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Patient Voices Network for Addressing Health Disparities

解决健康差异的患者之声网络

基本信息

批准号：
8782556
负责人：
Donald Bartlett
金额：
$ 33.58万
依托单位：
STATE UNIVERSITY OF NEW YORK AT BUFFALO
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-01-01 至 2016-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8782556
关键词：
Accounting Address Adult African American Age Automobile Driving Behavioral Buffaloes Caring Categories Censuses Chronic Disease Cities Communities Complex Country County Diagnosis Disadvantaged Disease Outcome Effectiveness Enabling Factors Ensure Feedback Goals Grant Guidelines Hispanics Home environment Individual Intervention Latino Leadership Low income Measures Medical Medically Underserved Area Medicine Minority National Committee for Quality Assurance Needs Assessment New York Office Visits Outcome Measure Patient Education Patients Perception Population Preparation Prevention Primary Health Care Principal Investigator Provider Quality of life Recruitment Activity Refugees Registries Reporting Research Research Design Research Infrastructure Research Institute Resources Risk Factors Role Sampling Self Management Services Side Site Social support Specialist Surveys Testing Underrepresented Minority Universities Update Voice base cohort community based participatory research design empowerment experience functional status health disparity improved inner city instrument meetings member multiple chronic conditions patient oriented patient registry practice-based research network primary care setting primary outcome research study safety net skills social

项目摘要

DESCRIPTION (provided by applicant): Chronic disease is a major contributor to health disparities. It is increasingly common for patients to have multiple chronic conditions requiring multiple specialists, posing significant challenges for primary care providers and patients to manage competing demands and make appropriate use of condition-specific guidelines that do not account for complications of multiple conditions. Challenges are compounded in underserved communities where resources are limited, chronic disease is common, and risk factors are elevated. This Community Based Participatory Research (CBPR) study will be conducted in inner-city Buffalo, NY, which was recently ranked by the U. S. Census Bureau as the third-poorest city in the nation. The population is predominantly minority (African American) and ethnically diverse (Hispanic and resettled refugees from over 70 counties). The Research team includes four Pi's from an existing partnership (one research PI, two practice site PIs and one patient PI representing Patient Voices, a network of Patient Action Teams from each of the sites). The specific aims of this study, using a CBPR approach, are to: 1) Conduct a needs assessment of a cohort of patients with complex chronic disease at 2 safety net primary care sites in medically underserved areas, 2) Design a Pilot Self-Management Intervention to address identified needs based on patient-reported factors that enable or hinder chronic disease self-management among patients age 18 and older, and 3) Implement a Pilot Self-Management Intervention among a systematic sample of 120 patients with CCD, recruited from an existing registry. Feasibility and effectiveness of the pilot intervention will be assessed over an 18-month period. The primary outcome will be change in the chronic disease outcomes. Intermediate outcome measures related to patient empowerment (social support, patient activation, self-management skills, functional status, and quality of life) will also be assessed. This study brings together patients and providers to create a patient centered intervention that meets patients' needs and can be practically implemented in the primary care setting. RELEVANCE: Patients with multiple chronic diseases are more common particularly in minority underserved communities. A research team (led by a research PI, two practice site PIs, and a patient PI) will develop and implement a patient-centered intervention, in partnership with both patients and providers, to improve self-management among patients with two or more chronic diseases. Using a participatory approach will ensure that the intervention meets patients' needs and is practical in the primary care setting

描述（由申请人提供）：慢性病是造成健康差异的一个主要原因。患者患有多种慢性病，需要多名专科医生就诊的现象越来越普遍，这给初级保健提供者和患者带来了巨大的挑战，他们需要管理相互竞争的需求，并适当使用不考虑多种疾病并发症的针对特定疾病的指南。在资源有限、慢性病常见且风险因素升高的服务欠缺社区，挑战更加复杂。这项基于社区的参与性研究 (CBPR) 研究将在纽约州布法罗市中心进行，该市最近被美国人口普查局列为全美第三贫困城市。人口主要是少数族裔（非裔美国人）和多元化种族（西班牙裔和来自 70 多个县的重新安置的难民）。研究团队包括来自现有合作伙伴的四名 PI（一名研究 PI、两名实践站点 PI 和一名代表患者之声的患者 PI，即来自每个站点的患者行动团队网络）。本研究采用 CBPR 方法，其具体目标是：1) 在医疗服务不足地区的 2 个安全网初级保健点对一组患有复杂慢性病的患者进行需求评估，2) 设计一项试点自我管理干预措施，根据患者报告的促进或阻碍 18 岁及以上患者进行慢性病自我管理的因素来满足已确定的需求，以及 3) 在 120 名慢性病患者的系统样本中实施一项试点自我管理干预措施。 CCD，从现有登记处招募。试点干预措施的可行性和有效性将在 18 个月内进行评估时期。主要结果将是慢性病结果的变化。还将评估与患者赋权相关的中期结果指标（社会支持、患者激活、自我管理技能、功能状态和生活质量）。这项研究带来患者和医疗服务提供者共同创建以患者为中心的干预措施，满足患者的需求，并可以在初级保健机构中实际实施。相关性：患有多种慢性疾病的患者更为常见，特别是在服务不足的少数社区。研究团队（由一名研究 PI、两名实践中心 PI 和一名患者 PI 领导）将与患者和提供者合作，制定并实施以患者为中心的干预措施，以改善患有两种或多种慢性病的患者的自我管理。使用参与式方法将确保干预措施满足患者的需求并且在初级保健环境中实用