Unpacking Dimensions of Patient Preferences Related to Hypertension Management in Black Adults

项目总结 背景资料。高血压(HTN)是影响近十亿人的重大公共卫生问题 并解释了黑人和白人之间死亡率种族差异最大的原因。成功 HTN的治疗通常是通过药物治疗和改变生活方式来实现的。例如，证据- 基于生活方式的干预，如NHLBI资助的停止高血压(DASH)进食的饮食方法 与白人相比，计划已被证明可以改善黑人患者的HTN控制。然而，坚持 改变生活方式的干预措施仍然很少；一个潜在的解释是，这些决定并不是 基于偏好的。关于偏好对坚持改变生活方式的影响，我们知之甚少 针对患有HTN的黑人患者的干预。这款K01提供了一个独特的机会来解决这一差距 文学。 候选人概述。我的长期职业目标是成为一名独立调查员 专门致力于通过研究健康护理和沟通偏好来缩小健康差距 病人。我的短期目标是进行研究，以改善黑人成年人的HTN管理。 从历史上看，我做过癌症方面的工作；然而，我现在寻求扩大我的研究组合，以包括 泛指心血管疾病，尤其是高血压。 职业发展和培训计划。我的教育计划包括：a)有条理的课程作业， B)与我的兴趣有关的专业会议，c)定向阅读，d)跟踪临床医生，以及e)a 具有特定目标的研究项目的时间安排与这些活动相一致。与全国各地建立有组织的指导关系 专家包括Scott Braithwaite博士(医疗决策)、Olugbenga Ogedesbe博士(高血压、 Angela Fagerlin博士(共享决策)和Donna Shelley博士(执行科学)将促进 我继续发表手稿，在学术会议上发表演讲，以及一份R01申请。 研究策略。为了实现我的目标，我将使用定性方法(目标1和目标2)，包括聚焦 与黑人患者组成的小组和临床医生的访谈，导致了决策支持工具的开发 (目标3)为此，我将测试该工具的可行性和可用性，以增强偏好一致性决策 在黑人患者中做出决定，并与他们的临床医生分享决策。

PROJECT SUMMARY Background. Hypertension (HTN) is a significant public health problem that affects nearly a billion people worldwide and explains the most variance in the racial gap in mortality between blacks and whites. Successful management of HTN is often achieved through drug therapy and lifestyle change. For example, evidence- based lifestyle interventions like the NHLBI-funded Dietary Approaches to Stop Hypertension (DASH) eating plan have been shown to improve HTN control in black patients compared to whites. Yet, adherence to lifestyle change interventions still remains low; a potential explanation is that these decisions are not preference-based. Little is known about the impact of preferences on adherence to lifestyle change interventions for black patients with HTN. This K01 provides a unique opportunity to address this gap in the literature. Candidate Overview. My long-term career objective is to become an independent investigator who specializes in attenuating health disparities by studying the health care and communication preferences of patients. My short-term objective is to perform research to improve HTN management in black adults. Historically, I have done work in cancer; however, I now seek to expand my research portfolio to include cardiovascular disease broadly and hypertension specifically. Career Development and Training Plan. My educational program includes: a) structured course work, b) professional conferences pertinent to my interests, c) directed readings, d) shadowing of clinicians, and e) a research project with specific aims timed to coincide with these activities. Structured mentorship with national experts including Dr. Scott Braithwaite (medical decision making), Dr. Olugbenga Ogedegbe (hypertension, Dr. Angela Fagerlin (shared decision making), and Dr. Donna Shelley (implementation science) will promote my continued publication of manuscripts, presentations at academic meetings, and an R01 application. Research Strategy. To accomplish my aims, I will use qualitative methods (in Aims 1 and 2) including focus groups with black patients and interviews with clinicians, leading to the development of a decision support tool (in Aim 3) for which I will test the feasibility and usability of the tool to enhance preference-concordant decision making in black patients and shared decision making with their clinicians.