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: 8336884
• 负责人: JOHN MATTHEW INADOMI
• 金额: $ 18.87万
• 依托单位: UNIVERSITY OF WASHINGTON
• 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 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8336884
• 关键词: Adherence; Biometry; Chi-Square Tests; Clinical; Clinical Research; Clinical Sciences; 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

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 patient- oriented 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 patient- oriented 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 young 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 young 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.

目标：这项K24计划的目标是使候选人能够指导年轻的调查人员 成功整合临床、结果和卫生服务研究方法以优化管理 胃肠道疾病的治疗策略。背景：候选人有一个成功的项目-耐心- 面向胃肠道疾病的研究。他已经为他的研究获得了美国国立卫生研究院的独立资助，并且 有指导年轻调查人员的既定记录，这些调查人员成功地进行了患者- 以研究为导向，在同行评议的期刊上发表文章，并以K奖的形式获得NIH的支持。 应聘者被邀请向国内和国际教授以患者为中心的研究设计 受众，并在主要期刊上发表对研究技术的评论。方法：指导计划： 候选人的环境使年轻研究人员能够获得临床研究设计方面的正式培训， 流行病学和生物统计学。候选人的具体目标包括健康方面的正式课程 经济理论和参与加州大学旧金山分校临床和翻译科学研究所导师 发展计划。应聘者建议教授定量分析，以便生成 假说，可以通过适当设计的前瞻性临床试验进行检验。数据源自 这些研究可以整合到修订的决策模型中，以确定 管理，然后可以进行前瞻性的测试。测试这一假设的一个例子是 研究项目，该项目使用候选人的R01项目建立的基础设施来招聘和 跟随受试者。研究计划：筛查结直肠肿瘤的策略的有效性取决于 很大程度上取决于两次筛查测试之间的依从率。这项研究的目的是找出与 健康状况不佳的高危人群中未坚持大肠肿瘤筛查的情况 结果。我们正在进行一项前瞻性队列研究，研究对象是有平均发病风险的患者。 受试者接受关于使用粪便潜血检测或结肠镜检查进行筛查的咨询 或者他们选择哪一种测试。这项建议增加了一项调查，以确定基于健康信念的因素 模型，包括预测不遵守筛查的社会人口学变量。数据收集：1. 主要结果是确定与不遵守有关的变量。数据分析：卡方检验 比例和广义线性模型的检验。公共卫生：这笔赠款将支持对 年轻的研究人员对胃肠道疾病中以患者为中心的研究感兴趣。我们的目标是确定 通过量化分析来回答重要问题，然后通过 前瞻性临床试验。该研究项目将提供干预目标，以增加筛查 坚持治疗结直肠癌前病变，重点关注易感人群。