Racial Disparities in Physician Practice Patterns and Self-Management of Obesity

Sara N.Bleich，博士，约翰霍普金斯大学卫生政策和管理学助理教授 彭博公共卫生学院。这项拟议的NHLBI导师职业发展奖(K01)将 提供必要的支持，以促进Bleich博士成功过渡到独立研究人员 与肥胖相关的医疗保健领域的差距。布莱奇博士的长期目标是减少医疗保健 脆弱、高危人群在提供和使用与肥胖有关的服务方面存在差异。这个 拟议的培训计划包括一系列学习活动，以增加候选人对 医疗保健差异的理论基础和肥胖的临床管理以及 发展新的数据分析技能(例如，多层次建模、索赔数据、定性数据分析)、调查 开发，以及干预设计/实施方法。在这些学习目标的基础上，两个 在获奖期间，将进行各种类型的研究--二级分析和初级数据收集。 二次分析的项目目标是：检查医生执业中的黑人和白人的种族差异 肥胖症护理模式，使用具有全国代表性的健康计划数据(目标1)，并确定 个人体重自我管理中种族差异的多层次解释因素， 使用区域数据(目标2)。主要数据将通过焦点小组收集。将开展焦点小组活动 与肥胖患者、他们的家人、卫生专业人员和管理人员一起确定关键患者-以及 最佳肥胖护理的提供者层面的障碍，是否因患者种族不同而不同，以及这些障碍如何 可以克服(目标3)。这项拟议的职业发展计划旨在为布莱奇博士提供 支持成功提交拨款申请所需的其他经验和资源 (例如，R01)，以进一步探索医生执业模式和身体自我管理方面的种族差异 在健康计划人群中的体重，并开发必要的证据基础，以建立有效的 在这种情况下改善成人肥胖护理的干预措施。减少肥胖和消除健康差距 都是联邦政府的优先事项。该项目和未来计划中的研究将有助于这一努力。 相关性(请参阅说明)： 肥胖对少数群体的影响不成比例，是一个巨大的公共卫生挑战，以及 医生和病人管理不善。鉴于目前联邦政府在减少肥胖症和 为了消除健康差距，有必要更好地了解种族差异在实践中的模式 肥胖护理与患者体重自我管理的多层次解释因素。

Sara N. Bleich, PhD is an Assistant Professor of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health. This proposed NHLBI Mentored Career Development Award (K01) will provide the necessary support to facilitate Dr. Bleich's sucessful transition to an independent researcher in the field of obesity-related health care disparities. Dr. Bleich's long-term objective is to reduce health care disparities in the delivery and use of obesity-related services among vulnerable, high risk populations. The proposed training plan includes a series of learning activities to increase the candidate's knowledge of the theoretical underpinning of health care disparities and the clinical management of obesity as well as to develop new skills in data analysis (e.g., multilevel modeling, claims data, qualitiative data analysis),survey development, and intervention design/implementation methods. Building on these learning objectives, two types of research will be pursued during the award period - secondary analyses and primary data collection. Project aims for the secondary analyses are: to examine Black-White racial disparities in physician practice patterns of obesity care, using nationally representative and health plan data (Aim 1) and to identify the multilevel explanatory factors underlying racial disparities in individual self-management of body weight, using regional data (Aim 2). Primary data will be collected via focus groups. Focus groups will be conducted with obese patients, their families, health professionals and administrators to determine key patient- and provider-level barriers to optimal obesity care, whether they differ by patient race, and how these barriers can be overcome(Aim 3). This proposed career development plan is designed to provide Dr. Bleich with the additional experience and resources necessary to support the submission of a sucessful grant application (e.g., R01) to further explore racial disparities in physician practice patterns and self-management of body weight in a health plan population and to develop the necessary evidence base to mount effective interventions to improve adult obesity care in that setting. Reducing obesity and eliminating health disparities are both federal priorities. This project and future planned studies will contribute to that effort. RELEVANCE (See instructions): Obesity disproportionally impacts minority populations, represents an enormous public health challenge, and is under-managed by physicians and patients. In light of the current federal priorities to reduce obesity and eliminate health disparities, there is a need to better understand racial disparities in practice patterns of obesity care and the multilevel explanatory factors underlying patient self-management of weight.