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Development of a Community Health Worker-Led Stress Reduction Intervention for Low-Income COPD Patients

为低收入慢性阻塞性肺病患者制定社区卫生工作者主导的减压干预措施

基本信息

批准号：
10642484
负责人：
Trisha M Parekh
金额：
$ 16.89万
依托单位：
UNIVERSITY OF TEXAS AT AUSTIN
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-08-01 至 2025-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10642484
关键词：
Accident and Emergency department Acute Address Adult Anxiety Area Behavioral Caring Cessation of life Chronic Disease Chronic Obstructive Pulmonary Disease Chronic stress Clinical Communities Community Health Aides Competence Confidence Intervals Coping Behavior Custom Data Development Disadvantaged Disease Education Emergency department visit Engineering Epidemiology Feedback Food Access Foundations Frequencies Funding Future Genetic Goals Grant Health Health Care Costs Health Disparities Research Health Insurance Health behavior High Prevalence Hospitalization Income Individual Institute of Medicine (U.S.)Intervention Interview K-Series Research Career Programs Knowledge Lead Low Income Population Low income Medical Medicine Mental Depression Mentors Mentorship Methods Modeling Morbidity - disease rate Odds Ratio Outcome Outcome Measure Patients Physiological Poverty Preparation Psychological Stress Public Health Quality of life Randomized Randomized Controlled Trials Reduce health disparities Research Design Research Methodology Research Personnel Research Project Grants Resources Risk Risk Factors Series Smoking Status Social support Stress Stress and Coping Stressful Event Surveys Targeted Research Testing Tobacco use Training Training Activity Transportation United States United States National Academy of Sciences Work acute care adverse outcome base behavior influence biological adaptation to stress care systems career career development community based research community engaged research community engagement coping cost experience feasibility testing follow-up health care availability health care delivery health care service utilization health disparity high risk hospital readmission housing instability improved improved outcome innovation insight intervention mapping low socioeconomic status marginalized population mortality patient population perceived stress predict clinical outcome premature primary outcome programs prototype psychologic research and development research study response secondary outcome smoking prevalence social social disadvantage social health determinants stress management stress reduction stressor systemic inflammatory response theories therapy development

项目摘要

PROJECT SUMMARY The overall goal of this K23 proposal is to provide Trisha Parekh, D.O., with the career development and research experience necessary to allow her to become an independent researcher in chronic obstructive pulmonary disease (COPD) health disparities, with expertise in social care integration and psychological stress reduction in low-income communities using community health worker interventions. Disadvantages of social determinants of health, such as low socioeconomic status, are associated with adverse outcomes in COPD, including more frequent hospitalizations, early readmissions, and increased mortality. A majority of interventions to reduce readmission focus on addressing medical determinants of health, with a notable absence of addressing social needs that impede better health outcomes. The psychological stress associated with poverty and other disadvantages of social determinants of health can lead to negative downstream behavioral, psychological, and physiological effects. For COPD patients, these stress responses may include increased tobacco use, increased risk of anxiety or depression, or increased systemic inflammation, all of which are risk factors for acute exacerbations of COPD. Substantial knowledge gaps on the social determinants of health, their associated levels of perceived stress in COPD, and clinical outcomes associated with high levels stress in marginalized groups must be addressed in order to reduce health disparities and improve quality of life for these individuals. In this K23 proposal, under the guidance of an expert mentorship team, Dr. Parekh will conduct a mixed methods research study to inform the development of a targeted community health worker-led stress reduction intervention in low-income COPD patients that will focus on 1) addressing unmet social needs, 2) providing COPD disease education, and 3) promoting proactive coping behaviors. The specific aims for this research project are as follows: Aim 1: Identify modifiable social determinant of health predictors and clinical outcomes of perceived stress in COPD patients; Aim 2: Understand perceived stressful experiences in high-risk COPD patients; Aim 3: Develop and test the feasibility of a community health worker intervention to reduce stress in low-income COPD patients. At the completion of Aim 3, this intervention will be ready to be tested in a R-series grant funded randomized controlled pilot with the primary outcome of stress reduction and secondary outcomes of reduction in acute care use and tobacco use and improvement in quality of life. At the conclusion of this K23, Dr. Parekh will have the training and experience needed to transition to a successful independent investigator who has an expertise in COPD health disparities.

项目总结