Community Health Worker-Led Church-Based Intervention for Eliminating Cardiovascular Health Disparities in African Americans

项目总结 “社区卫生工作者主导(CHW)教会干预消除心血管健康” 非裔美国人的差异“(HERISH)研究是一项群集性随机对照试验，旨在测试 2019年以社区卫生工作者为主导的教会多方位实施战略 ACC/AHA心血管疾病一级预防指南将降低心血管健康 新奥尔良和路易斯安那州博加卢萨的非裔美国人之间的差异。然而，低水平的信任 非裔美国人中的医生和研究人员往往是参与研究和临床的障碍 关心。社区卫生服务提供了一个机会来了解社区和卫生系统之间是如何建立信任的，但是 几乎没有经验证据。社区妇女会在社区成员之间建立信任的过程是 很大程度上是轶事和理论。目前尚不清楚建立信任是如何发生、发展、发展或终止的。 时间，特别是在解决心血管疾病差距的干预措施方面。需要研究来了解CHW是如何 在非裔美国人和其他服务不足的群体中建立信任，以最大限度地提高 减少心血管疾病心脏代谢危险因素的干预措施。本PA-21-071管理的目的 补充是利用《珍爱研究》的规划阶段来确定社区卫生工作者在以下方面的作用 发展对提供者和研究人员的信任。我们的中心假设是CHW可以用来改善 信任提供者和研究人员。提出这项研究的理由是，社区卫生工作者起到了信任的作用。 增加合作可能性的中介机构(例如，遵守医生预约和 治疗建议)之间的非裔美国人和他们的提供者。来检验我们的中心假设 因此，为了达到总体目标，我们将在落实《超高卫生标准》的同时实现以下目标3 HERILE研究的规划阶段：(1)确定社区卫生工作者领导的建立信任的干预措施 通过对文献进行系统的回顾。(2)识别影响感知信任度的因素 通过珍惜学习重点小组，促进社区卫生工作者的健康发展。(3)开发测量工具，以 评估患者与社区卫生工作者之间的信任程度。该项目将提供初步的 R01申请的数据，以评估CHW领导的建立信任干预措施在 有心血管疾病危险因素的非裔美国人。干预的设计将由系统化的 回顾文献、焦点小组和CHW信任测量。

PROJECT SUMMARY The “Community Health Worker-Led (CHW) Church-Based Intervention for Eliminating Cardiovascular Health Disparities in African Americans” (CHERISH) study is a clustered randomized control trial to test whether a community health worker-led church-based multifaceted implementation strategy for applying the 2019 ACC/AHA Guidelines on the Primary Prevention of Cardiovascular Disease will reduce cardiovascular health disparities in African Americans in New Orleans and Bogalusa, Louisiana. However, low levels of trust in doctors and researchers among African Americans is often a barrier to participation in research and clinical care. CHWs offer an opportunity to understand how trust is built between communities and health systems, but there is little empirical evidence. The process by which CHWs engender trust among community members is largely anecdotal and theoretical. It is unknown how trust-building occurs, develops, grows, or terminates over time, particularly in interventions to address CVD disparities. Research is needed to understand how CHWs build trust among African Americans and other underserved groups to maximize the effectiveness of interventions to reduce cardiometabolic risk factors for CVD. The purpose of this PA-21-071 Administrative Supplement is to leverage the planning phase of the CHERISH study to identify the role of CHWs in developing trust in providers and researchers. Our central hypothesis is that CHWs can be used to improve trust in providers and researchers. The rationale for the proposed research is that CHWs act as trust intermediaries that increase the likelihood of cooperation (e.g., adherence to physician visit appointments and treatment recommendations) between African Americans and their providers. To test our central hypothesis and, thereby, attain the overall objective, we will pursue the following objectives in parallel with the UH3 planning phase of the CHERISH study: (1) Identify community health worker-led trust-building interventions through a systematic review of the literature. (2) Identify the factors that influence the perceived trustworthiness of community health workers through CHERISH study focus groups. (3) Develop a measurement tool to assess the level of trust between patients and community health workers. The project will provide preliminary data for an application for an R01 to assess the effectiveness of a CHW-led trust-building intervention among African Americans with risk factors for CVD. The design of the intervention will be informed by the systematic review of the literature, focus groups, and the CHW trust measure.