TRIAD Legacy Study allowing additional analyses of TRIAD dataset to be performed

项目简介：本申请提出6项分析建议，利用2000至2006年间作为三合会研究一部分收集的数据。三合会是一项多中心前瞻性队列研究。它包括2000-2001年期间在基线(第一轮)从大约12 000人收集的数据，18个月后从2002-2003年间约9 000名原始参与者收集的后续数据(第二轮)，以及2005年期间第二次后续行动(第三轮)从原始参与者队列中大约6 000人收集的数据。数据也从健康计划、提供者团体和个人提供者那里收集。此外，第四项调查，心血管风险调查，目标是那些心血管事件的高危人群和一组控制良好的患者。这些重点调查在设计上是横断面的，侧重于中期结果不佳的原因(即对A1C、血压和低密度脂蛋白的控制水平较差)。数据收集自2005-2006年间的1,137人。通过计算机辅助电话采访(CATI)和邮寄问卷收集患者数据，以优化应答率。这里提出的6项分析是一项遗留研究的一部分，该研究试图扩展可以从数据集中提出的科学问题。在印第安纳大学(IU)的三合会网站上，我们选择主要关注心血管风险调查，以解决以下问题并阐明以下问题：1)成人糖尿病患者的心血管风险因素控制有哪些相关性；2)患者感知的用药障碍在心血管疾病预后中扮演着什么角色；3)患者对风险的感知与心血管风险因素的控制之间有什么相关性；以及4)了解医生对口服高血糖失败的2型患者是否开始使用胰岛素的决定。此外，智库黑社会网站还将评估与智库黑社会合作的健康计划进行的两项试点干预措施：1)评估试点干预措施的影响，以改善有自我报告障碍的成人糖尿病患者的服药依从性；2)在3个医疗保健系统中实施诊所-社区联系以预防2型糖尿病的努力的过程和结果。

DESCRIPTION OF THE PROJECT: This application presents 6 analyses proposals that utilize data collected as part of the TRIAD study between 2000 and 2006. TRIAD is a multicenter prospective cohort study. It includes data collected at baseline (round 1) from approximately 12,000 individuals during 2000-2001, follow-up data (round 2) collected 18-months later from approximately 9,000 of the original participants during 2002-2003, and a second follow-up (round 3) collected data from approximately 6,000 individuals of the original cohort of participants during 2005. Data were also collected from health plans, provider groups, and individual providers. In addition, a fourth survey, the Cardiovascular Risk Survey, targeted those at high risk for CVD events and a comparison group of well-controlled patients. These focused surveys are cross-sectional in design and focus on reasons for poor intermediate outcomes (i.e., poor levels of control of A1C, blood pressure, and LDL-C). Data were collected from 1,137 individuals during 2005-2006. Patient data were collected via computer assisted telephone interviews (CATI) and mailed questionnaires to optimize response rates. The 6 analyses proposed here are part of a legacy study that seeks to extend the scientific questions that can be asked from the data sets. At the Indiana University (IU) TRIAD site, we have elected to focus primarily on the Cardiovascular Risk Survey to address the following questions and illuminate the following issues: 1) What are the correlates of CVD risk factor control in adults with diabetes; 2) What is the role that patient-perceived barriers to medication use play in CVD outcomes; 3) What is the correlation between patients risk perception and control of cardiovascular risk factors; and 4) Understanding physicians' decisions to initiate or not initiate insulin in type 2 patients who are oral hyperglycemic failures. In addition, the IU TRIAD site will also evaluate two pilot interventions that were conducted with the IU TRIAD collaborating health plans; 1) Evaluating the impact of a pilot intervention to improve medication adherence in diabetic adults with self-reported barriers to taking medications as prescribed by their providers, 2) Process and outcomes of efforts to implement clinic-community linkages to prevent Type 2 diabetes in 3 systems of health care.