Mentoring in community influences on CVD risk

描述（由申请人提供）：这是一个在以病人为导向的研究中的职业中期研究者奖的建议。Corbie-Smith博士将有时间专注于以患者为导向的心血管疾病预防研究，并招募和指导一些最聪明的年轻科学家参与医疗保健差异研究。她的直接职业目标是：1）通过开发干预措施来预防心血管疾病，以解决患者在其社区的背景下，扩展她在研究中从事有色人种社区的工作; 2）了解社区因素在服务不足的社区的影响及其对医疗保健利用和心血管疾病和心血管危险因素的健康结果的影响;和3）通过创造一个培训环境，支持在心血管预防和结果方面进行高影响力的研究，提供出色的指导。通过K24中期研究者奖支持的新研究的具体目标包括：1）确定培训当前社区健康顾问队列作为导航员的可行性，将具有多种心血管风险因素的居民与当地医疗保健系统联系起来; 2）确定导航员对心血管危险因素控制的影响（糖化血红蛋白，体力活动，血压控制，吸烟）和获得护理的社区成员在增加风险的心血管疾病; 3）确定社区和社会因素，影响心血管风险因素的控制和结果。这项双组试验将调查导航员在社区外展计划中对心血管结局的作用，以改善医疗服务的获取和利用。将在四个地点中的每个地点使用两到三个导航器。患者将被随机分配至导航干预或常规患者管理实践，并在基线和6个月时进行测量。这项研究针对的疾病状况和人口的显着重要性-心血管疾病的危险因素预防在农村非洲裔美国人-并扩展了现有的有效模式在几个重要的方面。这项研究将导航员和患者置于社区（而不是医疗保健系统）中，从而增加了干预的文化相关性。而不是专注于一个条件，导航器将支持访问和管理几个慢性疾病，从而解决了现实中的多种并存病的服务不足的患者。最后，用社区变量增加患者数据可以全面分析心血管疾病预防和医疗保健利用的外部影响。 公共卫生相关性：这项拟议中的研究将通过测试一项患者导航计划来促进公共卫生，以改善那些有心脏病风险因素的人的医疗服务和质量。指导部分将培训新的研究人员进行高影响力的心脏病预防研究。

DESCRIPTION (provided by applicant): This is a proposal for a midcareer investigator award in patient-oriented research. This career development award will give Dr. Corbie-Smith the dedicated time to focus on patient-oriented research in cardiovascular disease prevention, and recruit and mentor some of the brightest young scientists at UNC into healthcare disparities research. Her immediate career objectives are: 1) To extend her work in engaging communities of color in research by developing interventions to prevent cardiovascular disease that address patients in the context of their communities; 2) To understand the influence of community factors in underserved communities and their impact on healthcare utilization and health outcomes in cardiovascular disease and cardiovascular risk factors; and 3) To provide outstanding mentorship by creating a training environment that supports the conduct of high impact research in cardiovascular prevention and outcomes. The specific aims for the new research to be supported through this K24 Midcareer Investigator award include 1) Determine the feasibility of training a current cohort of community health advisors as navigators to link residents with multiple cardiovascular risk factors to local healthcare systems; 2) Determine the impact of navigators on cardiovascular risk factor control (HgbA1C, physical activity, BP control, smoking) and access to care for community members at increased risk for cardiovascular disease; 3) Identify community and social factors that influence cardiovascular risk factor control and outcomes. This two-arm trial will investigate the role of navigators on cardiovascular outcomes in community based outreach programs to improve access and utilization of medical services. Two to three navigators at each of the four sites will be utilized. Patients will be randomized to either a navigator intervention or to usual patient management practices, with measurement at baseline and six months. This study targets a disease condition and population of significant importance - CVD risk factor prevention in rural African Americans - and extends an existing effective model in several important ways. This study situates the navigator and patient within the community (rather than the healthcare system) thus increasing the cultural relevance of the intervention. Rather than a focus on one condition, navigators will support access and management of several chronic conditions, thus addressing the reality of multiple co-morbidities in underserved patients. Lastly, augmenting patient data with community variables allows a comprehensive analysis of external influence on cardiovascular disease prevention and healthcare utilization. PUBLIC HEALTH RELEVANCE: The proposed research will advance public health by testing a patient navigator program to improve access to and quality of care for those with heart disease risk factors. The mentoring component will train new researchers to conduct high impact heart disease prevention research.