; Goals; Healed; Health; Health Personnel; Health Promotion; Health Sciences; Health behavior; Health education; Healthcare; Home visitation; House Call; Infant Mortality; Institution; Interview; Knowledge; Licensing; Mainstreaming; Measures; Medical; Modeling; Nurses; Oklahoma; Outcome; Participant; Patients; Perception; Pharmaceutical Preparations; Phase; Physicians; Pregnancy; Pregnant Women; Prevalence; Prevention; Preventive; Process; Provider; Questionnaires; Recommendation; Recruitment Activity; Research; Resources; Screening procedure; Site; Source; Training; Transportation; Tribes; Universities; Woman; base; care delivery; care seeking; coping; diabetes education; diabetes educator; diabetes management; diabetic; experience; healing; health belief; health care delivery; health disparity; help-seeking behavior; implementation research; improved; infant outcome; meetings; non-diabetic; pregnant; satisfaction; social; tool; treatment planning; tribal community

This research will elicit Explanatory Models of diabetes during pregnancy from pregnant diabetics (n=40), 60 pregnant non-diabetics (n=60), and their health care providers (n=60 ) regarding etiology, course, and treatment in order to reduce barriers to adherence and improve diabetes outcomes. All pregnant subjects are AI's. "Health Care Providers" are defined as physicians, licensed nurses, Certified Diabetes Educators (CDE's), and tribal Community Health Representatives (CHR's: paraprofessionals trained for home visits, screenings, health education, community resource identification, and transportation to health care sites). Collaboration with the Choctaw and Chicksaw Nations of Oklahoma will be continuous to strengthen all phases of the research process and assure that appropriate research goals will be met. Specific Aim # 1: Collaboration with Choctaw and Chickasaw Nations on decisions regarding questionnaire refinement, research implementation, and application of the research findings. Specific Aim # 2: Recruit 60 health care providers and 100 pregnant patients to serve as subjects for interviews. Specific Aim #3: Delineate the Explanatory Models held by 100 pregnant women of which 10 will have pre-gestational diabetes, 30 will have gestational diabetes, and 60 will not have diabetes. Hypothesis: Explanatory Models will vary by category of disease experience. Specific Aim # 4: Delineate the Explanatory Models held by patients about maternal and infant outcomes relevant to diabetes during pregnancy. Hypothesis: Patient's Explanatory Models of maternal and infant outcomes may predict help-seeking and adherence behaviors. Specific Aim # 5: Delineate the Explanatory Models of diabetes held by providers regarding their patients' diabetes education, care-seeking behaviors, and adherence/non-adherence to treatment plans. Hypothesis: Provider Explanatory Models of diabetes may be discordant with patient models of diabetes, contributing to communication barriers. Perceptions of patient help-seeking and adherence may either facilitate or be a barrier to optimal care. Specific Aim #6: Delineate provider models of care delivery. Hypothesis: Provider models of care delivery may either facilitate or impede patients' help-seeking and adherence behaviors.. Specific Aim #7: Delineate subjects' degree of identification with traditional AI culture or mainstream culture. Hypothesis: Subjects' cultural identification may predict their Explanatory Model of diabetes. Specific Aim # 8: In collaboration with Choctaw and Chickasaw Nations, disseminate the findings of the research to health care providers in both tribes.

这项研究将从妊娠期引出妊娠期糖尿病的解释模型 糖尿病患者 (n=40)、60 名非糖尿病孕妇 (n=60) 及其医疗保健提供者 (n=60) 病因、病程和治疗，以减少依从性障碍并改善糖尿病结局。 所有怀孕的受试者都是AI。 “医疗保健提供者”被定义为医生、有执照的护士、 认证糖尿病教育者 (CDE) 和部落社区健康代表 (CHR)： 接受过家访、筛查、健康教育、社区资源培训的专业人员辅助人员 身份识别以及前往医疗保健场所的交通）。与 Choctaw 和 Chicksaw 的合作 俄克拉荷马州将继续加强研究过程的各个阶段，并确保 将实现适当的研究目标。 具体目标#1：与乔克托和契卡索民族就有关问题的决定进行合作 问卷细化、研究实施和研究结果的应用。 具体目标#2：招募 60 名医疗保健提供者和 100 名怀孕患者作为研究对象 采访。 具体目标#3：描绘由 100 名孕妇持有的解释模型，其中 10 名将怀孕 孕前糖尿病，30岁就会有妊娠糖尿病，60岁不会有糖尿病。 假设：解释模型将根据疾病经历的类别而变化。 具体目标#4：描绘患者对孕产妇和婴儿结局的解释模型 与妊娠期糖尿病有关。 假设：患者对母婴结局的解释模型可以预测寻求帮助和 遵守行为。 具体目标#5：描绘提供者关于其糖尿病的解释模型 患者的糖尿病教育、就医行为以及遵守/不遵守治疗计划。 假设：糖尿病提供者解释模型可能与糖尿病患者模型不一致， 造成沟通障碍。对患者寻求帮助和依从性的看法可能是 促进或成为最佳护理的障碍。 具体目标#6：描绘护理服务的提供者模式。 假设：提供护理服务的提供者模式可能会促进或阻碍患者寻求帮助和帮助 遵守行为.. 具体目标#7：描绘受试者对传统人工智能文化或主流的认同程度 文化。 假设：受试者的文化认同可以预测他们的糖尿病解释模型。 具体目标#8：与乔克托和契卡索国家合作，传播调查结果 对两个部落的医疗保健提供者进行研究。