The Research Core extends the impact of Project 1 and Project 2 by using data gathered from these studies to project population impact on national stroke rates and stroke disparities using an established and validated computer simulation of cardiovascular disease and stroke (the CVD Policy Model). Computer simulations of this type have been useful for researchers and policy makers to translate the results of scientific studies into projections of population-level impact, and our CVD Policy Model is particulariy well-suited to projections of demographic and risk factor trends and assessing the impact of interventions on disparities. The overarching goal of the Research Core is to use the CVD Policy Model to translate the results of Projects 1 and 2 into estimates of the potential impact of expansion of stroke prevention interventions nationally on stroke rates and stroke disparities. The following aims are proposed:
Aim 1 : Using data from Project 1, project the impact of widespread national adoption of the """"""""Shake, Rattle, and Roll"""""""" intervention (Project 1) on incident stroke rates in African Americans in the US and on disparities in stroke rates between African Americans and Whites in the US. Secondary outcomes modeled for Aim 1 include incident coronary heart disease events, cardiovascular and all-cause mortality, quality-adjusted and disability-adjusted life-years, and healthcare costs.
Aim 2 : Using data from Project 2, project the impact of temporal trends in stroke and cardiovascular disease risk factors among children and young adults on future stroke, cardiovascular disease, and quality-adjusted and disability-adjusted life years, as well as racial disparities in stroke and cardiovascular disease.

Public Health Relevance

The overarching goal of the Research Core is to use the CVD Policy Model to translate the results of Projects 1 and 2 into estimates of the potential impact of expansion of stroke prevention interventions nationally on stroke rates and stroke disparities. This type of modeling allows for the knowledge generated in Project 1 and Project 2 to be placed in context relevant to health policy decision makers and those interested in designing and choosing among programs aimed at preventing stroke and reducing stroke disparities.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Specialized Center--Cooperative Agreements (U54)
Project #
5U54NS081760-03
Application #
8727683
Study Section
Special Emphasis Panel (ZNS1)
Project Start
Project End
Budget Start
2014-09-01
Budget End
2015-08-31
Support Year
3
Fiscal Year
2014
Total Cost
Indirect Cost
Name
Kaiser Foundation Research Institute
Department
Type
DUNS #
City
Oakland
State
CA
Country
United States
Zip Code
94612
Mayeda, Elizabeth Rose; Filshtein, Teresa J; Tripodis, Yorghos et al. (2018) Does selective survival before study enrolment attenuate estimated effects of education on rate of cognitive decline in older adults? A simulation approach for quantifying survival bias in life course epidemiology. Int J Epidemiol 47:1507-1517
Fontil, Valy; Lyles, Courtney R; Schillinger, Dean et al. (2018) Safety-net institutions in the US grapple with new cholesterol treatment guidelines: a qualitative analysis from the PHoENIX Network. Risk Manag Healthc Policy 11:99-108
Fontil, Valy; Gupta, Reena; Moise, Nathalie et al. (2018) Adapting and Evaluating a Health System Intervention From Kaiser Permanente to Improve Hypertension Management and Control in a Large Network of Safety-Net Clinics. Circ Cardiovasc Qual Outcomes 11:e004386
Mayeda, Elizabeth Rose; Banack, Hailey R; Bibbins-Domingo, Kirsten et al. (2018) Can Survival Bias Explain the Age Attenuation of Racial Inequalities in Stroke Incidence?: A Simulation Study. Epidemiology 29:525-532
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Fontil, Valy; Bibbins-Domingo, Kirsten; Nguyen, Oanh Kieu et al. (2017) Management of Hypertension in Primary Care Safety-Net Clinics in the United States: A Comparison of Community Health Centers and Private Physicians' Offices. Health Serv Res 52:807-825
Mayeda, Elizabeth R; Glymour, M Maria; Quesenberry, Charles P et al. (2017) Survival after dementia diagnosis in five racial/ethnic groups. Alzheimers Dement 13:761-769
Vasudeva, Eshan; Moise, Nathalie; Huang, Chen et al. (2016) Comparative Cost-Effectiveness of Hypertension Treatment in Non-Hispanic Blacks and Whites According to 2014 Guidelines: A Modeling Study. Am J Hypertens 29:1195-205
Odden, Michelle C; Moran, Andrew E; Coxson, Pamela G et al. (2016) Gait Speed as a Guide for Blood Pressure Targets in Older Adults: A Modeling Study. J Am Geriatr Soc 64:1015-23
Moran, Andrew E; Odden, Michelle C; Thanataveerat, Anusorn et al. (2015) Cost-effectiveness of hypertension therapy according to 2014 guidelines. N Engl J Med 372:447-55

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