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Improving Metabolic Screening in Diverse Severely Mentally Ill Populations

改善不同严重精神疾病人群的代谢筛查

基本信息

批准号：
9119047
负责人：
Christina Mangurian
金额：
$ 17.77万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-08-16 至 2017-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9119047
关键词：
Adult Antipsychotic Agents Applications Grants Area Attention Biometry California Cardiovascular Diseases Clinic Clinical Clinical Decision Support Systems Clinical Investigator Clinical Research Communities Complement Complex County Dedications Diabetes Mellitus Dyslipidemias Early Diagnosis Early treatment Effectiveness Effectiveness of Interventions Electronics Ensure Epidemiology Ethnic Origin Evidence based intervention Focus Groups General Hospitals General Population Goals Guidelines Health Services Research Healthcare Systems High Prevalence Hypertension International Internist Intervention Knowledge Laboratories Language Lead Link Measurement Medicaid Medicine Mental Health Mental Health Services Mentally Ill Persons Mentored Patient-Oriented Research Career Development Award Mentors Metabolic Metabolic Diseases Methods Minority Modeling Monitor Online Systems Performance Pharmaceutical Preparations Pilot Projects Population Primary Health Care Provider Psychiatrist Public Health Publications Race Recommendation Research Research Design Research Methodology Research Personnel Research Training Risk San Francisco Services Surface System Target Populations Time Training Translations Underserved Population Universities Visit Vulnerable Populations Washington Weight Gain base cardiovascular risk factor career clinical practice ethnic diversity evidence base experience health disparity high risk implementation research improved metabolic rate multidisciplinary programs racial and ethnic racial diversity randomized trial research study screening severe mental illness support tools tool underserved minority uptake

项目摘要

DESCRIPTION (provided by applicant): This application for a K23 Mentored Patient-Oriented Research Career Development Award will support critical additional training for the candidate, Dr. Christina Mangurian, a psychiatrist at the University of California, San Francisco (UCSF), based at San Francisco General Hospital. Dr. Mangurian's research plan focuses on improving metabolic screening among ethnically and racially diverse severely mentally ill populations served in community mental health clinics. To further develop her career as a mental health services researcher and to accomplish her research plan, she requires specific training in three areas: 1) clinical research methods (e.g., biostatistics, epidemiology, and mixed methods); 2) implementation research; and 3) mental health disparities research. Dr. Mangurian has assembled a multidisciplinary team of mentors to facilitate her training and research. Her primary mentor is Dr. Dean Schillinger, a UCSF primary care internist with international expertise in primary care health services research, including implementation research in public health settings. He will oversee all training and research plans, providing his wealth of experience in this field, including his dedication to improving services for underserved populations. His expertise will be complemented by Dr. Martha Shumway, a UCSF mental health services researcher; and Dr. John Newcomer, a Washington University clinical investigator who is an expert in clinical and laboratory measurement of metabolic risk in severely mentally ill populations and in the translation of monitoring objectives into clinical practice. People with severe mental illness die, on average, 25 years earlier than the general population, most often from cardiovascular disease. Metabolic abnormalities (e.g., diabetes, hypertension, dyslipidemia) resulting from antipsychotic medications used to treat this population can lead to increased rates of cardiovascular disease. Despite national guidelines emphasizing the importance of screening, metabolic screening rates for this population remain low. There is an urgent need for evidence-based, generalizable interventions that can be feasibly implemented to improve metabolic screening at community mental health clinics where this vulnerable population is primarily served. Therefore, in Aim 1, Dr. Mangurian proposes to characterize metabolic screening rates among adults with severe mental illness who receive services at community mental health clinics in San Francisco County. In Aim 2, she will tailor an intervention to improve metabolic screening for adults with severe mental illness by engaging multiple stakeholders and focusing on barriers that may impact high-risk racial/ethnic subpopulations. In Aim 3, she will conduct a pilot study of the intervention. The results of this research will contribute new information about implementation efforts to improve metabolic screening in community mental health clinics and will form the basis of an R01 application to study the effectiveness of this intervention.

描述（由申请人提供）：本 K23 指导患者导向研究职业发展奖申请将支持候选人克里斯蒂娜·曼古里安 (Christina Mangurian) 博士的关键额外培训，她是加州大学旧金山分校 (UCSF) 旧金山综合医院的精神病学家。 Mangurian 博士的研究计划重点是改善社区心理健康诊所服务的不同种族和种族的严重精神疾病人群的代谢筛查。为了进一步发展她作为心理健康服务研究员的职业生涯并完成她的研究计划，她需要在三个领域进行专门培训：1）临床研究方法（例如生物统计学、流行病学和混合方法）； 2）实施研究； 3）心理健康差异研究。 Mangurian 博士组建了一支多学科导师团队来促进她的培训和研究。她的主要导师是 Dean Schillinger 博士，他是加州大学旧金山分校的初级保健内科医生，在初级保健卫生服务研究（包括公共卫生环境中的实施研究）方面拥有国际专业知识。他将监督所有培训和研究计划，提供他在该领域的丰富经验，包括致力于改善服务不足的人群的服务。加州大学旧金山分校心理健康服务研究员 Martha Shumway 博士将补充他的专业知识；约翰·纽科默 (John Newcomer) 博士是华盛顿大学的临床研究员，他是严重精神疾病人群代谢风险的临床和实验室测量以及将监测目标转化为临床实践方面的专家。患有严重精神疾病的人平均比普通人群早 25 年死亡，最常见的是心血管疾病。用于治疗该人群的抗精神病药物导致的代谢异常（例如糖尿病、高血压、血脂异常）可能导致心血管疾病的发病率增加。尽管国家指南强调筛查的重要性，但该人群的代谢筛查率仍然很低。迫切需要基于证据的、可推广的干预措施，这些干预措施可以切实可行地实施，以改善主要为这一弱势群体提供服务的社区精神卫生诊所的代谢筛查。因此，在目标 1 中，Mangurian 博士建议描述在旧金山县社区心理健康诊所接受服务的患有严重精神疾病的成年人的代谢筛查率。在目标 2 中，她将通过让多个利益相关者参与并重点关注可能影响高风险种族/族裔亚群的障碍，制定一项干预措施，以改善患有严重精神疾病的成年人的代谢筛查。在目标 3 中，她将对干预措施进行试点研究。这项研究的结果将提供有关改善社区心理健康诊所代谢筛查的实施工作的新信息，并将构成 R01 应用程序的基础，以研究该干预措施的有效性。

项目成果

期刊论文数量（21）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

The missing vital sign.

DOI：
10.1136/bmj.f4163
发表时间：
2013-07-05
期刊：
BMJ (Clinical research ed.)
影响因子：
0
作者：
Mangurian C;Cowan MJ
通讯作者：
Cowan MJ

First-Episode Schizophrenia and Diabetes Risk.

首发精神分裂症和糖尿病风险。

DOI：
10.1001/jamapsychiatry.2017.0762
发表时间：
2017
期刊：
JAMA psychiatry
影响因子：
25.8
作者：
Mangurian,Christina;Riano,NicholasS;Newcomer,JohnW
通讯作者：
Newcomer,JohnW

Pop-up treatment plans for the urban psychiatric emergency room.

城市精神科急诊室的弹出治疗计划。

DOI：
10.1176/appi.ps.640602
发表时间：
2013
期刊：
Psychiatric services (Washington, D.C.)
影响因子：
0
作者：
Cheng,JasonE;Dilley,JamesW;Mangurian,ChristinaV
通讯作者：
Mangurian,ChristinaV

Descriptive analysis of a novel health care approach: reverse colocation-primary care in a community mental health "home".

对一种新颖的医疗保健方法的描述性分析：社区心理健康“之家”中的反向并置初级保健。

DOI：
10.4088/pcc.13m01530
发表时间：
2013
期刊：
The primary care companion for CNS disorders
影响因子：
0
作者：
Shackelford,JRyan;Sirna,Megan;Mangurian,Christina;Dilley,JamesW;Shumway,Martha
通讯作者：
Shumway,Martha

Increasing HIV Testing in Inpatient Psychiatry.

增加住院精神病学中的艾滋病毒检测。

DOI：
10.1016/j.psym.2017.10.007
发表时间：
2018
期刊：
Psychosomatics
影响因子：
3.4
作者：
Shumway,Martha;Mangurian,Christina;Carraher,Noah;Momenzadeh,Amanda;Leary,Mark;Lee,EmilyK;Dilley,JamesW
通讯作者：
Dilley,JamesW