Mentoring in community engaged implementation research to reduce cardiovascular disparities

项目摘要 这是Namratha的K24职业中期研究者以患者为导向的研究（POR）奖的提案 Kandula，医学博士，西北大学范伯格医学院公共卫生硕士。Kandula博士是助理 医学和预防医学教授，社区卫生中心联合主任。 博士Kandula的奖学金专注于了解心血管疾病的社会和文化决定因素， 南亚裔美国人的心血管疾病（CVD）差异和实施循证干预措施（EBI） 社区参与式研究（CBPR）。南亚裔美国人，其中大多数 是移民，与非西班牙裔白人和其他亚洲人相比， 美国人虽然有充分的证据表明，密集的饮食和体力活动干预改善心血管疾病 成年人的风险因素，这些EBI在南亚和其他弱势群体中的影响有限， 大多数EBI是在狭窄的临床人群中发展起来的，缺乏文化显著性，不能解释多层次的 这是健康的社会决定因素，很难在新的环境中实施。坎杜拉医生擅长 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 学生和初级调查员的健康差距和社区参与的研究。的目的 K24应用是为了促进社区参与实施研究的科学和导师制， 以最佳方式提供和维持以健康差距负担沉重的人群为重点的EBI。支持 从K24将为Kandula博士提供受保护的时间：1）投入更多的时间来指导一个多样化的群体 社区参与实施研究的年轻研究者; 2）提高她的实施科学 通过导师培训和高级导师的指导，提高研究和指导技能; 3） 目前资助的工作，以填补关键差距的科学提供和维持EBI为弱势群体 人口; 4）在新的多部门合作研究中发挥领导作用，研究如何以最佳方式提供 EBI旨在消除健康差距。目前的K24提案建立在科学前提之上， PI的研究和指导在她的两个NIH资助的背景下，社区参与的生活方式 减少南亚成人和青少年CVD差异的干预试验（SAHELI和SAATH 审判）。PI和她的学员将使用混合方法：1）调查社会和结构决定因素 导致SAHELI和SAATH试验中EBI实施结果差异的因素; 2)评价SAHELI和SAATH试验中实施的EBI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的看法 在健康差异人群中实施EBI预防CVD是可行的。行为 拟议的目标将加速科学和指导，以建立可持续的社区伙伴关系， 以最佳方式提供EBI的模式，改善弱势群体的健康状况，促进健康公平。

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.