NY Community-Hospital-Academic Maternal Health Equity Partnerships (NY-CHAMP)

纽约社区-医院-学术界孕产妇健康公平合作伙伴关系 (NY-CHAMP)

• 批准号: 10748868
• 负责人: Sevonna Brown
• 金额: $ 232.81万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-17 至 2030-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10748868
• 关键词: Accounting; Address; Affect; Artificial Intelligence; Asian; Biological; Birth; Black Populations; Black race; Cardiovascular system; Caribbean region; Caring; Centers of Research Excellence; Cities; Clinical Decision Support Systems; Cognitive Therapy; Collaborations; Communities; Community Healthcare; Community Hospitals; Data; Disparity; Ecosystem; Electronic Health Record; Ensure; Equity; Evaluation; Goals; Government; Government Agencies; Health Sciences; Health care facility; Health system; Healthcare; Hispanic; Hospitalization; Hospitals; Individual; Inequity; Infrastructure; Institution; Intervention; Justice; Knowledge; Lead; Leadership; Link; Maternal Health; Maternal Health Services; Maternal Mortality; Maternal health equity; Medicaid eligibility; Medical center; Medicine; Mental Health; Methods; Modeling; New York; New York City; Outcome; Pathway interactions; Patient Education; Patient-Centered Care; Patients; Perinatal; Persons; Policies; Postpartum Period; Prevalence; Process; Provider; Race; Research; Research Personnel; Resources; Rural; Science; Service delivery model; Services; Site; Sterile coverings; Structural Racism; Structure; System; Test Result; Time; Training; Training Programs; Trauma; United States National Institutes of Health; Universities; Vision; Women' s Health; Work; access disparities; anti-racism; black women; cardiovascular health; care delivery; career development; community center; community engaged research; community engagement; community organizations; community partnership; comorbidity; cost; design; disability; effectiveness/implementation trial; empowerment; equity, diversity, and inclusion; evidence base; experience; health care service utilization; health disparity; health inequalities; member; novel; patient oriented; pilot test; pregnancy related death; programs; psychologic; research data dissemination; response; risk prediction model; severe maternal morbidity; social health determinants; training opportunity

OVERALL: PROJECT SUMMARY/ABSTRACT The broad goal of the New York Community-Hospital-Academic Maternal Health Equity Partnerships (NY- CHAMP) is to upend the maternal healthcare ecosystem in New York City (NYC) and New York State (NYS) by establishing a sustainable, highly collaborative infrastructure for community-centered maternal health science. We have carefully co-designed, with our partners, a research, training, and community engagement agenda that will 1) identify and address the comorbid biologic and psychologic pathways linking adverse social determinants of health (SDoH) to disparities in SMM and MM; and 2) co-create and implement scalable multi-level strategies grounded in anti-racism and empowerment to inform systems and policy change in our city and region. NY- CHAMP is set against the compelling backdrop of persistently high rates and disparities in SMM/MM across urban and rural parts of our state alike, despite a multitude of healthcare facilities and resources. More effective partnerships that break down siloes and leverage the knowledge and strengths of our diverse communities, hospitals, academic institutions, and government agencies are essential to assuring equitable access to culturally congruent, patient-centered care, redressing SMM/MM inequities, and maximizing our collective impact. We convene Columbia University and Weill Cornell Medicine, four lead community organizations (Black Women's Blueprint, Caribbean Women's Health Association, Northern Manhattan Perinatal Partnership, and The Bridge), and a broad coalition of multisector actors to address 3 synergistic Overall Aims. In Aim 1, we will implement a unified, community-driven research program that will: Project 1) Develop and implement novel artificial intelligence risk prediction models and a resulting clinical decision support system for SMM, accounting for SDoH, bias and fairness. Project 2) Conduct a Type 1 Hybrid Effectiveness-Implementation Trial of a novel doula-delivered cognitive behavioral therapy program holistically designed to address CV, MH, and SDoH outcomes during postpartum; build trauma-informed and empowerment-based service delivery models; and strengthen hospital-community care linkages. Project 3) Apply mixed methods to evaluate the effects of and excess costs attributable to structural racism and SMM/MM and the mitigating effects of two policy interventions for reducing maternal health disparities. In Aim 2, we will establish the Community Engagement and Policy Action Core (CEPA) to serve as an enduring platform for iterative community input, co-design processes, and research dissemination, capacity building, and policy action. In Aim 3, we will establish the Career Development and Training Core (CDTC) to transform the maternal health research culture and pipeline of early-stage investigators expertly trained in community partnerships, interdisciplinarity, anti-racism, and diversity, equity, inclusion, and justice. Our vision is perfectly aligned with the priorities, needs, and assets of our communities and with the NIH's IMPROVE initiative. Ultimately, NY-CHAMP will alter the underlying structural drivers of SMM/MM in NYC and NYS and shift the scientific paradigm for excellence in maternal health research.

总体而言：项目摘要/摘要 纽约社区-医院-学术界孕产妇健康公平合作伙伴关系 (NY- CHAMP）旨在通过以下方式颠覆纽约市 (NYC) 和纽约州 (NYS) 的孕产妇医疗保健生态系统： 为以社区为中心的孕产妇保健科学建立可持续的、高度协作的基础设施。 我们与合作伙伴精心共同设计了研究、培训和社区参与议程， 1) 识别并解决与不利社会决定因素相关的共病生物学和心理途径 健康 (SDoH) 与 SMM 和 MM 差异的关系； 2) 共同制定并实施可扩展的多层次战略 立足于反种族主义和赋权，为我们城市和地区的系统和政策变革提供信息。纽约- CHAMP 的背景是 SMM/MM 汇率持续高企且存在差异 尽管有大量的医疗设施和资源，但我们州的城市和农村地区都一样。更有效 打破孤岛并利用我们多元化社区的知识和优势的伙伴关系， 医院、学术机构和政府机构对于确保公平获得医疗服务至关重要 文化上一致、以患者为中心的护理、纠正 SMM/MM 不平等并最大化我们的集体 影响。我们召集了哥伦比亚大学和威尔康奈尔医学院这四个主要社区组织（黑人 妇女蓝图、加勒比妇女健康协会、北曼哈顿围产期伙伴关系，以及 桥梁），以及一个由多部门参与者组成的广泛联盟，以实现 3 个协同总体目标。在目标 1 中，我们将 实施一个统一的、社区驱动的研究计划，该计划将： 项目 1) 开发和实施新颖的 人工智能风险预测模型以及由此产生的 SMM、会计临床决策支持系统 对于 SDoH，偏见和公平。项目 2) 对小说进行 1 类混合有效性-实施试验 导乐提供的认知行为治疗计划，整体设计用于解决 CV、MH 和 SDoH 产后的结果；建立创伤知情和基于赋权的服务提供模式；和 加强医院与社区护理的联系。项目3）应用混合方法来评估和 结构性种族主义和 SMM/MM 造成的超额成本以及两项政策干预措施的缓解效果 减少孕产妇健康差异。在目标 2 中，我们将制定社区参与和政策 行动核心（CEPA）作为迭代社区输入、协同设计流程和 研究传播、能力建设和政策行动。在目标 3 中，我们将建立职业发展 和培训核心（CDTC），以改变孕产妇健康研究文化和早期阶段的管道 调查人员接受过社区伙伴关系、跨学科、反种族主义、多样性、公平、 包容和正义。我们的愿景与社区的优先事项、需求和资产完全一致 以及 NIH 的 IMPROVE 计划。最终，NY-CHAMP 将改变潜在的结构性驱动因素 纽约市和纽约州的 SMM/MM 并转变科学范式，以实现卓越的孕产妇健康研究。