Shared Decision-Making to Reduce Racial Disparities in Oral Anticoagulation Use in Patients with Non-Valvular Atrial Fibrillation
Shared Decision-Making to Reduce Racial Disparities in Oral Anticoagulation Use in Patients with Non-Valvular Atrial Fibrillation
批准号:
10700858
负责人:
Larry R Jackson
金额:
$15.44万
依托单位:
依托单位国家:
美国
项目类别:
财政年份:
2021
资助国家:
美国
项目状态:
未结题
起止时间:
2021-09-01 至 2026-08-31
关键词:
AddressAdherenceAdoptionAnticoagulantsAnticoagulationArrhythmiaAtrial FibrillationAwardAwarenessBenefits and RisksBiomedical ResearchBlack PopulationsBlack raceCardiacCardiologyCardiovascular systemCaringCessation of lifeClinicClinicalClinical Trials DesignCommunicationCompetenceConflict (Psychology)ConsentCounselingDataDecision MakingDevelopmentDiagnosisDiseaseEducationEnsureEthnic PopulationEvidence based interventionFacultyFeedbackFutureGoalsGuidelinesHealth systemHealthcareHeart AbnormalitiesInterventionInterviewIschemic StrokeK-Series Research Career ProgramsKnowledgeMeasuresMedicineMentorsOralOutcomeOutcome MeasurePatient PreferencesPatient-Centered CarePatientsPerceptionPhysiciansPilot ProjectsPrimary CarePrimary Care PhysicianProcessProductivityProfessional OrganizationsProviderPsychologistQualifyingQuestionnairesRaceResearchResearch PersonnelResearch ProposalsRiskRisk ReductionRoleSamplingScientistSiteStrokeStroke preventionStructureTestingTherapeutic InterventionTrainingUnited StatesUniversitiesWorkacceptability and feasibilityblack patientcare outcomescareerclinical practicedesigndisparity reductioneffectiveness testingefficacy evaluationefficacy testingempowermentethnic minorityethnic minority populationevidence baseexperiencefeasibility testinghealth care deliveryhealth care disparityhealth care qualityheart rhythmimplementation scienceimprovedimproved outcomelow health literacymedical schoolspatient orientedpatient-clinician communicationprimary outcomeprofessorracial disparityracial minorityracial minority populationracial populationrandomized trialrandomized, clinical trialssatisfactionshared decision makingskillssocialstroke risksupport toolstool developmentuptake
中文摘要
黑人非瓣膜性房颤(NVAF)不太可能接受口服抗凝剂(OAC)治疗卒中
英文摘要
Blacks with non-valvular atrial fibrillation (NVAF) are less likely to receive oral anticoagulants (OAC) for stroke
prevention compared with Whites. This is notable given that Blacks have a 3-fold greater risk of NVAF-related
ischemic stroke compared to Whites. My long-term goal is to reduce racial disparities in arrhythmia (defined as
an abnormal heart rhythm) care. My goal in applying for a Mentored Career Development Award to Promote
Faculty Diversity in Biomedical Research is to acquire the research skills and hands-on experience necessary
to become a productive, independent, clinician-scientist. My research focuses on addressing racial disparities in
the use of OAC in patients with NVAF. Candidate and Mentors: I am an Assistant Professor of Medicine at
Duke University’s School of Medicine where I practice as an cardiac electrophysiologist. My primary mentor, Dr.
Kevin Thomas, has expertise in healthcare disparities, specifically the contributors to lower quality of health care
delivery and outcomes among racial and ethnic minority populations. Research and Training: The goal of this
research proposal is to develop a patient decision support tool aimed at facilitating shared decision making,
improving decision quality, and increasing the uptake of OAC in Blacks with NVAF. Shared decision making,
aided through the use of patient decision support tools, has been associated with improved outcomes including
increased knowledge, less decisional conflict, and increased uptake of therapeutic interventions. Unfortunately,
Blacks are more likely to experience non-participatory decision making than non-racial and ethnic minority
populations. In this proposal, I will: 1) conduct interviews among Black and White patients with NVAF and
clinicians to understand the barriers and facilitators toward participating in shared decision making regarding use
of OACs; 2) develop and iteratively evaluate a patient decision support tool; and 3) conduct a pilot study to
assess the feasibility and acceptability of a patient decision support tool to facilitate shared decision making. The
training plan will prepare me for a career aimed at addressing racial disparities in arrhythmia care and will include
education in 1) implementation science to promote the adoption of our patient decision support tool in clinical
practice; 2) accruing skills in the design and testing of patient decision support tools; and 3) design of clinical
trials to assess the efficacy of our intervention. This research will provide data to support a R01 proposal to test
the efficacy of a patient decision support tool to improve shared decision making, decision quality, and potentially
increase the use an adherence of OAC in Blacks in a multisite randomized clinical trial. Summary: The proposed
research will lead to the development of a patient decision support tool intervention used to facilitate shared
decision making in Blacks with NVAF, improve decision quality, and potentially increase the uptake of OAC in
Blacks with NVAF. The K01 Diversity award will support my development into a leader in healthcare disparities
research with the goal of promoting patient-centered care by empowering patients to make informed, values-
based decisions needed to improve decision quality and potentially reduce racial disparities in arrhythmia care.
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DOI:
10.2147/ceor.s402344
发表时间:
2023
期刊:
ClinicoEconomics and outcomes research : CEOR
影响因子:
--
作者:
[]
通讯作者:
Call to action: Understanding the differences in the use of SGLT-2 inhibitors and GLP-1 receptor agonists.
行动呼吁:了解SGLT-2抑制剂和GLP-1受体激动剂的使用差异。
DOI:
10.1016/j.ajpc.2023.100477
发表时间:
2023-03
期刊:
AMERICAN JOURNAL OF PREVENTIVE CARDIOLOGY
影响因子:
4.1
作者:
[Khedagi, Apurva, Hoke, Cara, Kelsey, Michelle, Coviello, Andrea, Jones, W Schuyler, Jackson, Larry R 2nd, Patel, Manesh R, McGarrah, Rob W, Pagidipati, Neha J, Shah, Nishant P]
通讯作者:
Shah, Nishant P
DOI:
10.1016/j.hroo.2022.09.003
发表时间:
2022-12
期刊:
HEART RHYTHM O2
影响因子:
--
作者:
[Kiernan, Katherine, Dodge, Shayne E., Kwaku, Kevin F., Jackson, Larry R., II, Zeitler, Emily P.]
通讯作者:
Zeitler, Emily P.
Safety of continuous left atrial phased-array intracardiac echocardiography during left atrial ablation for atrial fibrillation.
在左心消融期间,左室阵列阵列的距离左侧阵列的安全性超声心动图的安全性。
DOI:
10.1016/j.hroo.2022.08.001
发表时间:
2022-12
期刊:
HEART RHYTHM O2
影响因子:
--
作者:
[Jackson, Larry R., II, Holmqvist, Fredrik, Parish, Alice, Green, Cynthia L., Piccini, Jonathan P., Bahnson, Tristram D.]
通讯作者:
Bahnson, Tristram D.
DOI:
10.1016/j.ajpc.2021.100284
发表时间:
2021-12
期刊:
American journal of preventive cardiology
影响因子:
4.1
作者:
[Mendys P, Jackson LR 2nd, Solimon EZ, Howard G, Ferdinand K]
通讯作者:
Ferdinand K
共 8 条
Shared Decision-Making to Reduce Racial Disparities in Oral Anticoagulation Use in Patients with Non-Valvular Atrial Fibrillation
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批准号:10471407
-
项目类别:
-
资助金额:$15.82万
-
财政年份:2021
-
负责人:Larry R Jackson
-
依托单位:
Shared Decision-Making to Reduce Racial Disparities in Oral Anticoagulation Use in Patients with Non-Valvular Atrial Fibrillation
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批准号:10282856
-
项目类别:
-
资助金额:$16.18万
-
财政年份:2021
-
负责人:Larry R Jackson
-
依托单位:
海外基金