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

描述(由申请人提供)：Sara N.Bleich，博士，约翰霍普金斯大学彭博公共卫生学院卫生政策和管理学助理教授。这项拟议的NHLBI导师职业发展奖(K01)将提供必要的支持，以促进Bleich博士成功地过渡到肥胖相关医疗保健差异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保健差距。拟议的培训计划包括一系列学习活动，以增加候选人对卫生保健差异的理论基础和肥胖症的临床管理的知识，并在数据分析(例如，多水平建模、索赔数据、定性数据分析)、调查开发和干预设计/实施方法方面发展新技能。在这些学习目标的基础上，将在授奖期间开展两类研究--二级分析和初级数据收集。二次分析项目的目标是：利用具有全国代表性的健康计划数据(目标1)，检查肥胖护理医生执业模式中的黑人和白人种族差异(目标1)，并利用区域数据(目标2)，确定个人自我管理体重方面存在种族差异的多层次解释因素(目标2)。主要数据将通过焦点小组收集。将与肥胖患者、他们的家人、卫生专业人员和管理人员开展重点小组，以确定实现最佳肥胖护理的关键患者和提供者层面的障碍，这些障碍是否因患者种族不同而不同，以及如何克服这些障碍(目标3)。这项拟议的职业发展计划旨在为Bleich博士提供必要的额外经验和资源，以支持提交成功的拨款申请(例如，R01)，以进一步探索健康计划人群中医生执业模式和体重自我管理方面的种族差异，并开发必要的证据基础，以采取有效的干预措施，改善该环境下的成人肥胖护理。减少肥胖和消除健康差距都是联邦政府的优先事项。该项目和未来计划中的研究将有助于这一努力。相关性(见说明)：肥胖对少数群体的影响不成比例，是一个巨大的公共卫生挑战，医生和患者管理不善。鉴于目前联邦政府在减少肥胖和消除健康差距方面的优先事项，有必要更好地了解实践中的种族差异、肥胖护理模式以及患者自我体重管理背后的多层次解释因素。(摘要结束)

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)