the Diabetes Research for Equity through Advanced Multilevel Science Center for Diabetes Translational Research (DREAMS-CDTR)

项目概要/摘要 糖尿病在美国是一个重大的健康负担，加利福尼亚州的发病率和发病率均居全国首位。 2 型糖尿病的费用。社会经济地位较低的个人、老年人、农村人口和种族 少数族裔面临的风险最高。这些差异的驱动因素包括以下因素的复杂组合： 个人、家庭、社区、卫生系统、社会和政策层面的相互作用因素。计划和 能够有效地将高质量、基于证据的糖尿病干预措施转化为广泛的政策 迫切需要在不同的社区、交付方式和各种环境中进行实践。的 通过先进的多层次糖尿病转化科学中心进行糖尿病研究以实现公平 研究 (DREAMS-CDTR) 旨在通过开发和转化来推进健康公平科学 1) 医疗保健服务系统的创新和结构性变革会大幅降低健康水平 不平等，以及 2) 创新、可扩展的干预措施，以改变 2 类社会环境驱动因素 糖尿病流行及相关差异。 DREAMS-CDTR 将重点关注加州北部和加州中央谷地区 旨在为卫生系统的实践和政策变化提供信息的临床研究和干预措施， 社区和政策层面。 DREAMS-CDTR（以前的健康交付系统）汇集了 转化科学核心教师在不同、多层次的领域拥有专业知识，包括：粮食不安全、 药物依从性、健康沟通、健康信息技术、社会政策和成本效益分析。 DREAMS-CDTR 将涉及四个区域学术机构以及一系列公共和非营利卫生系统 为大量且多样化的人群提供服务：Kaiser Permanente 北加州研究和部门 加州大学旧金山分校默塞德分校和戴维斯分校。 DREAMS-CDTR 活动包括：行政核心、试点和可行性计划、丰富化 计划和三个协调研究核心 - 健康公平与行动转化 (HEAT) 核心、方法 和数据集成（MDI）翻译核心，以及国家糖尿病政策研究资源（DPR）核心。 HEAT Core 将采用多层次系统方法来设计严格的、以行动为导向的观察 和介入研究。 MDI 核心将系统地准备和支持 DREAMS-CDTR 成员 利用方法和数据方面的新进展来实现 2 型糖尿病的更大健康公平。最后， 新颖的国家 DPR 核心将把 DREAMS-CDTR 专业知识和资源的覆盖范围扩展到其他国家之外 五个关键专业领域的主要机构：（1）自然实验研究，（2）卫生经济学， 包括比较效果和成本效益分析； (3)仿真建模，(4)机器 学习，以及 (5) 将科学传播给决策机构、社区合作伙伴、卫生部门 部门和人类服务组织。

Project Summary/Abstract Diabetes mellitus is a significant health burden in the U.S. and California leads the nation in incident cases and costs of Type 2 Diabetes. Individuals with low socioeconomic status, older adults, rural populations, and racial and ethnic minorities are at highest risk. The drivers of these disparities include a complex combination of interacting factors at the individual, family, community, health system, societal, and policy levels. Programs and policies that can effectively translate high-quality, evidence-based diabetes interventions into widespread practice across diverse communities, modes of delivery, and a range of settings are desperately needed. The Diabetes Research for Equity through Advanced Multilevel Science Center for Diabetes Translational Research (DREAMS-CDTR) aims to advance health equity science through the development and translation of: 1) innovations and structural changes to healthcare delivery systems that substantively reduce health inequalities, and 2) innovative, scalable interventions to alter the socioenvironmental drivers of the Type 2 Diabetes epidemic and associated disparities. Focusing on the northern California and Central Valley regions of California, the DREAMS-CDTR will conduct clinical research and interventions designed to inform practice and policy change at the health system, community and policy levels. The DREAMS-CDTR (formerly Health Delivery Systems) brings together translational science core faculty who have expertise in diverse, multi-level areas including: food insecurity, medication adherence, health communication, health IT, social policy, and cost effectiveness analysis. DREAMS-CDTR will involve four regional academic sites with a range of public and non-profit health systems that serve large and diverse populations: Kaiser Permanente Northern California’s Division of Research and the University of California at San Francisco, Merced and Davis. The DREAMS-CDTR activities include: an Administrative Core, Pilot and Feasibility Program, Enrichment Program, and three coordinated research cores - Health Equity & Action Translational (HEAT) core, Methods and Data Integration (MDI) translational core, and National Diabetes Policy Research Resource (DPR) core. The HEAT Core will employ a multi-level systems approach to designing rigorous action-oriented observational and interventional research. The MDI Core will systematically prepare and support DREAMS-CDTR members in harnessing novel advances in methods and data to achieve greater health equity in Type 2 Diabetes. Lastly, the novel National DPR Core will extend the reach of the DREAMS-CDTR expertise and resources beyond the primary institutions in five key areas of expertise: (1) natural experiments research,(2) health economics, including comparative effectiveness and cost-effectiveness analysis; (3) simulation modeling, (4) machine learning, and (5) communicating science to policy-making institutions, community partners, health departments, and human service organizations.