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Improving Outcomes Among Mexican and Central-American Patients with Nonalcoholic Fatty Liver Disease

改善墨西哥和中美洲非酒精性脂肪肝患者的预后

基本信息

批准号：
10688299
负责人：
Maya Balakrishnan
金额：
$ 17.25万
依托单位：
BAYLOR COLLEGE OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-08-22 至 2027-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10688299
关键词：
Acceleration Acculturation Address Age Area Behavior Behavior Therapy Behavioral Biological Markers Black Populations Body Weight decreased Central American Cirrhosis Clinical Cognitive Complex County Coupled Cultural Sensitivity Data Diet Disease Outcome Disparity Documentation Environment Epidemiology Evolution Fatty acid glycerol esters Feedback Fibrosis Focus Groups Foundations Funding Goals Health Health behavior change Hepatology Hispanic Hispanic Populations Infrastructure Injury Institution Intervention Interview K-Series Research Career Programs Liver Liver Fibrosis Liver diseases Medicine Mentors Mentorship Mexican Mexican Americans Modeling Modification Morbidity - disease rate National Institute on Minority Health and Health Disparities Not Hispanic or Latino Obesity Outcome Participant Patients Perception Persons Physical activity Population Positioning Attribute Primary Prevention Primary carcinoma of the liver cells Process Public Health Qualitative Methods Research Research Personnel Sampling Scientist Secondary Prevention Series Source Structure Subgroup Target Populations Testing Time Training Training Activity United States National Institutes of Health Weight acceptability and feasibility behavior change behavior test burden of illness career development chronic liver disease cohort college design diabetic effective therapy ethnic minority population experience health disparity improved improved outcome insight intervention effect intervention participants lifestyle intervention liver injury minority communities multidisciplinary non-alcoholic fatty liver disease participant enrollment patient oriented patient population sex social social cognitive theory social factors social influence social structure sociodemographics stem structural determinants systematic review treatment arm treatment as usual trial design weight loss intervention

项目摘要

Project Summary/Abstract Nonalcoholic fatty liver disease (NAFLD) is a highly prevalent public health problem that disproportionately hurts Mexican and Central Americans (M/CA). Weight loss through behavioral changes in diet and physical activity can lead to reductions in liver fat, injury, and fibrosis, but is rarely successfully achieved. Targeted behavioral weight loss interventions may improve the outcomes of M/CA patients with NAFLD. However, little is known about the personal, cognitive, and social factors that, if changed, may lead to improved weight loss rates and avert complications. The objective of this proposal is to identify the barriers to health behavior change experienced by M/CA patients with NAFLD and to adapt and test a weight loss intervention to address their needs. Dr. Maya Balakrishnan is a clinician investigator with a strong foundation in clinical hepatology and epidemiology that has positioned her to advance toward her goal of improving NAFLD outcomes among minority communities. Through this NIMHD K23 Mentored Patient Oriented Career Development Award, Dr. Balakrishnan will obtain experience in developing, implementing, and testing behavioral interventions, with a special focus on weight loss among M/CA patients with NAFLD. She will train in qualitative methods to gain an in-depth understanding of patients’ experience with weight loss behaviors. She will gain experience in the adaptation, implementation, and testing of behavioral interventions in the context of health disparities. With her inter-disciplinary team of mentors, Dr. Balakrishnan intends to use the Harris County NAFLD Cohort, a unique cohort of predominantly M/CA patients with NAFLD, as the source of data and participants for her proposed aims. Among M/CA patients with NAFLD, she will 1) identify the personal, cognitive and socio- structural barriers to weight loss behavioral change (Aim 1), 2) adapt the Look AHEAD lifestyle intervention for their needs through feedback from patients and expert stakeholders using an Ecological Validity Model (Aim 2) and 3) assess the feasibility and acceptability of the adapted intervention among M/CA patients with NAFLD (Aim 3). Dr. Balakrishnan has the full institutional support of leaders at Baylor College of Medicine and its vibrant and nurturing research environment. The training plan and research strategy in this K23 application will afford Dr. Balakrishnan the time, mentorship, and foundational data necessary to successfully transition into an independently funded investigator.

项目概要/摘要非酒精性脂肪肝（NAFLD）是一种非常普遍的公共卫生问题，其发病率不成比例。伤害墨西哥和中美洲（M/CA）。通过饮食和身体行为的改变来减肥活性可以导致肝脏脂肪减少、损伤和纤维化，但很少能成功实现。有针对性行为减肥干预可能会改善患有 NAFLD 的 M/CA 患者的预后。然而，很少了解个人、认知和社会因素，如果改变这些因素，可能会改善减肥效果率并避免并发症。该提案的目的是确定健康行为的障碍患有 NAFLD 的 M/CA 患者经历的变化，并调整和测试减肥干预措施以解决他们的需求。 Maya Balakrishnan 博士是一位临床研究者，在临床肝病学和流行病学使她能够朝着改善非酒精性脂肪肝 (NAFLD) 结局的目标迈进少数民族社区。通过 NIMHD K23 指导的以患者为导向的职业发展奖，Dr. Balakrishnan 将获得开发、实施和测试行为干预措施的经验，特别关注患有 NAFLD 的 M/CA 患者的体重减轻。她将接受定性方法的培训，以获得深入了解患者的减肥行为体验。她将获得以下领域的经验在健康差异的背景下调整、实施和测试行为干预措施。 Balakrishnan 博士打算与她的跨学科导师团队合作，利用哈里斯县 NAFLD 队列，一个主要由患有 NAFLD 的 M/CA 患者组成的独特队列，作为她的数据和参与者的来源拟议的目标。在患有 NAFLD 的 M/CA 患者中，她将 1) 确定个人、认知和社会方面的减肥行为改变的结构性障碍（目标 1）、2）调整 Look AHEAD 生活方式干预措施使用生态有效性模型，通过患者和专家利益相关者的反馈来了解他们的需求（目标 2） 3) 评估针对患有 NAFLD 的 M/CA 患者进行适应性干预的可行性和可接受性（目标 3）。 Balakrishnan 博士得到了贝勒医学院及其充满活力和活力的领导者的全力支持。培育研究环境。此 K23 应用程序中的培训计划和研究策略将为 Dr. Balakrishnan 成功转型为成功所需的时间、指导和基础数据独立资助的调查员。