Patient-Centered Anticoagulation Self-Monitoring in Minority Patients.

描述（由申请人提供）：抗凝患者自我监测的采用主要限于非少数民族和社会经济地位较高的个体。尚未对影响采用抗凝自我监测的因素进行系统研究。了解这些因素对于少数服务不足的患者尤其重要，这些患者在获得高质量护理和抗凝相关并发症方面风险最高。候选人的长期目标是发展成功的职业生涯，作为一个独立的比较有效性报告，重点是以技术为基础的以患者为中心的干预措施，支持慢性病患者的方便，可及和具有成本效益的护理模式。本K23应用程序的目标是 确定影响少数民族患者抗凝自我监测的采用和可行性的因素，并完善以患者为中心的教育干预。中心假设是，患者自我监测加上以患者为中心的少数患者教育干预，将导致抗凝控制的质量与专业抗凝临床监测相当。拟议研究的基本原理是，少数人群并发症的风险最高，并创建一个有效的自我监测模型。在这些人群中，护理是降低抗凝控制不良引起的并发症风险的第一个关键步骤。在初步数据的指导下，本提案的研究目标将通过追求三个具体目标来实现：1）确定影响少数人群采用抗凝自我监测的患者和提供者因素。2)调整和完善教育干预措施，既解决已确定的障碍，又强调已确定的对抗凝自我监测的积极影响。3)证明抗凝自我监测结合教育干预在少数人群中的可行性和有效性。这种方法是创新的，因为它偏离了标准的自我测试技能干预措施，它针对的是需要有效和方便的选择来管理可能危及生命的疾病的弱势、高风险人群。拟议的研究是重要的，因为它是第一步，以减少健康的差距，获得和采用有效的模式，自我保健的高风险患者。为了实现所概述的研究目标，Nutescu博士制定了一项职业发展计划，重点是指导和教学相结合，以提高她在定性方法，健康行为研究，临床试验设计以及解决跨文化和健康差异研究的方法学问题方面的技能。Nutescu博士的研究和职业发展计划将主要在伊利诺伊大学芝加哥分校进行。她经验丰富的指导团队包括高素质，资金充足的独立研究人员，他们对Nutescu博士的职业潜力和研究计划充满热情。

DESCRIPTION (provided by applicant): The adoption of anticoagulation patient self-monitoring has been limited primarily to non-minority and higher socioeconomic individuals. Factors influencing the adoption of self-monitoring of anticoagulation have not been systematically examined. Understanding these factors is especially important in minority underserved patients who are at highest risk for accessing high-quality care and of anticoagulation related complications. The long term goal of the candidate is to develop a successful career as an independent comparative-effectiveness re- searcher with a focus in technology-based patient-centered interventions that support convenient, accessible, and cost-effective models of care in patients with chronic illness. The objective in this K23 application is to identify factors influencing adoption and feasibility of anticoagulation self-monitoring in minority patients and refine a patient-centered educational intervention. The central hypothesis is that patient self-monitoring coupled with a patient-centered educational intervention for minority patients will result in anticoagulation control of comparable quality to that seen in specialized anticoagulation clinic-based monitoring The rationale for the proposed research is that minority populations are at highest risk of complications and creating a model of effective self-care is the first critical step in reducing the risk of complications resulting from poor anticoagulation control in these populations. Guided by preliminary data, the research objective of this proposal will be accomplished by pursuing three specific aims: 1) Identify patient and provider factors that influence adoption of anti- coagulation self-monitoring in a minority population. 2) Adapt and refine an education intervention that both addresses identified barriers and emphasizes identified positive influences to anticoagulation self-monitoring. 3) Demonstrate the feasibility and effectiveness of anticoagulation self-monitoring coupled with the educational intervention in a minority population. The approach is innovative, because it is a departure from the standard self-testing skill-based interventions, and it targets a disadvantaged, high-risk population in need of effective and convenient options to manage a potentially life threatening condition. The proposed research is significant, because it is the first step towards a reduction of health disparities for access to and adoption of effective models of self-care in high risk patients. To achieve the outlined research goals, Dr. Nutescu has developed a career development plan that focuses on a combination of mentoring and didactics to enhance her skills in qualitative methods, health behavior research, clinical trial design, and methodological issues addressing cross- cultural and health disparities research. Dr. Nutescu's research and career development plans will take place predominantly at the University of Illinois at Chicago. Her experienced mentoring team includes highly qualified, well funded independent investigators who are dedicated and enthusiastic about Dr. Nutescu's career potential and research proposal.