EVALUATION OF STROKE DISPARITIES IN NATIVE HAWAIIANS AND OTHER PACIFIC ISLANDERS

夏威夷原住民和其他太平洋岛民的中风差异评估

• 批准号: 9369108
• 负责人: Marjorie K. Leimomi Mala Mau
• 金额: $ 14.54万
• 依托单位: UNIVERSITY OF HAWAII AT MANOA
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-11-01 至 2017-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9369108
• 关键词: Accounting; Acute; Admission activity; Age; Blood Vessels; Brain hemorrhage; Cardiovascular Diseases; Cerebral hemisphere hemorrhage; Clinical; Clinical Research; Communities; Diabetes Mellitus; Disease; Ethnic group; Etiology; Evaluation; Filipino; Focus Groups; Future; Hawaii; Hawaiian population; High Density Lipoprotein Cholesterol; High Prevalence; Hospitals; Hypertension; Incidence; Intervention Studies; Japanese Population; Lead; Measures; Medical center; Mental Health; Metabolic syndrome; Methamphetamine; Minority Groups; Morbidity - disease rate; Neuronal Injury; Obesity; Outcome; Pacific Island Americans; Patients; Pilot Projects; Population; Primary Prevention; Quality of life; Race; Randomized; Reporting; Research; Risk Factors; Secondary Prevention; Services; Stroke; Survivors; Sympathomimetics; Testing; United States; Universities; Work; base; burden of illness; disability; functional outcomes; health disparity; health related quality of life; high risk; improved; methamphetamine abuse; mortality; post stroke depression; programs; racial and ethnic; racial disparity; racial minority

Intracerebral hemorrhage (ICH) is a devastating hemorrhagic stroke that accounts for 10-15% of the approximately 700,000 annual strokes in the Unites States and results in disproportionately high morbidity and mortality. To date, there is no definitive treatment that results in reversal of neuronal injury and improvement in outcome after ICH. Therefore, it is important to identify the high-risk group and focus on primary and secondary prevention to reduce the incidence and burden of ICH. Recent evidence suggests that the burden of ICH is not borne equally by all, with racial minority groups reported to have a higher incidence and poorer outcomes than whites. Although Native Hawaiians and other Pacific Islanders (NHPI) have been reported to have higher burden of cardiovascular diseases compared to other major racial-ethnic groups, the burden of vascular risk factors related to ICH in this population has not been adequately studied. Furthermore, long-term functional outcome and quality-of-life measures after ICH among NHPI have not been studied. The overall strategy for this project will be to build on the findings from our preliminary work on ICH disparities, utilizing the clinical and research expertise at The Queen's Medical Center, a university-affiliated hospital that is the primary tertiary referral center in the Pacific and has the largest stroke service in the state. We plan to prospectively identify patients who are hospitalized at The Queen's Medical Center for acute ICH, and assess racial disparities in clinical and sociodemographic risk factors and long-term disease-specific health-related quality of life and functional outcomes, which will be measured at 3-, 6-, and 12-month from admission. We hypothesize that NHPI race is associated with younger age of presentation with ICH, better quality of life and less disability at 3 months after ICH compared to other major racial-ethnic groups in Hawaii. In addition, we will develop and test, in a randomized controlled pilot study, the impact of a culturally-informed, stroke-specific Patient Navigation program on psychological health-related quality of life and post-stroke depression among the ICH survivors.

脑内出血（ICH）是毁灭性的出血性中风，占10-15％ 在联合州的年度大约700,000次中风，导致发病率不成比例 和死亡率。迄今为止，尚无确切的治疗可导致神经元损伤的逆转 ICH之后的结果改善。因此，重要的是要确定高风险群体并专注于 初级和次要预防，以减轻ICH的发病率和负担。最近的证据表明 ICH的负担并不是所有人平等承担的，据报道的种族少数群体的负担更高 发病率和差的结果比白人。虽然夏威夷原住民和其他太平洋岛民（NHPI） 据报道，与其他主要种族族裔相比，心血管疾病的负担更高 尚未充分研究与该人群中与ICH有关的血管危险因素的负担。 此外，NHPI之后的长期功能结果和生活质量措施尚未 被研究。 该项目的总体策略将是基于我们对ICH的初步工作的发现 差异，利用皇后医学中心的临床和研究专业知识，这是一个与大学相关的 医院是太平洋的主要三级转诊中心，在该州拥有最大的中风服务。 我们计划前瞻性地识别在女王医疗中心住院的患者， 并评估临床和社会人口统计学危险因素和长期疾病特异性的种族差异 与健康相关的生活质量和功能结果 入场。我们假设NHPI种族与ICH的年轻年龄有关，更好 与其他主要种族族群相比 夏威夷。此外，我们将在一项随机对照的试点研究中开发和测试，这是一种文化信息的影响， 关于心理健康相关的生活质量和中风的中风特异性患者导航计划 ICH幸存者中的沮丧。