Improving Gastrointestinal Disease Outcomes in Vulnerable Populations

改善弱势群体胃肠道疾病的治疗效果

• 批准号: 7626692
• 负责人: JOHN MATTHEW INADOMI
• 金额: $ 17.8万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-07-01 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7626692
• 关键词: Adherence; Biometry; Chi-Square Tests; Clinical; Clinical Research; Clinical Trials; Cohort Studies; Colonoscopy; Colorectal Neoplasms; Counseling; Data; Data Analyses; Data Collection; Decision Modeling; Development; Disease Outcome; Educational process of instructing; Effectiveness; Environment; Epidemiology; Fecal occult blood; Funding; Gastrointestinal Diseases; Gender; Goals; Grant; Health; Institutes; International; Intervention; Journals; K-Series Research Career Programs; Linear Models; Mentors; Mentorship; Methods; Modeling; Outcome; Outcomes and Health Services Research; Patients; Peer Review; Polyps; Premalignant; Program Development; Public Health; Publishing; Recruitment Activity; Research; Research Design; Research Infrastructure; Research Methodology; Research Personnel; Research Project Grants; Research Technics; Risk; Screening procedure; Surveys; Testing; Training; Translational Research; United States National Institutes of Health; Vulnerable Populations; base; design; health belief; health economics; high risk; improved; interest; patient oriented research; primary outcome; programs; prospective; racial and ethnic; theories

DESCRIPTION (provided by applicant): Objectives: The objective of this K24 proposal is to enable the candidate to mentor young investigators to successfully integrate clinical, outcomes and health services research methods to optimize management strategies for gastrointestinal disease. Background: The candidate has a successful program of patientoriented research in gastrointestinal disease. He has obtained independent NIH funding for his research, and has an established record of mentoring young investigators who have been successful in conducting patientoriented research, publishing in peer-reviewed journals and obtaining NIH support in the form of K-awards. The candidate has been invited to teach patient-oriented research design to national and international audiences, and publish reviews of research techniques in leading journals. Methods: Mentoring plan: The candidate's environment allows new investigators to obtain formal training in clinical study design, epidemiology and biostatistics. Specific goals for the candidate include formal coursework in health economic theory and participation in the UCSF Clinical and Translational Science Institute Mentor Development Program. The candidate proposes to teach quantitative analysis in order to generate hypotheses, which can be tested through properly designed prospective clinical trials. Data derived from these studies can be integrated into revised decision models to identify the optimal competing strategies of management, which can then be prospectively tested. An example testing this hypothesis is presented as a research project, which uses the infrastructure established by the candidate's R01 project to recruit and follow subjects. Research plan: The effectiveness of strategies to screen for colorectal neoplasia depends heavily on the rate of adherence between screening tests. This study aims to identify factors associated with non-adherence to colorectal neoplasia screening in a vulnerable population at high-risk for poor health outcomes. We are conducting a prospective cohort study of patients at average risk for development of polyps in which subjects receive counseling about screening using fecal occult blood testing or colonoscopy or their choice of either test. This proposal adds a survey to identify factors based on the Health Belief Model, including sociodemographic variables that predict non-adherence to screening. Data Collection: 1. The primary outcome is identification of variables associated with non-adherence. Data Analysis: Chi-square testing of proportions and generalized linear models. Public health: This grant will support mentorship of new investigators interested in patient-oriented research in gastrointestinal disease. We aim to identify important questions through quantitative analysis and then definitively answer these questions through prospective clinical trials. The research project will provide targets for intervention to increase screening adherence for pre-malignant colorectal neoplasia, focusing on vulnerable populations.

描述（由申请人提供）： 目的：该K24提案的目的是使候选人能够指导年轻的研究人员成功地整合临床，结果和卫生服务研究方法，以优化胃肠道疾病的管理策略。背景：候选人在胃肠道疾病方面有一个成功的以病人为导向的研究项目。他的研究获得了独立的NIH资助，并在指导年轻研究人员方面取得了成功，这些年轻研究人员成功地进行了以患者为导向的研究，在同行评审的期刊上发表文章，并以K奖的形式获得了NIH的支持。该候选人已受邀向国内和国际观众教授以患者为导向的研究设计，并在领先期刊上发表研究技术评论。研究方法：指导计划：候选人的环境允许新的研究者获得临床研究设计，流行病学和生物统计学方面的正式培训。候选人的具体目标包括健康经济理论的正式课程，并参与UCSF临床和转化科学研究所导师发展计划。候选人建议教授定量分析，以产生假设，这些假设可以通过适当设计的前瞻性临床试验进行测试。从这些研究中获得的数据可以整合到修订后的决策模型中，以确定管理层的最佳竞争策略，然后可以进行前瞻性测试。测试这一假设的一个例子是作为一个研究项目，它使用的基础设施建立的候选人的R01项目招募和跟踪科目。研究计划：筛查结直肠肿瘤策略的有效性在很大程度上取决于筛查试验之间的依从性。本研究的目的是确定与不遵守结直肠肿瘤筛查在一个脆弱的人群在高风险的健康结果不佳的因素。我们正在进行一项前瞻性队列研究，研究对象为平均息肉发生风险的患者，受试者接受有关使用粪便潜血试验或结肠镜检查或选择任何一种试验进行筛查的咨询。该提案增加了一项调查，以确定基于健康信念模型的因素，包括预测不遵守筛查的社会人口变量。数据收集：1.主要结局是识别与不依从相关的变量。数据分析：比例卡方检验和广义线性模型。公共卫生：该补助金将支持对胃肠道疾病患者导向研究感兴趣的新研究人员的指导。我们的目标是通过定量分析确定重要的问题，然后通过前瞻性临床试验明确回答这些问题。该研究项目将提供干预目标，以增加对癌前结直肠肿瘤的筛查依从性，重点关注弱势人群。