Racial Disparities in Physician Practice Patterns and Self-Management of Obesity

描述（由申请人提供）：Sara N. Bleich博士是约翰霍普金斯彭博公共卫生学院的卫生政策和管理助理教授。这个拟议的NHLBI指导职业发展奖（K 01）将提供必要的支持，以促进Bleich博士成功过渡到肥胖相关医疗差距领域的独立研究人员。Bleich博士的长期目标是减少弱势、高危人群在提供和使用肥胖相关服务方面的医疗差距。拟议的培训计划包括一系列学习活动，以增加候选人对医疗保健差异的理论基础和肥胖症的临床管理的知识，并培养数据分析方面的新技能（例如，多层次建模、索赔数据、定性数据分析）、调查开发和干预设计/实施方法。在这些学习目标的基础上，在奖励期间将进行两种类型的研究-次要分析和主要数据收集。二次分析的项目目标是：使用全国代表性和健康计划数据（目标1）检查肥胖护理医生实践模式中的黑人-白人种族差异，并使用区域数据（目标2）确定个体自我体重管理中种族差异的多层次解释因素。主要数据将通过焦点小组收集。焦点小组将与肥胖患者，他们的家人，卫生专业人员和管理人员进行，以确定最佳肥胖护理的关键患者和提供者层面的障碍，他们是否因患者种族而异，以及如何克服这些障碍（目标3）。这一拟议的职业发展计划旨在为Bleich博士提供额外的经验和必要的资源，以支持提交成功的资助申请（例如，R 01）进一步探讨健康计划人群中医生执业模式和体重自我管理的种族差异，并建立必要的证据基础，以采取有效干预措施，改善该环境中的成人肥胖护理。减少肥胖和消除健康差距都是联邦的优先事项。该项目和今后计划的研究将有助于这一努力。相关性（参见说明）：肥胖症对少数群体造成了严重影响，是一个巨大的公共卫生挑战，医生和患者对肥胖症的管理不足。鉴于目前联邦的优先事项，以减少肥胖和消除健康差距，有必要更好地了解种族差异的实践模式的肥胖护理和多层次的解释因素的患者自我管理的体重。 (End摘要）

DESCRIPTION (provided by applicant): Sara N. Bleich, PhD is an Assistant Professor of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health. This proposed NHLBI Mentored Career Development Award (K01) will provide the necessary support to facilitate Dr. Bleich's sucessful transition to an independent researcher in the field of obesity-related health care disparities. Dr. Bleich's long-term objective is to reduce health care disparities in the delivery and use of obesity-related services among vulnerable, high risk populations. The proposed training plan includes a series of learning activities to increase the candidate's knowledge of the theoretical underpinning of health care disparities and the clinical management of obesity as well as to develop new skills in data analysis (e.g., multilevel modeling, claims data, qualitiative data analysis),survey development, and intervention design/implementation methods. Building on these learning objectives, two types of research will be pursued during the award period - secondary analyses and primary data collection. Project aims for the secondary analyses are: to examine Black-White racial disparities in physician practice patterns of obesity care, using nationally representative and health plan data (Aim 1) and to identify the multilevel explanatory factors underlying racial disparities in individual self-management of body weight, using regional data (Aim 2). Primary data will be collected via focus groups. Focus groups will be conducted with obese patients, their families, health professionals and administrators to determine key patient- and provider-level barriers to optimal obesity care, whether they differ by patient race, and how these barriers can be overcome(Aim 3). This proposed career development plan is designed to provide Dr. Bleich with the additional experience and resources necessary to support the submission of a sucessful grant application (e.g., R01) to further explore racial disparities in physician practice patterns and self-management of body weight in a health plan population and to develop the necessary evidence base to mount effective interventions to improve adult obesity care in that setting. Reducing obesity and eliminating health disparities are both federal priorities. This project and future planned studies will contribute to that effort. RELEVANCE (See instructions): Obesity disproportionally impacts minority populations, represents an enormous public health challenge, and is under-managed by physicians and patients. In light of the current federal priorities to reduce obesity and eliminate health disparities, there is a need to better understand racial disparities in practice patterns of obesity care and the multilevel explanatory factors underlying patient self-management of weight. (End of Abstract)