Long-Term Adherence to Monitoring/Treatment in Underserved Asian Americans with Chronic HBV
服务不足的亚裔美国人慢性乙型肝炎患者长期坚持监测/治疗
基本信息
- 批准号:10015225
- 负责人:
- 金额:$ 24.89万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2018
- 资助国家:美国
- 起止时间:2018-09-19 至 2023-08-31
- 项目状态:已结题
- 来源:
- 关键词:AbdomenAddressAdherenceAfrican AmericanAmericanAntiviral AgentsAsian AmericansBlood TestsCancer EtiologyCaringCessation of lifeChronicChronic Hepatitis BClinicalCommunitiesCommunity NetworksComparative StudyControl GroupsDataDeath RateDisease ManagementDoctor of PhilosophyDoseEducationEffectiveness of InterventionsEnvironmentEthnic groupEvidence based interventionFeedbackGoalsGoldGuidelinesHealth Care CostsHepatitis B VirusHepatitis C virusHispanic AmericansIncidenceIndividualInstitute of Medicine (U.S.)InterventionKnowledgeLiver diseasesLongterm Follow-upMalignant NeoplasmsMalignant neoplasm of liverMeasuresMediator of activation proteinMonitorMotivationMultilingualismNot Hispanic or LatinoOutcomeParticipantPatient Self-ReportPatientsPersonsPopulationPrevalencePrimary Health CarePrimary carcinoma of the liver cellsRandomized Controlled TrialsResearchResearch Project GrantsResourcesRiskSelf EfficacySystemTechnologyTenofovirTestingText MessagingTimeTrainingTranslatingTreatment EffectivenessUltrasonographyUnited States National Institutes of HealthViralVirus DiseasesVisitVisual Aidbasecancer health disparitycohortcomparative effectivenesscompare effectivenessdesigneffectiveness testingentecavirevidence baseexperiencefollow-uphealth care availabilityhigh riskhigh risk populationimprovedinnovationmHealthmedication compliancemortalitymultidisciplinarynon-complianceoptimal treatmentspatient orientedpreventprimary care settingprogramsracial and ethnicresponsestandard carestandard of caretreatment adherencetreatment armtreatment guidelinesvirtual
项目摘要
PROJECT SUMMARY
Full Research Project 1 – Liver Cancer
Long-Term Adherence to Monitoring/Treatment in Underserved Asian Americans with Chronic HBV
TU FCCC: Grace X. Ma, PhD (Co-Leader) and Nestor Esnaola, MD, MPH (Co-Leader, URM ESI)
HC: Sarit A. Golub, PhD (Co-Leader) and Chibuzo Enemchukwu, MD (Co-Leader, URM ESI)
Although Asian Americans make up 6% of total U.S. population, they account for over 50% of Americans with
chronic hepatitis B (CHB), which is associated with 75% of hepatocellular carcinoma (HCC), the most common
type of liver cancer. Asian Americans as a liver cancer disparity population are 8-13 times more likely to
develop liver cancer with 60% higher death rate than non-Hispanic whites (NHWs). Research indicates that
blood tests every six months and an abdominal ultrasound every 12 months, combined with antiviral treatment
(e.g. entecavir or tenofovir) when appropriate, is the gold standard of care to reduce the risk of liver disease
(including HCC). However, adherence to monitoring and antiviral treatment guidelines among Asian American
patients with CHB is as low as 40% to 53%. Poor healthcare access and significant cultural barriers may
prevent long-term adherence to monitoring and optimal treatment, placing Asian Americans at a
disproportionately high risk for HCC and increased healthcare costs. Building on previous studies on a patient
navigator-led intervention to improve monitoring and care among noncompliant Asian American with CHB,
conducted by our established academic-clinical-community research team, we developed and pilot tested a
virtual patient navigation toolkit system (VPN toolkit) to replace our traditional patient navigator-led CHB
management. Since our preliminary data and other studies indicate that text messaging (TM) interventions
have potential to significantly improve adherence to treatment across illnesses, we propose to test the
effectiveness of TM versus enhanced mHealth intervention (VPN Toolkit + TM) designed to help sustain and
improve long-term adherence (i.e., 24 months follow ups) to monitoring and antiviral treatment guidelines,
thereby reducing cancer health disparities among underserved at-risk Asian Americans with CHB leveraging
our existing cohort of CHB patients. The specific aims are: 1) Evaluate the comparative effectiveness of TM
vs VPN+TM for improving long-term adherence to monitoring (doctor visit and blood tests) every six months (6-
, 12-, 18-, and 24-month follow-ups) and ultrasound (at 12 and 24 months); 2) Compare the effectiveness of
TM vs VPN+TM in improving and sustaining medication adherence (measured through self-report and
electronic monitoring) among Asian Americans with CHB who meet antiviral treatment guidelines; 3) Examine
mediators of intervention effectiveness, including dose-response (i.e., utilization of the TM and VPN toolkit),
information (knowledge), motivation, and self-efficacy. Our comparative study of mHealth approaches will
demonstrate how technology-based interventions can be integrated most effectively into real-world clinical
settings to reduce HBV-related liver cancer disparities. If effective, this VPN+TM intervention is a highly
disseminable intervention with the potential to have a significant impact on reducing viral-related cancer
disparities among underserved Asian Americans and other highest-risk populations.
项目总结
项目成果
期刊论文数量(0)
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GRACE X. MA其他文献
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{{ truncateString('GRACE X. MA', 18)}}的其他基金
Impact of Structural Racism and Discrimination on Liver Disease Disparities in High-Risk Asian American Populations
结构性种族主义和歧视对高危亚裔美国人肝病差异的影响
- 批准号:
10474736 - 财政年份:2022
- 资助金额:
$ 24.89万 - 项目类别:
Impact of Structural Racism and Discrimination on Liver Disease Disparities in High-Risk Asian American Populations
结构性种族主义和歧视对高危亚裔美国人肝病差异的影响
- 批准号:
10633201 - 财政年份:2022
- 资助金额:
$ 24.89万 - 项目类别:
Unpacking the Mechanisms of Disparities for HIV-related Hypertension in African American and Asian Pacific American MSM
揭示非裔美国人和亚太裔 MSM 中 HIV 相关高血压差异的机制
- 批准号:
9897219 - 财政年份:2018
- 资助金额:
$ 24.89万 - 项目类别:
Unpacking the Mechanisms of Disparities for HIV-related Hypertension in African American and Asian Pacific American MSM
揭示非裔美国人和亚太裔 MSM 中 HIV 相关高血压差异的机制
- 批准号:
10349449 - 财政年份:2018
- 资助金额:
$ 24.89万 - 项目类别:
Long-Term Adherence to Monitoring/Treatment in Underserved Asian Americans with Chronic HBV
服务不足的亚裔美国人慢性乙型肝炎患者长期坚持监测/治疗
- 批准号:
10251232 - 财政年份:2018
- 资助金额:
$ 24.89万 - 项目类别:
Long-Term Adherence to Monitoring/Treatment in Underserved Asian Americans with Chronic HBV
服务不足的亚裔美国人慢性乙型肝炎患者长期坚持监测/治疗
- 批准号:
10462705 - 财政年份:2018
- 资助金额:
$ 24.89万 - 项目类别:
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