Engaging At-Risk Minority Women in Health System Diabetes Prevention Programs

让高危少数族裔妇女参与卫生系统糖尿病预防计划

基本信息

批准号：
9057526
负责人：
Susan Denise Brown
金额：
$ 15.11万
依托单位：
KAISER FOUNDATION RESEARCH INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-08-01 至 2018-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9057526
关键词：
Affect African American Asian Indian Behavior Biometry Body Weight decreased California Child health care Chinese People Clinical Clinical Psychology Collaborations Complement Computerized Medical Record Data Diabetes Mellitus Diabetes prevention Disease Doctor of Philosophy Ensure Ethnic Origin Ethnic group Gestational Diabetes Goals Health Health Promotion Health system Healthcare Healthcare Systems Individual Integrated Delivery of Health Care K-Series Research Career Programs Knowledge Life Style Literature Mentored Research Scientist Development Award Mentorship Methods Mexican Minority Modeling Nature Non-Insulin-Dependent Diabetes Mellitus Not Hispanic or Latino Obesity Outcome Overweight Patient risk Patient-Focused Outcomes Patients Population Predisposition Preventive Race Recording of previous events Research Research Personnel Risk Risk Factors Risk Reduction Scientist Series System Techniques Testing Training Translating Trust Ursidae Family Vulnerable Populations Woman Work World Health base design diabetes prevention program diabetes risk disparity reduction ethnic minority population evidence base health belief health care service health disparity high risk implementation science improved innovation knowledge base novel obesity prevention obesity treatment outreach prevent primary outcome programs psychosocial racial minority randomized trial research study response retention rate secondary outcome success theories

项目摘要

DESCRIPTION (provided by applicant): Preventing type 2 diabetes is a high priority for health care systems. Particular focus is needed on racial and ethnic minority populations who suffer disproportionately from diabetes and its complications. Success depends not only on patient access to lifestyle programs to reduce risk, but on patient engagement in such programs. Yet evidence-based strategies to increase engagement in clinical settings are lacking. This K01 career development award will provide Susan D. Brown, PhD with the expertise needed to achieve her long- term goal of reducing health disparities in diabetes by engaging diverse at-risk patients, such as overweight and obese women with a history of gestational diabetes, in preventive programs in health care settings. This proposal examines whether two theory-driven outreach strategies, tailored diabetes risk information and self- affirmation, impact three initial and sustained patient engagement outcomes: patient responses to outreach materials, and participation and retention in a lifestyle program. The central hypothesis is that diabetes risk information individually tailored to women's race/ethnicity and diabetes risk factors derived from electronic medical records may increase patient engagement. Yet tailored risk information can be psychologically threatening; thus its effects will be enhanced, and the threat mitigated, when individuals can affirm a sense of self-worth by actively reflecting on values that are important to them. Among overweight/obese women with a history of gestational diabetes, the Specific Aims are as follows. Aim 1: Develop novel, interactive outreach materials to be used in the clinical setting containing tailored diabetes risk information and self-affirmation, in collaboration with patients and health system stakeholders. Aim 2: Experimentally pre-test the impact of the developed outreach materials on patient responses in a 2 (tailored vs. non-tailored) x 2 (self-affirmation vs. no self-affirmation) design. Aim 3: Experimentally pilot test the impact of interactive outreach materials on patient engagement in a health system lifestyle program, as compared to standard outreach; I will also explore effects on weight loss. This theory-based research in a real-world clinical setting will expand our limited knowledge base regarding patient engagement for diabetes prevention. Dr. Brown will benefit from the primary mentorship of Assiamira Ferrara, MD, PhD, Senior Research Scientist and Section Chief for Women's and Children's Health at the Kaiser Permanente Northern California Division of Research. Complementing Dr. Brown's strengths in clinical psychology and obesity treatment, this K01 award will provide systematic training overseen by experts in diabetes and diabetes prevention (Dr. Ferrara), implementation science (Constance Weisner, DrPH, MSW and Julie Schmittdiel, PhD), health disparities (Alyce Adams, PhD), and biostatistics (Charles Quesenberry, PhD) to ensure Dr. Brown's success as an independent diabetes prevention investigator.

描述（由申请人提供）：预防2型糖尿病是医疗保健系统的重点。需要特别关注糖尿病及其并发症不成比例的种族和少数民族。成功不仅取决于患者获得生活方式计划以降低风险，还取决于患者参与此类计划。然而，缺乏基于证据的策略来增加在临床环境中的参与度。这项K01职业发展奖将为Susan D. Brown博士提供专业知识，以实现她的长期目标，即通过吸引多种高危患者（例如超重和肥胖的妇女，具有妊娠糖尿病史，在预防性计划中，都可以在糖尿病中降低健康差异。该提案研究了两种由理论驱动的外展策略，量身定制的糖尿病风险信息和自我确认，影响三个初始和持续的患者参与结果：患者对外展材料的反应，以及在生活方式计划中的参与和保留。中心假设是，糖尿病的风险信息是针对妇女种族/种族和糖尿病的糖尿病风险因素量身定制的，这些风险因素可能会增加患者的参与度。然而，量身定制的风险信息在心理上可能威胁到；因此，当个人可以通过积极反思对对的价值观而对自己的价值观肯定的意识时，它的影响将得到增强，并减轻威胁。他们。在具有妊娠糖尿病史的超重/肥胖女性中，具体目的如下。目标1：与患者和卫生系统利益相关者合作，开发出新颖的，互动的外展材料，以在临床环境中使用，其中包含量身定制的糖尿病风险信息和自我肯定。 AIM 2：在实验测试中，开发的外展材料对2（量身定制的与非销售）x 2（自我肯定与无自我肯定）设计中的患者反应的影响。 AIM 3：与标准外展相比，实验试验测试互动外展材料对卫生系统生活方式计划中患者参与计划的影响；我还将探索对体重减轻的影响。在现实世界中，这项基于理论的研究将扩大我们有关患者参与糖尿病预防的有限知识基础。布朗博士将受益于医学博士Assiamira Ferrara博士的主要指导，高级研究科学家兼妇女和儿童健康部门，位于Kaiser Permanente North California研究部。这项K01奖与布朗博士在临床心理学和肥胖治疗方面的优势相辅相成，将提供由糖尿病和糖尿病预防专家（Ferrara博士），实施科学（Constance Weisner，DRPH，MSW和MSW和Julie Schmittdiel，Phd），Phors Adams，Phresly，Phdermer，Phdermer，Phdermer，Phdermer，PHD）和PH DRESMER，PHD CHRERSIST，PHD rerdistic to perser conserice the Science（Ferrara博士）的系统培训。布朗作为独立糖尿病预防研究员的成功。