Native-Controlling Hypertension And Risk through Technology (Native-CHART)

摘要 在美国人口普查局认可的6个种族和民族类别中，有3个类别因其相似性而脱颖而出 历史、人口统计、能见度和健康：美洲印第安人(AIS)、阿拉斯加原住民(ANS)和原住民 夏威夷人和太平洋岛民(NHPI)。NHPI、AI和ANS(后两者通常组合在一起)是 美国最小和第二小的种族群体，人口分别为120万和520万。这些 与美国白人相比，这些群体在健康和死亡率方面存在严重差异。他们担心的是 高血压、心血管疾病和中风的人群患病率高达 通常比美国白人要高。尽管存在这些严重的公共卫生不平等，但这两个群体在很大程度上 被健康研究忽视了。一项以血压控制为目标的干预措施的文献搜索 AIS、ANS和NHPI中的心血管疾病和中风的贡献者没有返回任何结果。没有干预--因此没有 多水平干预研究--曾经专注于这些人群中的BP控制。因此，最重要的是 通过技术控制高血压和风险的目标(Native-Chart)是改进 在这些人群中控制BP及相关的心血管疾病和中风危险因素。我们的研究议程 阐述了一个基于生活经验和理论的健康和健康差距的实用模型。 我们以社区为基础的参与式方法增加了调查结果将赋予可持续发展的可能性 在AI、AN和NHPI社区内受益，范围从大城市地区到阿拉斯加的边境村庄。 我们的方法利用了参与者生活、工作和获得 医疗保健-包括电子健康记录、短信、在线杂货购物应用程序、可穿戴设备 体力活动监测仪和家庭血压监测仪。我们的3个研究项目以干预措施为特色 个人、家庭、社区和政策层面。我们的具体目标是：1)扩大和建立新的 与跨私人、部落和公共支持者的研究伙伴合作，解决BP控制问题 在多层次干预框架内；2)发展多层次、多部门的基础设施，以确保 纳入关于研究重点和控制BP的方法的地方、地区和国家意见；3) 促进科学严谨、文化知识渊博的调查计划，获得新知识以 实施创新方法，提高高血压知识和意识，激活患者， 提高用药依从性，改善AIS、ANS和NHPI之间的血压控制。我们的目标是搬家 这些社区的血压控制、心血管疾病和中风危险因素的研究超出了目前的主要范围 描述状态，并将这些知识转化为有意义的行动。

Abstract Among the 6 racial and ethnic categories recognized by the US Census Bureau, 3 stand out for their similarity in history, demographics, visibility, and health: American Indians (AIs), Alaska Natives (ANs), and Native Hawaiians and Pacific Islanders (NHPIs). NHPIs and AI and ANs (the latter 2 are typically combined) are the smallest and second-smallest US racial groups, with populations of 1.2 and 5.2 million, respectively. These groups experience harsh disparities in health and mortality compared to US Whites. Concerning are their population prevalences of hypertension, cardiovascular disease (CVD), and stroke, which are as high as, and usually higher than, US Whites. Despite these serious public health inequities, both groups have been largely neglected by health research. A literature search for interventions targeting blood pressure (BP) control as a contributor to CVD and stroke in AIs, ANs, and NHPIs returned no results. No interventions – and thus no multilevel intervention studies – have ever focused on BP control in these groups. Accordingly, the overarching objective of Native-Controlling Hypertension And Risks through Technology (Native-CHART) is to improve control of BP and associated CVD and stroke risk factors among these populations. Our research agenda articulates a practical model of health and health disparities grounded in lived experience as well as in theory. Our community-based participatory approach increases the likelihood that findings will confer sustainable benefits within AI, AN, and NHPI communities, which range from large urban areas to frontier villages in Alaska. Our approach harnesses technologies available in the settings where participants live, work, and obtain healthcare – including electronic health records, text messaging, online grocery shopping apps, wearable physical activity monitors, and home BP monitors. Our 3 Research Projects feature interventions at the individual, family, community, and policy levels. Our Specific Aims are to: 1) expand and establish new collaborations with research partners across private, tribal, and public constituencies that address BP control within a multilevel intervention framework; 2) develop a multilevel, multisector infrastructure that ensures inclusion of local, regional, and national views on research priorities and approaches to controlling BP; 3) promote a scientifically rigorous, culturally informed program of inquiry that acquires new knowledge to implement innovative approaches to increase hypertension knowledge and awareness, activate patients, increase medication adherence, and improve BP control among AIs, ANs, and NHPIs. Our goal is to move research on BP control and CVD and stroke risk factors in these communities beyond its current, largely descriptive state, and translate that knowledge into meaningful action.