Training in Medication Compliance and Health Literacy

描述(由申请人提供)： 2010年健康人将健康素养定义为“个人有能力获得、处理和理解做出适当健康决策所需的基本健康信息和服务的程度”。低HL可能影响美国25%-33%的成年人，与疾病相关知识和健康状况差有关，最近已被确定为影响服药依从性的一个因素。它对心血管疾病管理的影响尚未确定。这份提案描述了一项职业发展计划，旨在帮助申请者为成功地成为一名独立的临床调查员做好准备，检查健康素养对心血管护理和结果的影响，并注意药物依从性。候选人更直接的目标包括培养影响心血管药物依从性的因素的专业知识，对围绕健康素养的问题有更广泛的视角，以及在研究方法和统计分析方面的额外技能。为了实现这些目标，拟议的培训计划将先进的多学科课程与继续医学教育课程和有指导的研究经验相结合。环境非常有利，因为埃默里大学已经通过K12和K30资金建立了基础设施，以发展和培训以患者为导向的调查人员。格雷迪纪念医院是这项拟议研究的所在地，也是许多关于健康素养的原始研究的所在地。导师和共同导师是专注于心血管预防、结果研究和健康素养的临床研究人员。申请人还组建了一个咨询委员会，在服药依从性、健康素养和研究方法方面拥有丰富的经验。研究部分包括三个与健康素养和心血管药物依从性有关的项目--1)提高医生的用药咨询技能和与低文化患者沟通的培训计划，2)调查不稳定心绞痛住院患者健康素养与药物依从性的关系，以及3)通过低文化患者教育干预提高药物依从性的随机对照试验。如果成功，拟议的研究可以作为其他干预措施的典范，以改善依从性和心血管护理，特别是在文化程度低和服务不足的人群中。

DESCRIPTION (provided by applicant): Healthy People 2010 defines health literacy (HL) as "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions." Low HL, which may affect 25-33% of adults in the US, is associated with poor disease-related knowledge and health status, and recently has been identified as a factor in medication compliance. Its impact on the management of cardiovascular disease has not yet been determined. This proposal describes a career development plan designed to prepare the applicant for success as an independent clinical investigator examining the impact of health literacy on cardiovascular care and outcomes, with attention to medication compliance. The candidate's more immediate goals include developing expertise in the factors that influence cardiovascular medication compliance, a broader perspective on the issues surrounding health literacy, and additional skills in research methodology and statistical analysis. To meet these goals, the proposed training plan integrates advanced multidisciplinary coursework with continuing medical education courses and a mentored research experience. The environment is extremely supportive, as Emory University has established an infrastructure through K12 and K30 funding to develop and train patient-oriented investigators. Grady Memorial Hospital, site of the proposed research, was home to many of the original studies on health literacy. The Mentor and Co-Mentor are dedicated clinical investigators with expertise in cardiovascular prevention, outcomes research, and health literacy. The applicant has also assembled an Advisory Committee with vast experience in medication compliance, health literacy, and research methodology. The research component consists of three projects related to health literacy and cardiovascular medication compliance - 1) a training program to improve physicians' medication counseling skills and communication with low-literate patients, 2) an investigation of the association of health literacy with medication compliance among patients hospitalized for unstable angina, and 3) a randomized controlled trial to improve medication compliance through a low-literate patient education intervention. If successful, the proposed research could serve as a model for other interventions to improve compliance and cardiovascular care, particularly among low-literate and underserved populations.