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The SMART-CV Study: Systems Modeling Approaches to Reducing Disparities in Cardiovascular Diseases

SMART-CV 研究：减少心血管疾病差异的系统建模方法

基本信息

批准号：
10540227
负责人：
Roch Nianogo
金额：
$ 13.41万
依托单位：
UNIVERSITY OF CALIFORNIA LOS ANGELES
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：
2020-04-16 至 2024-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10540227
关键词：
African American population Age Alaska Native American Indians Behavioral Biological Models Birth California Cardiovascular Diseases Cause of Death Cessation of life Cigarette Communities Computer Simulation Computing Methodologies Coronary heart disease Cost Savings Cost of Illness Costs and Benefits Data Decision Making Diabetes Mellitus Disadvantaged Disease Disparity Disparity population Economically Deprived Population Economics Effectiveness of Interventions Environment Epidemiology Equilibrium Evaluation Failure Focus Groups Funding Future General Population Health Healthcare Heart Diseases High-Income Populations Hypertension Incidence Individual Intervention Intervention Studies Interview Knowledge Life Cycle Stages Los Angeles Low income Medical Mentorship Methods Non-Insulin-Dependent Diabetes Mellitus Obesity Patients Persons Physical environment Physicians Policies Policy Maker Population Populations at Risk Prevalence Study Prevention Public Health Quasi-experiment Randomized, Controlled Trials Reduce health disparities Research Research Personnel Review Literature Risk Risk Factors Sampling Science Secure Sodium Chloride Stroke System Taxes Testing Unhealthy Diet Vulnerable Populations Work cardiovascular disorder risk cardiovascular health cohort cost cost effective cost effectiveness design disease disparity disparity reduction experience health disparity high risk informant innovation intervention cost large scale data models and simulation novel population health prevent public health intervention racial population skills social determinants social disparities social factors social health determinants soda tax success systematic review therapy design virtual

项目摘要

ABSTRACT Cardiovascular diseases (CVDs) represent the leading cause of death in the US and are costly to the nation. Despite ongoing prevention efforts, socially and economically disadvantaged populations continue to bear the highest burden of CVDs. There is growing evidence that social determinants of health can play a role in producing such disparities in CVD. Yet current interventions designed to reduce disparities in CVD seldom focus on the social determinants of cardiovascular health across multiple domains and levels of influence but tend to focus on individual-level factors. Furthermore, when designing interventions, policymakers have to consider the trade-offs between interventions that maximize health in the general population and those that minimize health disparities and failure to reach a balance between these can result in increased health disparities and suboptimal population health. Therefore, to efficiently reduce disparities in CVD—coronary heart diseases and stroke, there is a pressing need for assisting policy decision-making in the design of sustainable and affordable targeted health interventions that integrate social factors across domains and levels of influence and which targets the socially and economically disadvantaged populations. This K01 proposal will apply several analytic approaches including key informant interviews, the synthetic control method and simulation modeling and systems science (SMSS) methods to evaluate the impact and costs of intervention strategies that have the potential to efficiently reduce CVD health disparities. To carry out this proposal, Dr. Nianogo will (1) identify interventions and policies that are implemented in California which focused on the social determinants of cardiovascular health across multiple domains and levels of influence, (2) investigate the impact of three societal policy interventions on CVD incidence; (3) develop a computer simulation model to project the long-term impact and cost-effectiveness of interventions and policies targeting disadvantaged subpopulations, high-risk subpopulations. Findings from this study help identify targeted health interventions that have the potential to reduce health disparities in CVD and inform policy decision-making. This K01 proposal builds on the candidate’s previous research that developed a computer simulation model (Virtual Los Angeles Cohort—ViLA) to study the prevalence and incidence of obesity and type 2 diabetes among a representative sample of U.S. persons born in Los Angeles and followed from birth to age 65. The proposal will be pursued within the context of a strong mentorship that has adequate extensive experience and expertise on intervention research, CVDs, health disparities and simulation modeling that is necessary for the success of this project. UCLA provides an adequate environment to conduct such innovative research. Throughout this proposal, the candidate will gain skills in SMSS and CVD disparities research; these skills are critical to providing Dr. Nianogo with the means and knowledge to become a successful independent investigator in computational epidemiology and SMSS and to secure future R01 funding.

在美国，心血管疾病（cvd）是导致死亡的主要原因，而且治疗成本很高