Heart Failure Disparities in Native Hawaiians

描述（由申请人提供）： 心力衰竭（HF）是导致相当大的心血管发病率和死亡率的主要公共卫生问题。 HF对少数民族人口的影响，如夏威夷土著人（NH）和其他太平洋民族（PP），是未知的。 众所周知，NHS具有高的HF风险因素率，是美国心血管疾病（CVD）死亡率最高的疾病之一。获得适当的护理可以改善HF患者的健康状况，但获得专科护理是NHS和PP的主要障碍，因为他们往往居住在医疗服务不足的地区。 为了解决NH和PP之间的HF差异，艾玛女王诊所（QEC）和NH卫生部之间将建立一个合作伙伴计划，即HF差异计划（HFD）。 HFD计划的合作伙伴包括：MedStar研究所，位于奥阿湖的社区卫生中心（CHCs）和夏威夷出口中心，这是一个由NIH资助的解决NH/PP中糖尿病相关差异的倡议。 HFD计划将实现以下研究和教育目标：1）确定由社区卫生工作者进行的超声心动图的可靠性和有效性，并将其与作为“黄金标准”的经过专业培训的超声波检查师进行比较。 2)确定与常规护理相比，心力衰竭的文化能力教育计划是否降低了HF住院率和死亡率。 3)描述住院的NH和PP与白人相比心力衰竭综合征的种族差异。 4)使用QEC鉴定的先证者构建HF家系，用于未来NH和PP的HF连锁研究。 5)教育以社区为基础的卫生工作者进行超声心动图扫描，以检测高风险人群的NH和PP的HF。 6)培训新的研究人员进行研究，重点是心血管疾病的差异，特别是心力衰竭。 通过实现这些目标，HFD计划将改善为NHS和PP服务的CHC获得HF护理的机会，填补NHS和PP中CVD差异的知识空白，并为未来对HF遗传决定因素的研究提供基础。

DESCRIPTION (provided by applicant): Heart failure (HF) is a major public health problem leading to considerable cardiovascular morbidity & mortality. The impact of HF on minority populations, such as Native Hawaiians (NHs) & other Pacific Peoples (PPs), is unknown. NHs are known to have high rates of risk factors for HF & one of the highest rates of cardiovascular disease (CVD) mortality in the U.S. Access to appropriate care is known to improve health outcomes for HF patients, but access to specialist care presents a major barrier for NHs & PPs because they tend to reside in medically underserved areas. To address HF disparities among NHs and PPs, a partnership program, the HF Disparities Program (HFD), will be established between the Queen Emma Clinic (QEC) and the Department of NH Health. Partners of the HFD Program include: MedStar Research Institute, Oahu-based Community Health Centers (CHCs) & the Hawaii EXPORT Center, an NIH-funded initiative addressing diabetes-associated disparities in NH/PP. The HFD Program will achieve the following research & educational aims: 1) Determine the reliability & validity of echocardiograms performed by community-based health workers compared to a professionally trained sonographer as the "gold standard". 2) Determine if a culturally competent educational program for heart failure reduces HF hospitalizations & mortality compared to usual care. 3) Characterize ethnic differences in the heart failure syndrome in hospitalized NHs & PPs compared to Caucasians. 4) Construct HF pedigrees using probands identified at the QEC for a future HF linkage study in NHs & PPs. 5) Educate community-based health workers to perform echocardiography scans for the detection of HF in a high risk population of NHs & PPs. 6) Train new investigators to conduct research focused on CVD disparities in general, and heart failure in particular. By achieving these aims, the HFD Program will improve access to HF care at CHCs that serve NHs & PPs, fill a gap in knowledge of CVD disparities in NHs & PPs and provide a foundation for future studies on genetic determinants of HF.