REDUCING DISPARITIES IN URINARY CONTROL SYMPTOMS FOR MINORITY WOMEN

减少少数族裔女性排尿控制症状的差异

• 批准号: 10733486
• 负责人: James William Griffith
• 金额: $ 8.12万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-20 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10733486
• 关键词: Adherence; Anxiety; Behavior Therapy; Behavioral; Bladder Control; Body Weight decreased; Chicago; Client satisfaction; Clinical; Cognitive Therapy; Communication; Communities; Community Health; Community Health Aides; Data; Diet Modification; Disease; Disparity; Educational Curriculum; Epidemiologist; Funding; Future; Health Services Accessibility; Healthcare; Home; Hospitals; Human; Incontinence; Insurance Coverage; Intervention; Interview; Knowledge; Lead; Left; Low income; Manipulative Therapies; Measures; Mediating; Medicaid; Medicare; Mental Depression; Mental Health; Minority; Minority Health Research; Minority Women; National Institute of Diabetes and Digestive and Kidney Diseases; Observational Study; Operative Surgical Procedures; Outcome; Participant; Patient-Focused Outcomes; Patients; Pelvic floor structure; Persons; Physical Exercise; Physical therapy; Physical therapy exercises; Population Study; Post-Traumatic Stress Disorders; Private Practice; Process; Psychologist; Psychology; Quality of life; Questionnaires; Recommendation; Reporting; Research; Research Design; Research Personnel; Sampling; Self Administration; Self Direction; Self Management; Symptoms; Therapeutic Intervention; Time; Training; Travel; Treatment Efficacy; Treatment Protocols; Urinary Incontinence; Urology; Woman; Writing; barrier to care; behavioral health; care burden; care seeking; community based treatment; copayment; cost; disparity reduction; efficacy evaluation; efficacy study; efficacy testing; efficacy trial; evidence base; feasibility testing; feasibility trial; handbook; health literacy; human centered design; improved; incontinence symptom; innovation; lifetime risk; lower urinary tract symptoms; micturition urgency; physical therapist; programs; prospective; response; sexual trauma; standard care; urologic

Urinary incontinence and lower urinary tract symptoms (UI/LUTS) are a major healthcare burden. Unfortunately, there are large disparities in knowledge, access to treatment and inclusion in research for minority women with UI/LUTS. One important disparity is the lack of access to evidence-based, non-surgical treatment options (e.g., diet and behavioral modification, weight loss and physical therapy (PT)). Minority women often to not have access to safer, conservative interventions due to poor access and insurance coverage. Additionally, UI/LUTS lead to anxiety and depression, which our preliminary studies have shown, exacerbate organic UI/LUTS symptoms. Given the barriers to accessing PT and the behavioral and mental health impacts on UI/LUTS, this project will evaluate the feasibility and efficacy of a culturally-specific, home- based, community health-worker (CHW) supported, conservative intervention for UI/LUTS. The SUPPORT intervention will include self-managed cognitive behavioral therapy (CBT), behavioral modifications and self-directed physical therapy exercises. We propose to adapt our clinician-guided CBT for UI/LUTS to a self-managed CBT curriculum supplemented with self-directed PT and behavioral retraining and support from a CHW. Our intervention will test the feasibility, efficacy, adherence and acceptability of an intervention like this is in a large, publicly funded hospital in Chicago. Over 4 years, we aim to 1) write a home CBT and PT handbook that is sensitive to patient culture and health literacy and can be followed by the patient at home over 8 weeks to improve UI/LUTS; 2) to determine the efficacy of this intervention in treating UI/LUTS and the acceptability and adherence to this program of our participants. We hypothesize that SUPPORT therapy will significantly improve UI/LUTS and will be satisfying and feasible for patients to complete.

尿失禁和下尿路症状(UI/LUTS)是主要的医疗负担。不幸的是，患有尿路感染/下尿路感染的少数族裔妇女在知识、获得治疗和纳入研究方面存在很大差距。一个重要的差距是缺乏基于证据的非手术治疗选择(例如，饮食和行为调整、减肥和物理治疗(PT))。少数群体妇女往往由于缺乏机会和保险覆盖面而无法获得更安全、保守的干预措施。此外，UI/LUTS会导致焦虑和抑郁，我们的初步研究表明，这会加剧器质性UI/LUTS症状。考虑到获得PT的障碍以及行为和心理健康对UI/LUTS的影响，本项目将评估针对特定文化的、以家庭为基础的、社区卫生工作者(CHW)支持的对UI/LUTS进行保守干预的可行性和有效性。支持干预将包括自我管理认知行为疗法(CBT)、行为矫正和自我定向物理治疗练习。我们建议将我们的临床医生指导的针对UI/LUTS的CBT调整为自我管理的CBT课程，辅之以自我指导的PT和来自CHW的行为再培训和支持。我们的干预措施将在芝加哥的一家大型公共资助医院测试这样的干预措施的可行性、有效性、依从性和可接受性。在4年的时间里，我们的目标是1)编写一本对患者文化和健康素养敏感的家庭CBT和PT手册，并可供在家的患者在8周内遵循，以改善UI/LUTS；2)确定这种干预措施在治疗UI/LUTS方面的有效性，以及我们参与者对此计划的接受度和依从性。我们假设支持治疗将显著改善UI/LUTS，并将是令患者满意和可行的完成。