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

项目摘要 背景高血压（HTN）是影响近10亿人的重大公共卫生问题 这是全世界范围内的最大差异，解释了黑人和白人之间死亡率的种族差异。成功 HTN的管理通常通过药物治疗和生活方式改变来实现。例如，证据- 基于生活方式的干预措施，如NHLBI资助的停止高血压饮食方法（DASH） 与白人相比，该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低;一个可能的解释是，这些决定并不重要。 基于偏好。关于偏好对坚持改变生活方式的影响， 对患有HTN的黑人患者进行干预。K 01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， 专门研究通过研究健康护理和通信偏好， 患者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，我在癌症方面做过工作;然而，我现在寻求扩大我的研究组合，包括 心血管疾病，特别是高血压。 职业发展和培训计划。我的教育计划包括：a）结构化的课程工作， B）与我兴趣相关的专业会议，C）指导阅读，D）临床医生的跟踪，以及E）A 有具体目标的研究项目与这些活动同时进行。结构化的导师与国家 包括Scott Braithwaite博士（医学决策），Olugbenga Ogedegbe博士（高血压， 博士Angela Fagerlin（共同决策）和Donna Shelley博士（实施科学）将促进 我继续出版手稿，在学术会议上发表演讲，以及R 01申请。 研究战略。为了实现我的目标，我将使用定性方法（在目标1和2中）， 小组与黑人病人和采访临床医生，导致决策支持工具的发展 (in目标3），我将测试该工具的可行性和可用性，以加强偏好一致的决策 在黑人患者中做出决策，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.