Mentoring in community influences on CVD risk

描述(由申请人提供)：这是一个关于以患者为中心的研究中的职业生涯中期研究员奖的建议。这一职业发展奖将使Corbie-Smith博士有专门的时间专注于心血管疾病预防方面的以患者为导向的研究，并招募和指导北卡罗来纳大学一些最聪明的年轻科学家从事医疗保健差异研究。她的直接职业目标是：1)通过开发针对社区患者的预防心血管疾病的干预措施，扩展她在有色人种社区参与研究的工作；2)了解服务不足社区的社区因素的影响，以及它们对心血管疾病和心血管风险因素的医疗利用和健康结果的影响；以及3)通过创建支持在心血管预防和结果方面进行高影响力研究的培训环境，提供出色的指导。这项由K24职业中期调查员奖支持的新研究的具体目标包括：1)确定培训当前社区健康顾问队列为导航员的可行性，将有多种心血管风险因素的居民与当地医疗系统联系起来；2)确定导航员对心血管风险因素控制(HgbA1C、体力活动、血压控制、吸烟)的影响，以及获得心血管疾病风险增加的社区成员的护理的机会；3)确定影响心血管风险因素控制和结果的社区和社会因素。这项双臂试验将调查导航员在社区外展计划中对心血管结果的作用，以改善医疗服务的获得和利用。将在四个地点的每个地点使用两到三个导航员。患者将随机接受导航仪干预或常规的患者管理措施，以基线和6个月为测量标准。这项研究的目标是一个非常重要的疾病状况和人群--非裔美国人农村中的心血管疾病风险因素预防--并在几个重要方面扩展了一个现有的有效模型。这项研究将导航员和患者置于社区(而不是医疗保健系统)中，从而增加了干预的文化相关性。导航员将支持对几种慢性病的访问和管理，而不是专注于一种疾病，从而解决服务不足的患者合并多种疾病的现实。最后，通过使用社区变量增强患者数据，可以全面分析外部影响对心血管疾病预防和医疗保健利用的影响。 与公共健康相关：拟议的研究将通过测试患者导航器计划来促进公共健康，以改善那些有心脏病风险因素的人的获得机会和护理质量。指导部分将培训新的研究人员进行高影响力的心脏病预防研究。

DESCRIPTION (provided by applicant): This is a proposal for a midcareer investigator award in patient-oriented research. This career development award will give Dr. Corbie-Smith the dedicated time to focus on patient-oriented research in cardiovascular disease prevention, and recruit and mentor some of the brightest young scientists at UNC into healthcare disparities research. Her immediate career objectives are: 1) To extend her work in engaging communities of color in research by developing interventions to prevent cardiovascular disease that address patients in the context of their communities; 2) To understand the influence of community factors in underserved communities and their impact on healthcare utilization and health outcomes in cardiovascular disease and cardiovascular risk factors; and 3) To provide outstanding mentorship by creating a training environment that supports the conduct of high impact research in cardiovascular prevention and outcomes. The specific aims for the new research to be supported through this K24 Midcareer Investigator award include 1) Determine the feasibility of training a current cohort of community health advisors as navigators to link residents with multiple cardiovascular risk factors to local healthcare systems; 2) Determine the impact of navigators on cardiovascular risk factor control (HgbA1C, physical activity, BP control, smoking) and access to care for community members at increased risk for cardiovascular disease; 3) Identify community and social factors that influence cardiovascular risk factor control and outcomes. This two-arm trial will investigate the role of navigators on cardiovascular outcomes in community based outreach programs to improve access and utilization of medical services. Two to three navigators at each of the four sites will be utilized. Patients will be randomized to either a navigator intervention or to usual patient management practices, with measurement at baseline and six months. This study targets a disease condition and population of significant importance - CVD risk factor prevention in rural African Americans - and extends an existing effective model in several important ways. This study situates the navigator and patient within the community (rather than the healthcare system) thus increasing the cultural relevance of the intervention. Rather than a focus on one condition, navigators will support access and management of several chronic conditions, thus addressing the reality of multiple co-morbidities in underserved patients. Lastly, augmenting patient data with community variables allows a comprehensive analysis of external influence on cardiovascular disease prevention and healthcare utilization. PUBLIC HEALTH RELEVANCE: The proposed research will advance public health by testing a patient navigator program to improve access to and quality of care for those with heart disease risk factors. The mentoring component will train new researchers to conduct high impact heart disease prevention research.