Patient-Oriented Research Addressing Disparities in Hypertension and Kidney Disease

以患者为中心的研究解决高血压和肾脏疾病的差异

• 批准号: 10657430
• 负责人: DEIDRA CANDICE CREWS
• 金额: $ 10.49万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-17 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10657430
• 关键词: Address; Adherence; Adoption; Adult; Affect; African American population; Age of Onset; Albumins; Albuminuria; Beverages; Blood Pressure; Cardiovascular Diseases; Chronic Kidney Failure; Clinical; Clinical Research; DASH diet; Diet; Dietary Factors; Dietary Intervention; Dietary Practices; Disease Progression; Disparity; Disparity population; Eating; Economically Deprived Population; End stage renal failure; Excretory function; Face; Faculty; Food; Future; Gifts; Goals; Health Food; Healthy Eating; Housing; Hypertension; Individual; Intervention; Intervention Studies; Interview; Kidney; Kidney Bean; Kidney Diseases; Kidney Failure; Knowledge; Low Income Population; Medicine; Mentors; Mentorship; Mid-Career Clinical Scientist Award (K24); Midcareer Investigator Award in Patient-Oriented Research; Nephrology; Nutritional; Nuts; Observational Study; Outcome; Participant; Pattern; Persons; Phase; Phase Transition; Postdoctoral Fellow; Prevention Research; Randomized; Reporting; Research; Research Methodology; Research Personnel; Resources; Risk; Risk Reduction; Scholarship; Socioeconomic Factors; Structure; Students; Time; Universities; Work; base; career; dietary; disorder risk; disparity reduction; epidemiology study; ethnic minority; experience; food desert; food insecurity; fruits and vegetables; good diet; group intervention; health equity; high risk; implementation research; improved outcome; indexing; low socioeconomic status; medical schools; mid-career faculty; patient oriented research; phase 1 study; primary outcome; racial difference; racial disparity; racial minority; randomized trial; renal damage; research and development; secondary outcome; socioeconomic disadvantage; therapy design; treatment arm; treatment as usual; urinary

PROJECT SUMMARY/ABSTRACT This is a proposal for a K24 Midcareer Investigator Award in Patient-Oriented Research for Deidra C. Crews, MD, ScM of Johns Hopkins University School of Medicine. Dr. Crews is an Associate Professor of Medicine in the Division of Nephrology, Core Faculty in the Welch Center for Prevention, Epidemiology and Clinical Research, and Associate Director for Research Development in the Center for Health Equity. Dr. Crews has spent the majority of her career and scholarship focused on patient-oriented research in disadvantaged populations with hypertension and/or chronic kidney disease (CKD). African Americans are disproportionately affected by hypertension and CKD, and socioeconomic factors contribute to these disparities. Racial disparities in CKD are most profound among socioeconomically disadvantaged populations. Low socioeconomic status (SES) and limited availability of healthy foods contribute to poor dietary patterns which influence CKD risk. There is evidence from observational studies that adherence to healthy dietary patterns, such as the Dietary Approaches to Stop Hypertension (DASH) diet, may substantially reduce risk of CKD and short-term randomized trials suggest the adoption of a healthy diet in adults with CKD may reduce risk of disease progression. The important problem to be addressed by the applicant over the proposed 5-year K24 award period is that low SES African Americans with hypertension and CKD face multiple barriers to healthful eating which can lead to their poor outcomes, including cardiovascular disease and ESRD. This K24 award will protect time for the applicant to mentor junior investigators and conduct significant research aimed at developing sustainable dietary interventions for individuals at high risk for poor clinical outcomes related to hypertension and CKD. The proposed original research will be conducted in the context of the Five, Plus Nuts and Beans for Kidneys trial, a randomized controlled dietary intervention study of low SES African Americans with hypertension and CKD, and will (a) elucidate experiences of recent intervention-arm (Coaching-DASH) participants determining their views on intervention components and factors facilitating or impeding their dietary changes, (b) examine the purchase patterns of the usual care group (Shopping-DASH), who received a trackable gift card to a local grocer but no guidance on purchases and (c) characterize and determine the impact of financial resource strain (defined as housing and/or food insecurity) on the primary and secondary outcomes of the trial—reductions in urinary albumin excretion and blood pressure. These aims will be addressed while Dr. Crews provides mentorship to new and existing junior faculty, post-doctoral fellows and students. Work performed during the K24 award will both inform future intervention design and implementation approaches to maximize sustainability of the applicant’s work, and will allow her to more effectively pursue her long-term career goals to improve outcomes for disadvantaged populations with or at risk for CKD.

项目总结/摘要 这是Deidra C的K24职业中期研究者奖的提案。船员们， 约翰霍普金斯大学医学院医学博士、理学硕士。克鲁斯博士是一名医学副教授， 韦尔奇预防、流行病学和临床研究中心的肾脏病学分部 研究，健康公平中心研究开发副主任。克鲁斯医生 她的大部分职业生涯和奖学金都集中在以病人为导向的研究中， 患有高血压和/或慢性肾病（CKD）的人群。非洲裔美国人不成比例地 受高血压和CKD影响，社会经济因素导致了这些差异。种族差异 CKD的发病率在社会经济弱势群体中最为严重。社会经济地位低 (SES)健康食品的有限供应导致影响CKD风险的不良饮食模式。 有证据表明，从观察性研究，坚持健康的饮食模式，如饮食 停止高血压的方法（DASH）饮食可以大幅降低慢性肾病和短期的风险 随机试验表明，CKD成人采用健康饮食可降低疾病风险 进展申请人在拟议的5年K24奖中需要解决的重要问题 在此期间，患有高血压和慢性肾病的非裔美国人在健康饮食方面面临多重障碍 这可能导致他们的不良结局，包括心血管疾病和终末期肾病。K24奖项将 保护申请人指导初级研究人员和进行重要研究的时间， 为与以下疾病相关的临床结局不良的高风险个体制定可持续的饮食干预措施： 高血压和CKD。拟议的原始研究将在五个方面进行，加上坚果 豆类肾脏试验，一项针对低SES非洲裔美国人的随机对照饮食干预研究 高血压和CKD患者，并将（a）阐明近期干预组（指导-DASH）的经验 与会者确定他们对促进或阻碍其发展的干预内容和因素的看法。 饮食改变，（B）检查常规护理组（购物-DASH）的购买模式， 可跟踪的礼品卡给当地杂货店，但没有关于购买的指导，以及（c）表征和确定 财政资源紧张（定义为住房和/或粮食无保障）对小学和中学的影响 试验结果-尿白蛋白排泄和血压降低。这些目标将是 解决，而克鲁斯博士提供指导，以新的和现有的初级教师，博士后研究员， 学生在K24授予期间进行的工作将为未来的干预设计和实施提供信息 最大限度地提高申请人工作的可持续性的方法，并使她能够更有效地追求她的工作。 长期职业目标，以改善患有CKD或有CKD风险的弱势人群的结局。

项目成果

Health-Related Social Needs and Kidney Risk Factor Control in an Urban Population.

• DOI: 10.1016/j.xkme.2021.03.005
• 发表时间: 2021-07
• 期刊: Kidney medicine
• 影响因子: 3.9
• 作者: Novick TK;Han D;Jacobs EA;Zonderman A;Evans MK;Crews DC
• 通讯作者: Crews DC

Association between neighborhood social cohesion, awareness of chronic diseases, and participation in healthy behaviors in a community cohort.

社区社会凝聚力，对慢性疾病的认识以及社区人群中健康行为的关联。

• DOI: 10.1186/s12889-021-11633-8
• 发表时间: 2021-09-03
• 期刊: BMC public health
• 影响因子: 4.5
• 作者: Rosenblatt AM;Crews DC;Powe NR;Zonderman AB;Evans MK;Tuot DS
• 通讯作者: Tuot DS

Racial Differences in Trends and Prognosis of Guideline-Directed Medical Therapy for Heart Failure with Reduced Ejection Fraction: the Atherosclerosis Risk in Communities (ARIC) Surveillance Study.

射血分数降低的心力衰竭指南指导药物治疗的趋势和预后的种族差异：社区动脉粥样硬化风险 (ARIC) 监测研究。

• DOI: 10.1007/s40615-021-01202-5
• 发表时间: 2023
• 期刊: Journal of racial and ethnic health disparities
• 影响因子: 3.9
• 作者: Mathews,Lena;Ding,Ning;Sang,Yingying;Loehr,LauraR;Shin,Jung-Im;Punjabi,NareshM;Bertoni,AlainG;Crews,DeidraC;Rosamond,WayneD;Coresh,Josef;Ndumele,ChiadiE;Matsushita,Kunihiro;Chang,PatriciaP
• 通讯作者: Chang,PatriciaP

Race-Free Creatinine-Based Estimation of GFR and Projection of CKD to 2060 in the United States.

基于无种族肌酐的 GFR 估计和美国 2060 年 CKD 的预测。

• DOI: 10.2215/cjn.0000000000000245
• 发表时间: 2023
• 期刊: Clinical journal of the American Society of Nephrology : CJASN
• 作者: Mohebi,Reza;Coresh,Josef;Crews,DeidraC;Estrella,MichelleM;Levey,AndrewS;Liu,Yuxi;Matsushita,Kunihiro;Shlipak,MichaelG;JanuzziJr,JamesL
• 通讯作者: JanuzziJr,JamesL

Prevalence and Determinants of Substance Use Among Indigenous Tribes in South India: Findings from a Tribal Household Survey.

印度南部土著部落中药物使用的流行率和决定因素：部落家庭调查的结果。

• DOI: 10.1007/s40615-021-00964-2
• 发表时间: 2022
• 期刊: Journal of racial and ethnic health disparities
• 影响因子: 3.9
• 作者: Sadath,Anvar;Jose,Kurian;Jiji,KM;Mercy,VT;Ragesh,G;Arensman,Ella
• 通讯作者: Arensman,Ella