Tailored Communication to Reduce Cardiovascular Risk

描述(由申请人提供)：斯蒂芬·D·珀塞尔，医学博士，公共卫生硕士，是一名学术普通内科医生、卫生服务研究员和执业初级保健医生。他正在申请K08指导临床科学家发展奖，以推进他的长期目标，即开发一个独立的研究计划，利用定制的患者沟通和信息技术设计和测试集成到初级保健环境中的预防性心脏病质量改进干预措施。 这一目标将通过一个为期5年的职业发展计划来实现，该计划包括教学培训和有指导的研究。该计划的主要目标是：1)获得健康沟通方面的高级理论和实践技能；2)获得用于设计和评估基于信息技术的干预措施的研究方法方面的技能和经验；3)开发和测试旨在改善心血管事件高危患者适当使用阿司匹林和降胆固醇治疗的干预措施。这一干预措施将涉及使用以人口为基础的信息技术方法，同时开发直接发送给患者的个性化信息。 该奖项的目标将通过研究计划的四个阶段加以推进。第一阶段包括对使用当代电子病历的数据对患者的心血管风险进行分类并确定未处理的风险因素时发生的错误的准确性和来源进行分析。第二阶段包括一项定性和定量研究，以了解医生的态度、障碍和可能的解决方案，以实施办公室系统，通过与患者的直接沟通来改善预防性心脏病。阶段3包括对患者对模型消息的反应的研究。第四阶段是一项试验，测试信息干预的可行性和有效性，以改善患者适当使用阿司匹林和降胆固醇治疗。这项研究计划的结果应该证明这种干预措施的更大规模试验是合理的，并作为开发其他直接针对患者的干预措施的原型。该奖项将为Persell博士提供执行医疗保健系统干预的重要经验，并促进他高级技能的发展。

DESCRIPTION (Provided by the Applicant): Stephen D. Persell, MD, MPH is an academic general internist, health services researcher, and practicing primary care physician. He is applying for the K08 Mentored Clinical Scientist Development Award to advance his long-term goal of developing an independent research program to design and test preventive cardiology quality improvement interventions integrated into primary care settings using tailored patient communication and information technology. This goal will be achieved through a 5-year career development program that includes didactic training and mentored research. The major objectives of this program are: 1) to acquire advanced theoretical and practical skills in health communications; 2) to gain skills and experience in the research methods used to design and evaluate information technology-based interventions performed in real-life health care settings; and 3) to develop and test an intervention designed to improve the appropriate use of aspirin and cholesterol lowering therapy in patients at high risk for cardiovascular events. This intervention will involve using a population-based information technology approach coupled with the development of individually tailored messages sent directly to patients. The objectives of the award will be advanced through the four phases of the research plan. Phase 1 consists of an analysis of the accuracy and sources of error occurring when data from a contemporary electronic medical record are used to classify patients' cardiovascular risk and identify unaddressed risk factors. Phase 2 includes a qualitative and quantitative study to elicit physician attitudes, barriers and possible solutions to the implementation of an office system to improve preventive cardiology using direct communication with patients. Phase 3 consists of a study of patients' responses to model messages. Phase 4 is a trial testing the feasibility and efficacy of a messaging intervention to improve patients' appropriate use of aspirin and cholesterol lowering therapy. The results of this research plan should justify a larger trial of this intervention and serve as a prototype for the development of other direct-to-patient interventions. The award will provide Dr. Persell with a crucial experience performing a health-care system intervention and facilitate his development of advanced skills.