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Improving Equity in Atherosclerotic Cardiovascular Disease Risk
Improving Equity in Atherosclerotic Cardiovascular Disease Risk
상세정보
- 자료유형
- 학위논문 서양
- 최종처리일시
- 20260202103200
- ISBN
- 9798288806537
- DDC
- 610.73
- 서명/저자
- Improving Equity in Atherosclerotic Cardiovascular Disease Risk
- 발행사항
- [Sl] : Yale University, 2025
- 발행사항
- Ann Arbor : ProQuest Dissertations & Theses, 2025
- 형태사항
- 68 p
- 주기사항
- Source: Dissertations Abstracts International, Volume: 87-01, Section: B.
- 주기사항
- Advisor: Cyr, Mary-Ann.
- 학위논문주기
- Thesis (D.N.P.)--Yale University, 2025.
- 초록/해제
- 요약The current use of racial categorization in Atherosclerotic Cardiovascular Disease (ASCVD) risk, limits assessment of confounders beyond cholesterol. The Life's Essential Eight (LE8) categories of healthy diet, sleep, physical activity, smoking, body mass index, hypertension, total cholesterol, and blood glucose could reduce two million ASCVD events per year. The documentation of Z codes 55 - 65 describe social drivers of health (SDH) like housing, economics, and social systems which complicate care. Development of the ASCVD risk assessment and management protocol (ASCVD-RAMP) assessed ASCVD risk without race modification in patients aged 45 - 75 and improved health equity by pairing SDH with LE8 interventions. Implementation at a Federally Qualified Health Center (FQHC) involved training 9 providers, 3 case managers and 4 registered nurses on changes to clinical practice. ASCVD-RAMP was evaluated with a pre and post implementation survey, a comparison of ASCVD risk calculation and SDH Z code documentation. Following implementation in 164 patients, the ASCVD-RAMP was scaled across the organization. Integration into the EMR and updates to case manager and registered nursing roles ensured sustainability. Removing race from the ASCVD risk calculator resulted in lower risk categorization (p0.001), improved opinions of calculation (p = 0.013) and LE8 management. ASCVD-RAMP improved perception of management that emphasized patient's barriers to achieving better health (p=0.002). Utilization of SDH Z codes increased by 533% (p =0.054). Replacing race with SDH results in a change to dynamic variables in assessment of ASCVD risk and improved equity through a holistic patient centered approach to ASCVD prevention management.
- 일반주제명
- Nursing
- 일반주제명
- Pharmacology
- 일반주제명
- Health sciences
- 키워드
- Risk
- 키워드
- Z codes
- 기타저자
- Yale University Yale University School of Nursing
- 기본자료저록
- Dissertations Abstracts International. 87-01B.
- 전자적 위치 및 접속
- 로그인 후 원문을 볼 수 있습니다.
MARC
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■006m o d
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■020 ▼a9798288806537
■035 ▼a(MiAaPQ)AAI31998725
■040 ▼aMiAaPQ▼cMiAaPQ
■0820 ▼a610.73
■1001 ▼aLevandoski, Jordan Gerard.
■24510▼aImproving Equity in Atherosclerotic Cardiovascular Disease Risk
■260 ▼a[Sl]▼bYale University▼c2025
■260 1▼aAnn Arbor▼bProQuest Dissertations & Theses▼c2025
■300 ▼a68 p
■500 ▼aSource: Dissertations Abstracts International, Volume: 87-01, Section: B.
■500 ▼aAdvisor: Cyr, Mary-Ann.
■5021 ▼aThesis (D.N.P.)--Yale University, 2025.
■520 ▼aThe current use of racial categorization in Atherosclerotic Cardiovascular Disease (ASCVD) risk, limits assessment of confounders beyond cholesterol. The Life's Essential Eight (LE8) categories of healthy diet, sleep, physical activity, smoking, body mass index, hypertension, total cholesterol, and blood glucose could reduce two million ASCVD events per year. The documentation of Z codes 55 - 65 describe social drivers of health (SDH) like housing, economics, and social systems which complicate care. Development of the ASCVD risk assessment and management protocol (ASCVD-RAMP) assessed ASCVD risk without race modification in patients aged 45 - 75 and improved health equity by pairing SDH with LE8 interventions. Implementation at a Federally Qualified Health Center (FQHC) involved training 9 providers, 3 case managers and 4 registered nurses on changes to clinical practice. ASCVD-RAMP was evaluated with a pre and post implementation survey, a comparison of ASCVD risk calculation and SDH Z code documentation. Following implementation in 164 patients, the ASCVD-RAMP was scaled across the organization. Integration into the EMR and updates to case manager and registered nursing roles ensured sustainability. Removing race from the ASCVD risk calculator resulted in lower risk categorization (p0.001), improved opinions of calculation (p = 0.013) and LE8 management. ASCVD-RAMP improved perception of management that emphasized patient's barriers to achieving better health (p=0.002). Utilization of SDH Z codes increased by 533% (p =0.054). Replacing race with SDH results in a change to dynamic variables in assessment of ASCVD risk and improved equity through a holistic patient centered approach to ASCVD prevention management.
■590 ▼aSchool code: 0265.
■650 4▼aNursing
■650 4▼aPharmacology
■650 4▼aHealth sciences
■653 ▼aAtherosclerotic cardiovascular disease
■653 ▼aFederally qualified health center
■653 ▼aLife's Essential Eight
■653 ▼aRisk
■653 ▼aSocial determinants of health
■653 ▼aZ codes
■690 ▼a0569
■690 ▼a0566
■690 ▼a0419
■71020▼aYale University▼bYale University School of Nursing.
■7730 ▼tDissertations Abstracts International▼g87-01B.
■790 ▼a0265
■791 ▼aD.N.P.
■792 ▼a2025
■793 ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17357276▼nKERIS▼z이 자료의 원문은 한국교육학술정보원에서 제공합니다.
