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Racial Disparities in the Treatment of Psoriasis: A Mixed Methods Approach

银屑病治疗中的种族差异：混合方法

基本信息

批准号：
9341072
负责人：
Junko Takeshita
金额：
$ 14.82万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-09-01 至 2020-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9341072
关键词：
Address Affect African American Age Area Attitude Award Biological Response Modifier Therapy Cardiovascular system Caucasians Centers for Disease Control and Prevention (U.S.)Cessation of life Characteristics Chronic Clinic Clinical Comorbidity Data Data Files Data Set Definity Dermatologic Dermatology Disease Disease remission Doctor of Philosophy Economic Burden Emotional Event Federally Qualified Health Center Feeling Foundations Future General Population Goals Health Care Costs Healthcare Inflammatory Intervention Interview Longitudinal cohort study Medicare Medicare claim Mentored Patient-Oriented Research Career Development Award Mentors Mentorship Methods Oral Outcome Outpatients Patients Pennsylvania Perception Pharmaceutical Preparations Phototherapy Physicians Population Postdoctoral Fellow Psoriasis Public Health Qualitative Research Race Research Research Methodology Research Personnel Research Priority Risk Risk Factors Socioeconomic Status Structure Sum Systemic Therapy Thinking Training Treatment Effectiveness Universities beneficiary career clinical practice disorder prevention experience health care disparity health disparity health inequalities health related quality of life improved innovation instructor patient oriented patient oriented research premature public health relevance racial disparity racial health disparity racial minority skin disorder treatment disparity

项目摘要

DESCRIPTION (provided by applicant): The overall objective of this K23 award proposal is to provide support for the additional training and experience necessary for the candidate, Junko Takeshita, MD, PhD, to transition from recent post-doctoral trainee and current Instructor in Dermatology to an independent patient-oriented investigator with a focus on health and healthcare disparities in psoriasis. Specifically, the aims of this proposal are to identify, defin, and understand disparities between African American and Caucasian Medicare beneficiaries in the treatment of psoriasis. We hypothesize that: 1) initiation of specific psoriasis therapies and persistence on therapies are different between African American and Caucasian patients with psoriasis, and 2) there are important differences in patient-level factors such as perceptions of psoriasis and attitudes towards treatments between the two racial groups that contribute to differential treatment of psoriasis. As clinicians are currently unaware of existing disparities in psoriasis treatment, we seek to shift current clinical practice paradigms with this proposal by newly identifying and establishing an understanding of racial disparities in the treatment of psoriasis with the goal of reducing any identified disparities and ultimately improving treatment and clinical outcomes, particularly among African American patients with psoriasis. A sequential mixed methods approach will be utilized to address the proposed aims: i) first, a quantitative longitudinal cohort study using Medicare data will be performed in order to compare initiation of therapies and persistence on therapies between African American and Caucasian Medicare beneficiaries with psoriasis; and ii) second, a qualitative study, informed by results from the quantitative study, will be performed using semi-structured interviews and freelists in order to identify patient- level determinants of the identified psoriasis treatment disparities between African Americans and Caucasians. In order to achieve these goals, the candidate will need training in three critical areas: 1) use of Medicare claims data; 2) disparities research methods; and 3) qualitative and mixed methods research. The candidate's training plan, which includes a combination of didactic coursework, practical experience through the completion of her proposed research, and directed mentorship from her expert mentoring team over the five year award period, will enable her to launch a successful career as an independent investigator in patient-oriented research and make important contributions to the field of dermatology via the study of disparities in the care of psoriasis.