ACHIEVE GreatER: Addressing Cardiometabolic Health Inequities by Early PreVEntion in the Great LakEs Region

实现更大目标：通过早期预防解决五大湖地区心脏代谢健康不平等问题

• 批准号: 10494173
• 负责人: Phillip David Levy
• 金额: $ 361.8万
• 依托单位: WAYNE STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-24 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10494173
• 关键词: Address; Affect; Age; Area; Biological Specimen Banks; Black Populations; Black race; Cardiometabolic Disease; Cardiovascular Diseases; Cause of Death; Censuses; Characteristics; Chronic; Cities; Clinical; Collaborations; Communities; Community Health Aides; Community Outreach; Coronary heart disease; Custom; Data; Data Collection; Databases; Development; Diverse Workforce; Electronic Health Record; Ensure; Environment; Evidence based intervention; Fostering; Future; Geographic Locations; Goals; Grant; Great Lakes Region; Health; Health Services Accessibility; Health system; Heart; Heart Diseases; Heart failure; Home; Hypertension; Incidence; Inequality; Infrastructure; Ingestion; Institution; Interruption; Intervention; Life; Life Style; Location; Longevity; Mentors; Methods; Michigan; Mobile Health Units; National Institute on Minority Health and Health Disparities; Ohio; Participant; Pathogenesis; Pathway interactions; Persons; Pharmacists; Phase; Pilot Projects; Policy Maker; Poverty Areas; Practical Robust Implementation and Sustainability Model; Prevention; Public Health; Reach Effectiveness Adoption Implementation and Maintenance; Reduce health disparities; Research; Research Design; Research Personnel; Resources; Risk; Risk Factors; Savings; Scientist; Social Behavior; Statistical Data Interpretation; System; Training; Universities; University Hospitals; Vision; Work; biological specimen archives; black patient; blood pressure elevation; built environment; cardiometabolic risk; cardiometabolism; career; cloud based; cohort; collaborative care; community engagement; comorbidity; cost effective; data management; data warehouse; density; design; disease disparity; epidemiology study; evidence base; health disparity; health inequalities; high risk population; implementation intervention; improved; informatics tool; outreach; programs; recruit; remediation; social health determinants; social vulnerability; virtual

ABSTRACT Building upon the strength of existing collaborations and leveraging the intellectual resources and infrastructure across three major research institutions, two in Detroit (Wayne State University and the Henry Ford Health System) and one in Cleveland (Case Western Reserve University/University Hospitals), the ACHIEVE GREATER Center will, i) increase reach in areas with extreme social vulnerability by deploying a suite of community engagement resources in census tracts with heightened social vulnerability, ii) implement, evaluate and maintain an upscaled version of an evidence-based community health worker intervention to control multi-comorbid chronic cardiometabolic diseases by addressing multiple levels of influence across different domains, and iii) foster a diverse workforce of well-trained, early-career stage investigators who collectively focus on alleviating chronic cardiovascular disease disparities that drive U.S. lifespan inequality. In addition to conducting a pilot grants program across the three partnering institutions, ACHIEVE GREATER will perform three distinct but closely related special projects that focus on interrupting early stages of pathogenesis in different contexts (e.g., mobile health units versus fixed community locations). Importantly, this work will be nested in a larger epidemiologic study of multi-level cardiometabolic risk factors. Our team will develop a distributed Cloud-based database complete with a customized set of informatics tools that will enable investigators in the heart of each city to robustly profile multi-level risk factors across different domains using both publicly available information and investigator- generated data. Our evidence-based intervention pathways are designed to control risk factors, especially elevated blood pressure, which is the most important modifiable contributor to heart disease - far and away the leading cause of death in our region. By increasing reach in census tracts with increased social vulnerability where lifespan disparities and uncontrolled cardiometabolic risk factors are most prevalent, our study design optimizes both recruitment opportunities and potential intervention impact. Moreover, the alignment of resources across three institutions will efficiently enhance regional coordination, while increasing the number and diversity of research participants and highly trained early-career stage disparities investigators. If we are successful and cost-effective, then we will have demonstrated a scalable means of improving future lifespan equality by prioritizing risk factor control in high-risk populations from areas with extreme social vulnerability.

抽象的 建立在现有合作的基础上，利用智力资源和基础设施 横跨三个主要研究机构，其中两个位于底特律（韦恩州立大学和亨利福特健康中心） 系统）和克利夫兰的一个（凯斯西储大学/大学医院），ACHIEVE GREATER Center 将，i) 通过部署一套 社会脆弱性较高的人口普查区的社区参与资源， ii) 实施、评估和维护循证社区健康的升级版 通过解决多个层面的工人干预来控制多种合并症慢性心脏代谢疾病 跨不同领域的影响力，以及 iii) 培养一支训练有素、处于职业生涯早期阶段的多元化员工队伍 研究人员共同致力于减轻慢性心血管疾病的差异，这些差异推动了美国的发展 寿命不平等。除了在三个合作机构之间开展试点赠款计划外， ACHIEVE GREATER 将执行三个不同但密切相关的特别项目，重点关注 关于在不同情况下中断发病机制的早期阶段（例如，移动卫生单位与固定卫生单位） 社区地点）。重要的是，这项工作将嵌套在更大规模的多层次流行病学研究中 心脏代谢危险因素。我们的团队将开发一个基于云的分布式数据库，其中包含 定制的一套信息学工具将使每个城市中心的调查人员能够可靠地进行分析 使用公开信息和调查员来研究不同领域的多层次风险因素 生成的数据。我们基于证据的干预途径旨在控制风险因素，特别是 血压升高是导致心脏病的最重要的可改变因素——毫无疑问 我们地区的主要原因。通过扩大社会脆弱性增加的人口普查区域的覆盖面 在寿命差异和不受控制的心脏代谢危险因素最普遍的地方，我们的研究设计 优化招聘机会和潜在的干预影响。此外，对齐 三个机构的资源将有效加强区域协调，同时增加数量 研究参与者和训练有素的早期职业阶段差异调查人员的多样性。如果我们是 成功且具有成本效益，那么我们将展示一种可扩展的方法来改善未来 通过优先控制来自社会极端社会地区的高危人群的风险因素，实现寿命平等 脆弱性。