Mentoring in community engaged implementation research to reduce cardiovascular disparities

项目总结 这是Namratha的以患者为中心的研究(POR)的K24职业中期研究员奖的建议 坎杜拉，医学博士，西北大学范伯格医学院公共卫生硕士。坎杜拉博士是助理医生 医学和预防医学教授，社区卫生中心联席主任。 坎杜拉博士的学术重点是了解心血管疾病的社会和文化决定因素 南亚裔美国人的疾病(CVD)差异和实施循证干预(EBI) 使用基于社区的参与性研究(CBPR)方法。南亚裔美国人，其中大多数 与非西班牙裔白人和其他亚洲人相比，移民受到心血管疾病的影响不成比例 美国人。虽然有充分的证据表明，高强度的饮食和体力活动干预可以改善心血管疾病 成人中的风险因素，这些EBI在南亚和其他脆弱人群中的覆盖范围有限，因为 大多数EBI是在狭窄的临床人群中发展起来的，缺乏文化显着性，不能解释多层次 健康的社会决定因素，在新的环境中很难实施。坎杜拉博士在 流行病学研究和基于社区的生活方式干预试验，并一直积极指导 学生和初级调查人员关于健康差距和社区参与的研究。这样做的目的是 K24的应用是在社区参与实施研究中促进科学和指导 以最佳方式提供和维持以健康差距负担严重的人群为重点的EBI。支持 K24将为坎杜拉博士提供受保护的时间：1)将更多的时间投入到指导不同的群体 社区参与实施研究的年轻研究人员；2)提高实施科学水平 通过导师培训和资深导师的指导进行研究和指导技能；3)扩展她 目前资助的工作是填补为弱势群体提供和维持EBI的科学方面的重大空白 人口；以及4)在如何以最佳方式交付的新的多部门协作研究中发挥领导作用 EBIS旨在消除健康差距。目前的K24提案建立在科学前提的基础上，并扩展了 在美国国立卫生研究院资助的两种社区参与的生活方式背景下对PI的研究和指导 减少南亚成年人和青少年心血管疾病差距的干预试验(Saheli和Saath 试验)。PI和她的受训者将使用混合方法：1)调查社会和结构性决定因素 这导致了在Saheli和Saath试验中EBI的执行结果不同； 2)评估在Saheli和Saath试验中实施的EBIS的可持续性；以及3)了解 利益攸关方对哪些执行成果和评价战略最有意义 在实施EBIS预防健康差距人群中的心血管疾病时是可行的。的行为 拟议的目标将加快建立可持续社区伙伴关系的科学和指导，并 以最佳方式提供改善弱势人群健康和促进健康公平的EBI的模式。

PROJECT SUMMARY This is a proposal for a K24 Midcareer Investigator Award in Patient-Oriented Research (POR) for Namratha Kandula, MD, MPH of Northwestern University Feinberg School of Medicine. Dr. Kandula is Associate Professor of Medicine and Preventive Medicine and co-Director of the Center for Community Health. Dr. Kandula's scholarship is focused on understanding the social and cultural determinants of cardiovascular disease (CVD) disparities in South Asian Americans and implementing evidence-based interventions (EBIs) using community-based participatory research (CBPR) methods. South Asian Americans, the majority of whom are immigrants, are disproportionately affected by CVD compared to non-Hispanic whites and other Asian Americans. While there is ample evidence that intensive diet and physical activity interventions improve CVD risk factors in adults, these EBIs have limited reach in South Asian and other vulnerable populations because most EBIs were developed in narrow clinical populations, lack cultural salience, do not account for multilevel social determinants of health, and are difficult to implement in new settings. Dr. Kandula has expertise in epidemiologic studies and community-based lifestyle intervention trials and has been actively mentoring students and junior investigators on health disparities and community engaged research. The objective of this K24 application is to promote science and mentorship in community engaged implementation research to optimally deliver and sustain EBIs focused on populations with a high burden of health disparities. Support from the K24 will provide Dr. Kandula with protected time to: 1) Devote more time to mentoring a diverse group of young investigators in community engaged implementation research; 2) Improve her implementation science research and mentoring skills through mentor training and guidance from senior mentors; 3) Extend her currently funded work to fill critical gaps in the science of delivering and sustaining EBIs for vulnerable populations; and 4) Assume leadership in new multisector, collaborative research on how to optimally deliver EBIs to eliminate health disparities. The current K24 proposal builds upon the scientific premise and extends the research and mentorship of the PI in the context of her two NIH-funded, community engaged lifestyle intervention trials to reduce CVD disparities in South Asian adults and adolescents (SAHELI and SAATH trials). The PI and her mentees will use mixed methods to: 1) Investigate social and structural determinants that contributed to differences in implementation outcomes of EBIs in the SAHELI and SAATH trials; 2) Evaluate sustainability of the EBIs implemented in the SAHELI and SAATH trials; and 3) Understand stakeholder perspectives on which implementation outcomes and evaluation strategies are most meaningful and feasible when implementing EBIs for CVD prevention in health disparity populations. Conduct of the proposed Aims will accelerate science and mentorship in building sustainable community partnerships and models to optimally deliver EBIs that improve the health of vulnerable populations and advance health equity.