Michigan Center for Integrative Approaches to Health Disparities

说明(申请人提供)：拟议的修订旨在消除心血管疾病(CVD)中的种族、民族和社会经济差异，包括高血压和中风，这是所有美国人的主要死亡原因，也是导致美国死亡率种族差异的主要因素，也是AHRQ确定的优先疾病。修订的目标与母公司赠款中目前正在进行的活动直接相关，并以互补和协同的方式扩展这些活动。最重要的是，它将家长中心的范式和工作扩展到与消除心血管疾病健康差距特别相关的干预和CER。修订的具体目标是：1)比较三种策略的有效性，以保持体力活动和降低心血管风险，在基线干预后促进中低收入居民的体力活动，主要是肥胖症、高血压、糖尿病和心脏病的高风险的非裔美国人和拉丁裔社区；2)提高技能，帮助从健康差距人群中建立研究人员供应，做出贡献 在心血管疾病高危人群中进行比较有效性研究的能力；3) 通过开发比较有效性研究研究数据库来提高开展CER的能力，该数据库旨在评估旨在通过增加美国非裔美国人和西班牙裔/拉丁裔人群的体力活动来降低心血管风险的干预措施的比较有效性；4)积极传播CER研究结果，并制定战略，将研究结果转化为干预措施、计划和政策，以维持中低收入、种族和民族多样性人口的行为变化，使其成为心血管结局不良的高风险人群。AIM 1(研究子项目)的研究设计包括随机分成三种维持干预策略，并对量化数据进行纵向分析，以比较它们在维持体力活动和降低心血管风险方面的有效性。我们将使用系统的项目文件来评估目标2-4的过程和影响。

DESCRIPTION (provided by applicant): The proposed Revision aims to contribute to the elimination of racial, ethnic and socioeconomic disparities in cardiovascular disease (CVD), including hypertension and stroke, the leading cause of death for all Americans, a major contributor to racial disparities in mortality in the U.S., and a priority condition identified by AHRQ. The aims of the Revision are directly related to activities currently underway in the parent grant, and extend them in a way that is complementary and synergistic. Most importantly, it extends the paradigm and work of parent Center to intervention and CER of special relevance to the elimination of health disparities in cardiovascular disease. The specific aims for the Revision are: 1) To compare the effectiveness of three strategies to maintain physical activity and reductions in cardiovascular risk following a baseline intervention to promote physical activity among residents of low-to moderate income, predominantly African American and Latino communities at high risk for obesity, hypertension, diabetes and heart disease; 2) To enhance skills and help build the supply of researchers from health disparities populations, contributing to capacity to conduct comparative effectiveness research within populations at high risk of CVD; 3) To enhance capacity to conduct CER by developing a database of comparative effectiveness research studies designed to assess the comparative effectiveness of interventions designed to reduce cardiovascular risk through increased physical activity among African American and Hispanic/Latino populations in the U.S. and 4) To actively disseminate CER findings and develop strategies to translate findings into interventions, programs and policies regarding maintenance of behavioral change in low to moderate income, racially and ethnically diverse populations at high risk for poor cardiovascular outcomes. The study design for Aim 1 (the research subproject) involves randomization into three maintenance intervention strategies and longitudinal analysis of quantitative data to compare their effectiveness in maintaining physical activity and cardiovascular risk reductions. We will use systematic project documentation to evaluate process and impact of Aims 2-4.