Family Cardiac Caregiver Investigation to Evaluate Outcomes (FIT-O)

需要采取新的方法来实施经证实的预防和生活方式干预措施，以实现国家卫生和社会健康战略计划的目标，加速将科学转化为实践，减轻心血管疾病的公共卫生负担。已经确定的是，心脏护理人员是传递健康信息的载体，护理人员本身可能会增加心血管疾病的风险。我们的研究将评估心脏护理人员的潜在人群和人口特征，以及他们在提高患者护理质量和增强出院后二级预防指南依从性方面所起的作用。本研究也将提供针对特定护理人员的教育工作的重要信息，以提高住院冠心病患者的临床结果。本研究的目的是通过人口统计学因素（如患者年龄和种族/民族）来估计住院心脏病患者护理的流行程度，并将护理与心脏病患者的临床结果联系起来。第二个目标是收集家谱数据，这将使我们能够估计一级家庭成员的人数、他们的基本人口统计数据以及他们居住的距离医疗中心的距离，以便确定有针对性的预防干预的可行性和范围。具体目的是确定：1)在一家大型学术教学医院连续6个月住院的急性动脉粥样硬化性冠状动脉事件或手术或导管冠状动脉重建术患者中，主要心脏护理人员的患病率和人口统计学特征；2)根据患者人口统计学特征、入院诊断调整后，有或没有心脏护理人员与患者出院后30天临床结果的关系；3)扩大以家庭为中心的教育和行为干预的可行性，包括向CVD住院患者的家庭成员推广，以确保适当的筛查、生活方式教育，并在适当的时候向家庭成员推荐以证据为基础的降低风险治疗。这项研究的意义在于，它解决了最近NHLBI战略计划中概述的具体挑战，以制定和评估改善患者，提供者和卫生保健系统行为和绩效的计划，以提高护理质量和健康结果，特别是在经历不成比例疾病负担的人群中。将获得关于护理人员的独特信息，作为一种潜在的干预措施，以改善遭受不成比例心血管疾病负担的患者和家庭的预防保健和健康结果。改善对循证预防疗法的依从性可能对公共卫生产生重大益处。

New approaches to implement proven preventive and lifestyle interventions are needed to reach the NHLBI strategic plan goal to speed the translation of science into practice and reduce the public health burden of cardiovascular disease (CVD). It has been established that cardiac caregivers are a vehicle by which health information can be transmitted, and that caregivers themselves may be at increased CVD risk. Our research will evaluate the potential pool and demographic profile of cardiac caregivers as well as the role(s) they play in improving quality of patient care and to enhance adherence to secondary prevention guidelines post discharge. This research will also provide important information about targeting educational efforts to specific caregivers to enhance the clinical outcomes of hospitalized coronary patients. The purpose of this study is to estimate the prevalence of caregiving in hospitalized cardiac patients by demographic factors such as patient age and race/ethnicity, and to link caregiving to clinical outcomes in cardiac patients. A secondary aim is to collect family tree data which will allow us to estimate the number of first degree family members, their basic demographics, and the distance at which they live from the medical center in order to determine the feasibility and scope of a targeted preventive intervention. The specific aims are to determine: 1) the prevalence and demographic characteristics of primary cardiac caregivers among patients admitted with an acute atherosclerotic coronary event or surgical or catheter-based coronary revascularization procedure during a consecutive 6 month period at a major academic teaching hospital, 2) the relation between having or not having a cardiac caregiver and patient clinical outcomes at 30 days post hospital discharge adjusted for patient demographic characteristics, admitting diagnoses, and co-morbidities, 3) feasibility of an extended family-centered educational and behavioral intervention that will include an outreach to family members of patients hospitalized with CVD to ensure appropriate screening, lifestyle education, and referral of family members for evidence-based risk reduction therapies when appropriate. The significance of this research is that it addresses specific challenges outlined in the recent NHLBI strategic plan to develop and evaluate programs to improve patient, provider, and health care system behavior and performance to enhance quality of care and health outcomes, especially in populations that experience a disproportionate disease burden. Unique information will be obtained about caregivers as a potential intervention to improve preventive care and health outcomes of patients and families that suffer disproportionate CVD burden. Improved adherence to evidence-based preventive therapies could have a substantial public health benefit.