CVD RISK MANAGEMENT IN DIABETIC BLACKS

黑人糖尿病患者的 CVD 风险管理

• 批准号: 7604644
• 负责人: FELICIA HILL-BRIGGS
• 金额: $ 0.8万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-12-01 至 2007-09-16
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7604644
• 关键词: Adherence; African American; Behavior; Blood Glucose; Blood Pressure; Caring; Cholesterol; Class; Coin; Computer Retrieval of Information on Scientific Projects Database; Decision Making; Development; Diabetes Mellitus; Education; Educational process of instructing; Eligibility Determination; Funding; Glycosylated hemoglobin A; Goals; Grant; Health; Health behavior; Heart Diseases; High Blood Pressure; Institution; Intervention; Intervention Studies; Knowledge; Life Style; Measures; Medical; Methods; Non-Insulin-Dependent Diabetes Mellitus; Participant; Personal Satisfaction; Pilot Projects; Problem Solving; Quality of life; Questionnaires; Randomized; Range; Rate; Research; Research Personnel; Research Proposals; Resources; Risk; Risk Factors; Risk Management; Sampling; Score; Self Care; Self Management; Source; Telephone; Testing; Training; United States National Institutes of Health; Validity and Reliability; blood pressure regulation; diabetic; follow-up; heart disease risk; improved; prevent; skills; tool; validation studies

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. African Americans with type 2 diabetes suffer high rates of heart disease. Risk factors for heart disease, such as high blood sugar, blood pressure, and cholesterol, can be controlled through medical management and changes in lifestyle behaviors. Taking care of diabetes and changing lifestyle behaviors can be difficult. Problem solving is one self-management tool deemed important for effective self-care of diabetes and for overcoming barriers to making the lifestyle changes essential for preventing or managing heart disease. But, methods for training problem solving and decision making for managing health have not been well established. This study will test a new questionnaire for measuring health-related problem-solving abilities and a new problem-solving training applied to self-management of diabetes and heart disease risk factors in African Americans with type 2 diabetes. The specific aims are: 1) to assess the validity and reliability of a questionnaire of effective vs. ineffective health-related problem-solving ability (Health Problem-Solving Scale), 2) to develop a new intervention to teach health-related problem-solving skills to ineffective problem solvers, and 3) to conduct a pilot study with a sample of participants who have a high risk for heart disease AND ineffective health-related problem-solving skills, to test whether a brief vs. an intensive health problem-solving training improves problem solving ability, health behaviors, and heart disease risk factors. Participants are urban African Americans with type 2 diabetes. The research will be conducted in two parts, Health Problem-Solving Scale development (Study 1) and Health Problem-Solving Intervention (Study 2). Eligibility criteria for Study 1 include Low CVD Risk Profile (defined in this research proposal as optimal control of blood pressure, cholesterol, and blood sugar), or a High CVD Risk Profile (defined as high blood pressure, and/or high cholesterol, and/or high blood sugar). Participants will complete the Health Problem-Solving Scale and additional tests of problem solving and behavior. Upon completion of the Health Problem-Solving Scale questionnaire validation study, 60 participants who meet criteria for high CVD risk, and who score with a range of ineffective problem solving on the Health Problem-Solving Scale, will be participants in Study 2, the problem-solving training study. Participants will be randomly assigned, like flipping a coin, into either a Minimal Intervention group or an Intensive Intervention group. The Minimal Intervention group will receive Heart Disease Risk Education class + Brief Health Problem-Solving Training (2 weekly group sessions and 1 telephone follow-up). The Intensive Intervention Group will receive the Heart Disease Risk Education class + Intensive Health Problem-Solving Training (9 weekly group sessions and 1 telephone follow-up). At baseline and at 6 months after the intervention groups have ended, participants will have their blood sugar (HbA1c), cholesterol, and blood pressure assessed. In addition, they will complete questionnaires about problem solving, self-management adherence, knowledge, health behaviors, progress toward CVD risk management goals, and quality of life.

该子项目是利用该技术的众多研究子项目之一 资源由 NIH/NCRR 资助的中心拨款提供。子项目和 研究者 (PI) 可能已从 NIH 的另一个来源获得主要资金， 因此可以在其他 CRISP 条目中表示。列出的机构是 对于中心来说，它不一定是研究者的机构。 患有 2 型糖尿病的非裔美国人心脏病发病率很高。心脏病的危险因素，如高血糖、血压和胆固醇，可以通过医疗管理和改变生活方式来控制。治疗糖尿病和改变生活方式可能很困难。解决问题是一种自我管理工具，被认为对于有效自我护理糖尿病和克服障碍以改变生活方式以预防或控制心脏病非常重要。但是，培训问题解决和健康管理决策的方法尚未建立。这项研究将测试一种用于衡量健康相关问题解决能力的新问卷，以及一种应用于 2 型糖尿病非裔美国人自我管理糖尿病和心脏病危险因素的新问题解决培训。具体目标是：1) 评估有效与无效的健康相关问题解决能力调查问卷（健康问题解决量表）的有效性和可靠性，2) 制定新的干预措施，向无效的问题解决者传授与健康相关的问题解决技能，3) 对患有心脏病高风险和无效的健康相关问题解决技能的参与者样本进行试点研究，以测试简短与无效的问题解决能力是否有效。 强化健康问题解决培训可提高问题解决能力、健康行为和心脏病风险因素。 参与者是患有 2 型糖尿病的城市非裔美国人。该研究将分两部分进行：健康问题解决量表开发（研究1）和健康问题解决干预（研究2）。研究 1 的资格标准包括低 CVD 风险状况（在本研究提案中定义为血压、胆固醇和血糖的最佳控制）或高 CVD 风险状况（定义为高血压和/或高胆固醇和/或高血糖）。参与者将完成健康问题解决量表以及问题解决和行为的附加测试。完成健康问题解决量表问卷验证研究后，60 名符合高 CVD 风险标准且在健康问题解决量表上得分为一系列无效问题解决的参与者将成为研究 2（问题解决培训研究）的参与者。参与者将像抛硬币一样被随机分配到最低干预组或强化干预组。最小干预组将接受心脏病风险教育课程 + 简短的健康问题解决培训（每周 2 次小组会议和 1 次电话随访）。强化干预组将接受心脏病风险教育课程+强化健康问题解决培训（每周9次小组课程和1次电话随访）。 在基线和干预组结束后 6 个月时，将评估参与者的血糖 (HbA1c)、胆固醇和血压。此外，他们还将完成有关问题解决、自我管理依从性、知识、健康行为、CVD风险管理目标进展以及生活质量的调查问卷。