Addressing Low Cardiac Rehabilitation Participation among Patients with Low Socioeconomic Status

项目摘要/摘要 Lena Mathews，医学博士，MHS，约翰霍普金斯大学心脏病学系助理教授。 马修斯博士正在申请以患者为导向的导师研究职业发展奖，以期 获得技能、知识和研究经验，为独立职业生涯奠定基础 研究人员使用实施科学来解决心血管健康差距问题。马修斯博士的职业生涯 发展计划包括松下幸弘博士、奇阿迪·恩杜梅尔博士和 Kristin Riekert；教学论和定向学习；以及指导临床研究适应和实施 以理论为基础的多成分干预增加心脏病患者的心脏康复(CR)使用量 社会经济地位低。研究议程的具体目标是：1)定量评估障碍 在不同的住院人群中进行CR转诊和登记，考虑种族、性别和 其他社会人口学特征；2)定性地阐明认知能力利用的障碍 具有较低社会经济地位的多样化临床人群；3)适应和测试 导航员干预，由社区卫生工作者提供，并通过社区参与进行改进 利益攸关方，以提高社会经济地位较低的个人对CR的利用。她试图建立 根据她在流行病学和生物统计学方面的研究奖学金培训，以及她作为 约翰霍普金斯大学心脏病专家和心脏康复主任，通过获得额外的技能和 实现她的职业目标所需的专业知识。这对以患者为中心的研究职业发展的指导 (K23)奖将为她提供机会：1)发展高级流行病学和卫生方面的技能 使用电子健康记录的利用研究2)开发定性方法的专业知识，以提供信息 干预设计和评估3)发展行为改变理论的技能，以开发临床干预措施 吸引社会经济地位较低的患者；4)掌握实施科学方法的技能 包括基于社区的参与性研究；5)参与额外的职业发展活动，以 使她能够过渡到作为临床医生兼研究人员的独立。在颁奖过程中培养这些技能 Period将支持马修斯博士成为一名独立的临床研究员的长期目标，领导 努力改进向边缘化人群提供心血管疾病预防治疗，最终目标是 减少心血管疾病的差距。

PROJECT SUMMARY/ABSTRACT Lena Mathews, MD, MHS is an Assistant Professor in the Division of Cardiology at Johns Hopkins University. Dr. Mathews is applying for a Mentored Patient-Oriented Research Career Development Award in order to obtain the skills, knowledge and research experience to provide the foundation for a career as an independent investigator using implementation science to address cardiovascular health disparities. Dr. Mathews’s career development plan includes interdisciplinary mentorship from Drs. Kunihiro Matsushita, Chiadi E. Ndumele, and Kristin Riekert; didactics and directed learning; and mentored clinical research adapting and implementing a theory-based multi-component intervention to increase cardiac rehabilitation (CR) use among individuals with low socioeconomic status. The specific aims of the research agenda are to: 1) Quantitatively evaluate barriers to CR referral and enrollment in a diverse hospitalized population by SES, accounting for race, gender and other sociodemographic characteristics; 2) Qualitatively elucidate perceived barriers to CR utilization in a diverse clinical population with low socioeconomic status; 3) Adapt and test the feasibility and acceptability of a navigator intervention, delivered by community health workers and refined by engagement of community stakeholders, to increase CR utilization among individuals with low socioeconomic status. She seeks to build upon her research fellowship training in epidemiology and biostatistics, and her clinical background as a Cardiologist and the Director of Cardiac Rehabilitation at Johns Hopkins, by acquiring additional skills and expertise required to achieve her career goals. This Mentored Patient-Oriented Research Career Development (K23) Award will provide her with the opportunity to: 1) develop skills in advanced epidemiology and health utilization research using electronic health records 2) develop expertise in qualitative methods, to inform intervention design and evaluation 3) develop skills in behavior change theory to develop clinical interventions that engage patients with low socioeconomic status; 4) acquire skills in implementation science methods including community based participatory research; 5) engage in additional career development activities to enable her transition to independence as a clinician-investigator. Developing these skills during the award period will support Dr. Mathews’ long-term goal of becoming an independent clinical investigator, leading efforts to improve the delivery of CVD prevention therapies to marginalized populations, with the ultimate goal of reducing CVD disparities.