Pharmacist-CHW Team to Improve Medication Adherence and Reduce Hypertension Disparities

项目摘要 拟议的NHLBI多样性补充，美国越南移民的用药依从性， 将探讨社会支持、健康素养和服药依从性之间的相互关系 马萨诸塞州斯普林菲尔德患有高血压的越南移民。家长研究，药剂师-CHW团队 改善服药依从性和减少高血压差异，将测试一个跨专业护理团队 确定和解决个人、临床、社会文化和结构性用药障碍的干预措施 高血压、多药联用和不依从性高危少数民族患者的依从性。这个 拟议的多样性补充方案将支持Thupten Phuntsog女士(Dorney)，公共卫生硕士，第二代 西藏难民的女儿到美国，因为她获得了混合方法的研究经验和技能 完成社区健康教育博士学位的定性和定量资料收集与分析 在马萨诸塞大学。拟议的研究将扩大Phuntsog女士在难民问题上的专业知识 和移民健康，重点关注越南移民患者，这是 家长研究，在关爱健康中心，并将提供多维(定量和定性) 了解文化和结构上的促进者以及坚持用药的障碍 越南高血压患者。为本补充进行的研究是对 父项目，因为它提供了关于服药依从性中的社会因素的更深入的信息 越南参与者比父项目中的资源限制所允许的要多。候选人将会 完成对来自父研究的定量数据的其他分析，以检查相互关系 父母中越南参与者的社会支持、健康素养和服药依从性 研究(目标1)。在双语、双文化的CHW的帮助下，Phuntsog女士将与 越南参与者探讨他们对三种翻译工具的理解：两种社会支持 量表(MOS-社会支持调查和PRAPARE工具中的两个社会支持项目)和信念 关于药物调查问卷(目标2)。来自这些焦点小组的发现将改善这些 父研究中使用的标尺。此外，父母研究中的越南参与者的一个子样本将 完成深入访谈，以更好地了解社会支持、健康素养和 服药依从性(目标3)。通过重点深入了解社会支持和 在越南移民的健康知识普及方面，该项目将确定移民和 并帮助开发针对慢性疾病的定制资源和其他促进者 疾病管理。

Project Summary The proposed NHLBI Diversity Supplement, Medication Adherence among Vietnamese immigrants to the US, will explore the interrelationships among social support, health literacy, and medication adherence in Vietnamese immigrants with hypertension in Springfield, MA. The parent study, Pharmacist-CHW Team to Improve Medication Adherence and Reduce Hypertension Disparities, will test an interprofessional care team intervention to identify and address individual, clinical, social-cultural and structural barriers to medication adherence among high-risk minority patients with hypertension, polypharmacy use and nonadherence. The proposed Diversity Supplement will support Ms. Thupten Phuntsog (Dorney), MPH, a second-generation daughter of Tibetan refugees to the U.S., as she gains mixed-method research experience and skills in qualitative and quantitative data collection and analysis to complete her PhD in Community Health Education at the University of Massachusetts. The proposed research will expand Ms. Phuntsog’s expertise in refugee and immigrant health by focusing on Vietnamese immigrant patients, one of the 3 targeted subgroups in the parent study, at Caring Health Center, and will provide a multidimensional (quantitative and qualitative) understanding of the cultural and structural facilitators and barriers to medication adherence among Vietnamese patients with hypertension. Research conducted for this supplement is complementary to the parent project as it provides greater depth of information about social factors in medication adherence among Vietnamese participants than is allowed by resource constraints in the parent project. The candidate will complete additional analyses of the quantitative data from the parent study to examine the interrelationships among social support, health literacy, and medication adherence among Vietnamese participants in the parent study (Aim 1). With the help of a bilingual, bicultural CHW, Ms. Phuntsog will conduct focus groups with Vietnamese participants to explore their understanding of three translated instruments: two social support scales (the MOS-Social Support Survey and two social support items from the PRAPARE tool) and the Beliefs about Medicines Questionnaire (Aim 2). Findings from these focus groups will improve the translations of these scales used in the parent study. In addition, a sub-sample of Vietnamese participants in the parent study will complete in-depth interviews to better understand the relationships between social support, health literacy, and medication adherence (Aim 3). By focusing on an in-depth understanding of the role of social support and health literacy among Vietnamese immigrants, this project will identify barriers experienced by immigrant and refugee groups and contribute to the development of tailored resources and other facilitators for chronic disease management.