Community Health Worker-Led Church-Based Intervention for Eliminating Cardiovascular Health Disparities in African Americans

社区卫生工作者主导的教会干预措施，旨在消除非裔美国人的心血管健康差异

• 批准号: 10414464
• 负责人: Jiang He
• 金额: $ 19.81万
• 依托单位: TULANE UNIVERSITY OF LOUISIANA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-10 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10414464
• 关键词: Address; Adherence; Administrative Supplement; African American; Appointment; Church; Communities; Community Health Aides; Community Health Systems; Data; Development; Effectiveness of Interventions; Focus Groups; Guidelines; Health Personnel; Intervention; Louisiana; Measurement; Measures; Patients; Phase; Physicians; Primary Prevention; Process; Provider; Randomized; Recommendation; Research; Research Personnel; Review Literature; Risk Factors; Role; Sociology; Testing; Time; Trust; Underserved Population; Visit; base; cardiometabolic risk; cardiovascular disorder prevention; cardiovascular health; clinical care; control trial; effectiveness evaluation; health disparity; implementation strategy; improved; member; psychologic; systematic review; therapy design; tool; trustworthiness

PROJECT SUMMARY The “Community Health Worker-Led (CHW) Church-Based Intervention for Eliminating Cardiovascular Health Disparities in African Americans” (CHERISH) study is a clustered randomized control trial to test whether a community health worker-led church-based multifaceted implementation strategy for applying the 2019 ACC/AHA Guidelines on the Primary Prevention of Cardiovascular Disease will reduce cardiovascular health disparities in African Americans in New Orleans and Bogalusa, Louisiana. However, low levels of trust in doctors and researchers among African Americans is often a barrier to participation in research and clinical care. CHWs offer an opportunity to understand how trust is built between communities and health systems, but there is little empirical evidence. The process by which CHWs engender trust among community members is largely anecdotal and theoretical. It is unknown how trust-building occurs, develops, grows, or terminates over time, particularly in interventions to address CVD disparities. Research is needed to understand how CHWs build trust among African Americans and other underserved groups to maximize the effectiveness of interventions to reduce cardiometabolic risk factors for CVD. The purpose of this PA-21-071 Administrative Supplement is to leverage the planning phase of the CHERISH study to identify the role of CHWs in developing trust in providers and researchers. Our central hypothesis is that CHWs can be used to improve trust in providers and researchers. The rationale for the proposed research is that CHWs act as trust intermediaries that increase the likelihood of cooperation (e.g., adherence to physician visit appointments and treatment recommendations) between African Americans and their providers. To test our central hypothesis and, thereby, attain the overall objective, we will pursue the following objectives in parallel with the UH3 planning phase of the CHERISH study: (1) Identify community health worker-led trust-building interventions through a systematic review of the literature. (2) Identify the factors that influence the perceived trustworthiness of community health workers through CHERISH study focus groups. (3) Develop a measurement tool to assess the level of trust between patients and community health workers. The project will provide preliminary data for an application for an R01 to assess the effectiveness of a CHW-led trust-building intervention among African Americans with risk factors for CVD. The design of the intervention will be informed by the systematic review of the literature, focus groups, and the CHW trust measure.

项目摘要 社区卫生工作者主导的（CHW）基于教会的干预措施，以消除心血管健康 非裔美国人的差异”（CHERISH）研究是一项群集随机对照试验，旨在测试 社区卫生工作者领导的基于教会的多方面实施战略，以应用2019年 ACC/AHA心血管疾病一级预防指南将降低心血管健康 新奥尔良和路易斯安那州的博加卢萨的非裔美国人中的差异。然而，低水平的信任 非裔美国人中的医生和研究人员往往是参与研究和临床的障碍， 在乎社区卫生工作者提供了一个了解社区和卫生系统之间如何建立信任的机会， 几乎没有经验证据。社区工作者在社区成员中建立信任的过程是 主要是传闻和理论。不知道信任的建立是如何发生、发展、增长或终止的。 时间，特别是在干预措施，以解决心血管疾病的差距。需要研究来了解CHW如何 在非裔美国人和其他服务不足的群体之间建立信任，以最大限度地提高 干预措施，以减少心血管疾病的心脏代谢危险因素。本PA-21-071管理的目的 补充是利用CHERISH研究的规划阶段，确定CHW在以下方面的作用： 培养对供应商和研究人员的信任。我们的中心假设是，CHW可用于改善 信任供应商和研究人员。建议研究的基本原理是，CHW充当信任 增加合作可能性的中介（例如，遵守医生访视预约， 治疗建议）之间的非裔美国人和他们的供应商。为了验证我们的核心假设 为达致整体目标，我们会与UH 3同时达致以下目标 CHERISH研究的计划阶段：（1）确定社区卫生工作者领导的信任建立干预措施 通过对文献的系统回顾。(2)确定影响感知可信度的因素 社区卫生工作者通过CHERISH研究焦点小组。(3)开发测量工具， 评估患者与社区卫生工作者之间的信任程度。该项目将提供初步 R 01申请的数据，以评估CHW领导的建立信任干预措施的有效性， 有CVD危险因素的非裔美国人。干预措施的设计将通过系统的 文献回顾，焦点小组，和CHW信任措施。