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A Community Health Worker Service to Address Acute Care Utilization Among Young and Middle-Aged Men and Women Receiving Dialysis in High-Poverty Communities

2026年9月30日更新者：Johns Hopkins University

Pilot Testing a Community Health Worker Service to Address Acute Care Utilization Among Young and Middle-Aged Men and Women Receiving Dialysis in High-Poverty Communities

Among adults receiving in-center hemodialysis, young and middle-aged women (aged 18 to 49) have the highest hospitalization rates at 1.8 per person-year. Sex differences are most pronounced in this age group, even after accounting for multiple confounding factors, including comorbidities, primary insurance type, and length of time on dialysis. Sex differences exist across racial groups and within high-poverty communities. For example, women aged 18 to 49 who receive in-center hemodialysis and live in Baltimore City experience 2.9 hospital admissions per year compared to 1.2 admissions per year in men. Moreover, sex differences reflect underlying health - sex differences are markedly attenuated when comparing women and men with similar levels of systemic inflammation. Community health worker (CHW) models are an evidence-based approach to reduce acute care utilization, but have not been widely implemented in dialysis or targeted risk factors unique to young and middle-aged women receiving dialysis in high-poverty communities. The proposed study will address this gap by pilot testing a CHW service adapted for this population.

研究概览

地位

尚未招聘

条件

血液透析

研究类型

观察性的

注册 (估计的)

联系人和位置

本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。

学习联系方式

姓名：Kathryn Taylor, MD
电话号码：410-955-5000
邮箱：ktaylo45@jhmi.edu

参与标准

研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

18年至 49年 (成人)

接受健康志愿者

不

有资格学习的性别

全部

取样方法

非概率样本

研究人群

Participants receiving in-center or home dialysis from facilities in Baltimore City or from facilities in Baltimore County if poverty rates in the surrounding community are ≥20%

描述

Inclusion Criteria:

Age 18 - 49 years
Receiving in-center or home dialysis from facilities in Baltimore City or from facilities in Baltimore County if poverty rates in the surrounding community are ≥20%
Initiated dialysis after age 18; able to provide informed consent.

Exclusion Criteria:

Residence in a long-term care facility

学习计划

本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。

研究是如何设计的？

设计细节

观测模型：OTHER
时间观点：PROSPECTIVE

团体/队列数

队列和干预

团体/队列
Dialysis Facility Staff Focus Group After obtaining Institutional Review Board (IRB) approval, the PI will contact dialysis facility staff to determine interest in participating in focus groups. The PI will attempt to contact staff members no more than 2 times. For dialysis facility staff members, the investigators will initially invite staff within the study team's existing professional networks (e.g., the nephrologist and clinic manager at dialysis facilities where study team members see patients). If those staff members are not available, the investigators will work with dialysis facility leadership to identify available and interested dieticians and social workers in the Baltimore area via passive recruitment methods, such as a post via the organization's internal messaging software. The investigators will submit a change in research to enable IRB review of the recruitment post if the investigators need to recruit dialysis facility staff via internal messaging.

团体/队列

Dialysis Facility Staff Focus Group

After obtaining Institutional Review Board (IRB) approval, the PI will contact dialysis facility staff to determine interest in participating in focus groups. The PI will attempt to contact staff members no more than 2 times.

For dialysis facility staff members, the investigators will initially invite staff within the study team's existing professional networks (e.g., the nephrologist and clinic manager at dialysis facilities where study team members see patients).
If those staff members are not available, the investigators will work with dialysis facility leadership to identify available and interested dieticians and social workers in the Baltimore area via passive recruitment methods, such as a post via the organization's internal messaging software. The investigators will submit a change in research to enable IRB review of the recruitment post if the investigators need to recruit dialysis facility staff via internal messaging.

研究衡量的是什么？

主要结果指标

结果测量	措施说明	大体时间
Percentage of scheduled dialysis sessions attended 大体时间：Baseline to end of study, approximately 9 months	Adherence to Dialysis Treatment	Baseline to end of study, approximately 9 months

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

Johns Hopkins University

调查人员

首席研究员：Kathryn Taylor, MD、Johns Hopkins University

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (估计的)

2026年12月1日

初级完成 (估计的)

2028年9月30日

研究完成 (估计的)

2028年9月30日

研究注册日期

首次提交

2026年9月9日

首先提交符合 QC 标准的

2026年9月9日

首次发布 (实际的)

2026年9月15日

研究记录更新

最后更新发布 (实际的)

2026年10月1日

上次提交的符合 QC 标准的更新

2026年9月30日

最后验证

2026年9月1日