Socioecological Factors Associated With Ethnic Disparities In Bariatric Surgery Utilization - DEIA Mentorship Supplement

与减肥手术利用中的种族差异相关的社会生态因素 - DEIA 指导补充资料

• 批准号: 10600383
• 负责人: Sarah Elizabeth Messiah
• 金额: $ 40.66万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-16 至 2023-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10600383
• 关键词: Adherence; Administrative Supplement; Affect; Award; Bariatrics; Behavior; Belief; Black Populations; Blood; Blood Glucose; Body Weight decreased; Body mass index; Characteristics; Clinical; Clinical Sciences; Consultations; Development; Diabetes Mellitus; Educational Status; Endocrinology; Epidemiology; Ethnic Origin; Ethnic group; Faculty; Funding; Goals; Health; Heart Diseases; Hispanic Populations; Influentials; Infrastructure; Intervention; Joints; Malignant Neoplasms; Mediating; Medical; Medicine; Mentors; Mentorship; Metabolic; Mild obesity; Morale; Morbid Obesity; NCI Scholars Program; Non-Insulin-Dependent Diabetes Mellitus; Not Hispanic or Latino; Obesity; Operative Surgical Procedures; Outcome; Parents; Patients; Persons; Population; Postdoctoral Fellow; Postoperative Period; Prevalence; Principal Investigator; Procedures; Professional Organizations; Psychiatry; Public Health; Randomized; Recovery; Research Assistant; Research Personnel; Resolution; Risk Factors; Role; Schedule; Science; Scientist; Standardization; Training; United States; Vulnerable Populations; Weight; Work; bariatric surgery; base; cardiometabolic risk; clinical care; comorbidity; conventional therapy; diabetic; effective therapy; ethnic disparity; ethnic diversity; ethnic minority population; follow-up; gut microbiota; healthy weight; improved; interest; metabolic rate; mortality; obese person; pandemic disease; parent grant; patient population; peer; peer coaching; public health relevance; screening; social; social stigma; tool; treatment choice; undergraduate student; uptake

PROJECT ABSTRACT Metabolic and bariatric surgery (MBS) is a safe and medically effective treatment choice for severe obesity. Yet, despite (1) an increase in the number of MBS procedures performed in the United States annually, and (2) the fact that many people express interest in MBS, only about 50% of referred or eligible persons for MBS actually undergo the procedure. Furthermore, studies have documented Hispanics and non-Hispanic Blacks (NHB) are significantly less likely than non-Hispanic Whites (NHW) to complete MBS despite higher rates of both severe obesity and obesity-related comorbidities (e.g. type 2 diabetes, heart disease, cancer). Reasons for the ethnic group disparities in post-MBS weight loss and comorbidity resolution are largely unknown; therefore, the following aims are being conducted: AIM 1. Identify the socioecological characteristics associated with the following four patient-determined MBS groups: (1) early-completers of MBS (< 3 months), (2) later-completers of MBS (>3 months but within 12-15 months), (3) non-completers of MBS because surgery was electively cancelled after being scheduled; and (4) non-completers due to no interest in MBS after receiving a medical referral. AIM 2. Determine how differences in Groups 1 and 2 relate to post-operative weight loss and comorbidity resolution at 6- 12- and 24-months post- MBS. AIM 3. Explore the mediating and moderating effect of ethnicity, intrapersonal, interpersonal, clinical, and other environmental interactions on MBS commitment group differences. For this administrative supplement we are proposing over 1 year to (1) enhance our current parent study with two additional sub-projects, the first one led by our current postdoc fellow (Dr. Elisa Morales- Marroquín) titled Role of MBS and Ethnicity on the Relationship Between the Blood and Gut Microbiotas and the second led by our clinical collaborator (Dr. Jaime Almandoz) titled An In-Depth Exploration of the Impact of Weight Stigma and Bias on MBS Completion and Post-MBS Weight Loss in Ethnically Diverse Patients, each with their own set of specific aims; (2) add two additional graduate research assistant training slots from DEIA backgrounds to assist Drs. Morales Marroquín and Almandoz with their projects; (3) enhance the current mentoring infrastructure to expand our Summer Scholars Program for undergraduates; and (4) use the parent R01 as an example of successful team science. These goals will reach trainees at the faculty, postdoc, graduate, and undergraduate training level and will promote peer-to-peer mentoring through all levels, led by the parent grant Principal Investigator. In summary, the parent award has produced impactful work to date that is informing clinical care for MBS patients in post-pandemic recovery efforts. Our parent grant provides an excellent example of how team, interdisciplinary science, and scientists representing epidemiology, surgery, psychiatry, endocrinology, and obesity medicine can successfully collaborate to produce impactful outcomes to improve the health of vulnerable populations. Here we propose to continue with that interdisciplinary emphasis via one basic/clinical science sub-project and one clinical/public health sub-project.

项目摘要 代谢和减肥手术（MBS）是严重肥胖症的安全且具有医学上有效的治疗选择。然而， 任务（1）在美国年度执行的MBS程序数量增加，以及（2） 许多人对MB表示兴趣，实际上只有大约50％的推荐人或合格的人 进行程序。此外，研究记录了西班牙裔和非西班牙裔黑人（NHB） 比非西班牙裔白人（NHW）完成MBS目的地的可能性更高的可能性更高 肥胖和肥胖相关的合并症（例如2型糖尿病，心脏病，癌症）。种族原因 MBS后体重减轻和合并症分辨率的小组分布在很大程度上未知。因此， 正在进行以下目标：目标1。确定与 以下四个患者确定的MBS组：（1）MBS的早期完成者（<3个月），（2）后期完成者 MBS（> 3个月但在12-15个月内），（3）MBS的未完成者，因为手术是电子的 被安排后取消； （4）由于接受医疗后对MBS没有兴趣而导致的未完成者 推荐。目标2。确定第1组和2组的差异与术后减肥和合并症有关 分辨率为6-12和24个月后。目标3。探索种族的中介和调节作用， MBS承诺组的人际，人际，临床和其他环境互动 差异。对于这种行政补充，我们提议1年以上，以（1）增强我们当前的父母 研究了另外两个子项目，这是我们当前的博士后研究员领导的第一个（Elisa Morales-博士） Marroquín）标题为MBS和种族在血液与肠道微生物群和肠道关系之间的关系中的作用 由我们的临床合作者（Jaime Almandoz博士）领导的第二名 MBS完成的体重污名和偏见和种族多种患者的MBS减肥后体重减轻，每个患者，每个患者 以自己的一组特定目标； （2）添加Deia的另外两个研究生研究助理培训插槽 协助DRS的背景。 MoralesMarroquín和Almandoz的项目； （3）增强电流 心理基础设施，扩大我们针对本科生的夏季学者计划； （4）使用父母 R01作为成功的团队科学的一个例子。这些目标将接触到教师，博士后，毕业生， 和本科培训水平，并将在父母领导的各个层面上促进对等的心理 授予首席调查员。总而言之，迄今为止，父母奖已提出了有影响力的工作 大流行恢复工作中MBS患者的临床护理。我们的父母赠款提供了一个很好的例子 关于代表流行病学，手术，精神病学的团队，跨学科科学和科学家如何 内分泌学和肥胖医学可以成功合作以产生影响的结果以改善 脆弱人群的健康。在这里，我们建议继续通过一个人继续跨学科的重点 基础/临床科学副投影和一项临床/公共卫生子项目。