Hypertension Management in Minority and Low-income Populations

描述（由申请方提供）：本提案的总体目标是在安全网环境中开发、调整、实施和评价高血压控制干预措施，以治疗患有复杂共病（包括慢性肾脏疾病（CKD）和糖尿病）的种族/少数民族患者。Bibbins-Domingo博士是U 54合作基金的联合PI，该基金评估了临床提供的高血压控制干预措施，包括临床血压控制算法，以及旨在持续血压控制的文化定制饮食干预措施，这些干预措施将构成本文研究的适应性干预措施的基础。该提案涉及以下目标：目标1。在整个加州资源有限的安全网环境中调整、实施和评估U 54开发的高血压干预措施，以及目标2。使用新的微观模拟计算机模型来确定有效的高血压干预措施的基本要素，并使用已建立的基于人口的计算机模型（CVD政策模型）来预测此类干预措施对健康差异的人口影响。这项建议将加强比宾斯-多明戈博士的职业目标，以追求实施科学方法的教学和经验培训，发展多学科的研究人员团队（包括肾病学家、心脏病学家和执行科学家）能够制定有效的预防干预措施，在资源有限的环境中提供护理复杂患者，并将她先前的计算机建模工作整合到新的临床干预措施的分析中。她将通过涉及来自广泛学科的受训人员的指导研究来开展这里描述的工作。比宾斯-多明戈博士是 旧金山弗朗西斯科总医院弱势群体中心和临床和转化科学研究所K学者计划主任，该计划指导初级教师的职业发展奖。她在指导学员和初级教员方面有着悠久的历史，包括亚专科医生（即肾脏病学家，心脏病学家，内分泌学家）和来自URM背景的几个人。该提案将开发新的科学，同时为初级研究人员提供丰富的培训环境，并促进Bibbins-Domingo博士自己的职业发展。

DESCRIPTION (provided by applicant): The overarching goal of this proposal is to develop, adapt, implement, and evaluate hypertension control interventions in safety-net settings caring for race/ethnic minority patients with complex co-morbid conditions including chronic kidney disease (CKD) and diabetes. Dr. Bibbins-Domingo is the joint PI of a U54 collaborative grant that evaluates a clinically-delivered hypertension control intervention consisting of a clinical blood pressure control algorithm, as well as a culturally-tailored dietary intervention aimed at sustained blood pressure control delivered in an integrated health delivery system; these interventions will form the basis for the adapted interventions studied here. The proposal addresses the following aims: Aim 1. To adapt, implement, and evaluate hypertension interventions developed in the U54 to resource- limited, safety net settings in across California, and Aim 2. To use a new micro-simulation computer model to determine essential elements of effective hypertension interventions and an established population-based computer model (the CVD Policy Model) to project population impact of such interventions on health disparities. This proposal will enhance Dr. Bibbins-Domingo's career goals to pursue didactic and experiential training in implementation science methodologies, to develop multi-disciplinary teams of researchers (including nephrologists, cardiologists, and implementation scientists) capable of developing effective prevention interventions for delivery in resource-limited settings caring for complex patients, and to integrate her prior computer modeling work in the analysis of new clinically-based interventions. She will conduct the work described here through mentored studies involving trainees from a broad set of disciplines. Dr. Bibbins- Domingo is the Director of the UCSF Center for Vulnerable Populations at San Francisco General Hospital and the Director of the Clinical and Translational Sciences Institute K Scholars Program that mentors junior faculty with career development awards. She has a long track record of mentoring trainees and junior faculty, including sub-specialists (i.e. nephrologist, cardiologists, endocrinologists) and several individuals from URM backgrounds. This proposal will develop new science while providing a rich training environment for junior investigators and furthering Dr. Bibbins-Domingo's own career development.