Tailored Communication to Reduce Cardiovascular Risk

描述（由申请人提供）：Stephen D. Persell，MD，MPH是一位学术全科内科医生，卫生服务研究员和执业初级保健医生。他正在申请K 08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，设计和测试预防性心脏病学质量改善干预措施，并使用量身定制的患者沟通和信息技术将其融入初级保健环境。 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指导研究。该计划的主要目标是：1）获得健康传播的先进理论和实践技能; 2）获得用于设计和评估在现实生活中的医疗保健环境中进行的基于信息技术的干预措施的研究方法的技能和经验;和3）开发和测试一种干预措施，旨在改善阿司匹林和降胆固醇治疗在高风险患者中的适当使用，心血管事件。这一干预措施将涉及使用以人口为基础的信息技术方法，同时制定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推进。第1阶段包括分析来自当代电子病历的数据用于对患者的心血管风险进行分类并识别未解决的风险因素时发生的准确性和错误来源。第2阶段包括定性和定量研究，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，以改善预防心脏病学使用与患者的直接沟通。第3阶段包括研究患者对模型消息的反应。第四阶段是一项测试信息干预的可行性和有效性的试验，以改善患者对阿司匹林和降胆固醇治疗的适当使用。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，并作为其他直接针对患者的干预措施的发展原型。该奖项将为Persell博士提供进行卫生保健系统干预的重要经验，并促进他发展先进技能。

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.