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Kidney Awareness Registry and Education-2

肾脏意识登记和教育-2

基本信息

批准号：
9539476
负责人：
Delphine Tuot
金额：
$ 7.8万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
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：
2015-08-15 至 2020-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9539476
关键词：
Address Adherence Adoption Adult Affect African American Age Albuminuria Angiotensin Receptor Angiotensin-Converting Enzyme Inhibitors Asians Awareness Behavior Blood Pressure Cardiovascular system Caring Chronic Kidney Failure Clinic Clinical Clinical Data Communities Community Health Centers Computerized Medical Record Data Diabetes Mellitus Diagnosis Disease Management Disease Progression Education Educational Materials Effectiveness Excess Mortality Feasibility Studies Federally Qualified Health Center Goals Grant Guidelines Health Health Communication Health system Hispanics Individual Intervention Kidney Kidney Diseases Knowledge Linguistics Low Income Population Low income Measures Medical Care Team Mentored Patient-Oriented Research Career Development Award Morbidity - disease rate Multilingualism National Institute of Diabetes and Digestive and Kidney Diseases Outcome Patient Recruitments Patient risk Patients Persons Pharmaceutical Preparations Population Practice Management Prevalence Primary Health Care Proteinuria Provider Publishing Randomized Randomized Controlled Trials Regimen Registries Research Research Infrastructure Risk Reduction Behavior San Francisco Scientific Advances and Accomplishments Self Efficacy Self Management System Telephone Text Translating Translations Work base behavioral outcome blood pressure regulation chronic care model clinical care clinically relevant disease registry disparity reduction effective intervention ethnic diversity ethnic minority population evidence base experience glycemic control health care delivery healthy lifestyle high risk improved literacy mortality multi-component intervention multidisciplinary outreach point of care population health primary outcome programs provider intervention public health relevance racial and ethnic safety net satisfaction treatment as usual

项目摘要

DESCRIPTION (provided by applicant): Enhancing CKD health: Kidney Awareness Registry and Education-2 (KARE-2) trial Abstract Chronic kidney disease (CKD) is common, causes excess mortality and morbidity, and is associated with socio-demographic disparities with respect to prevalence and clinical outcomes. Measures such as glycemic control in persons with diabetes, blood pressure control, and reduction of proteinuria with angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARB) can help delay CKD decline and decrease CKD-associated morbidity and mortality; however, many individuals with CKD are not benefiting from these scientific advances. This lack of translation may be due in part to very low levels of CKD awareness among providers and patients leading to inadequate primary care provider self-efficacy for delivery of CKD care and poor patient engagement to participate in healthy lifestyles and adhere to medication regimens. To address this need, our multi-disciplinary team has developed and piloted two interventions that increasing awareness among providers and patients and translate that knowledge into more optimal CKD care. The provider intervention is a CKD registry tailored to the entire healthcare team that provides point-of-care decision support regarding CKD management and outside-of care summaries of CKD relevant clinical data to optimize delivery of guideline-concordant CKD care via outreach and population health. The patient intervention is a comprehensive self-management support program that includes low-literacy educational materials, linguistically/culturally tailored automated telephone self-management support (CKD-ATSM), health coaching, and reminder text messages. Our team has successfully piloted both interventions in a pilot feasibility study (NCT01530958) in one academic clinic that serves a low-income, multilingual population. We have since refined the interventions to integrate the registry with the electronic medical record and to include mobile texting in the self-management program. We are now poised to study the effectiveness of the refined interventions on health outcomes among a large diverse, low-income population using the Chronic Care Model framework of health care delivery. We propose a 2x2 factorial randomized controlled trial entitled Kidney Awareness Registry and Education-2 (KARE-2), in which we will randomize 60 providers and 400 patients with CKD in 6 federally qualified community health centers to receive the provider intervention (CKD registry) or usual care and the patient self- management support intervention (CKD-ATSM) or usual care. We will assess the impact of the provider intervention component of KARE-2 (Aim 1); the patient intervention component of KARE-2 (Aim 2); and their interaction (Aim 3) on patient-level clinical outcomes (e.g., blood pressure, CKD decline); provider behavioral outcomes (e.g., provider self-efficacy for CKD management); and patient behavioral outcomes (e.g., CKD awareness, participation in self-management behavior). If one or both KARE-2 interventions are effective at improving health among high-risk patients, they can be disseminated to other delivery systems to change the way CKD care is delivered in the US, leading to reductions in CKD-associated morbidity and mortality.