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，加州的发病率居全国首位， 2型糖尿病的危害社会经济地位低的人、老年人、农村人口和种族 少数民族的风险最高。这些差异的驱动因素包括以下复杂的组合： 个人、家庭、社区、卫生系统、社会和政策层面的相互作用因素。程序和 能够有效地将高质量的、基于证据的糖尿病干预措施转化为广泛的 迫切需要在不同社区、交付模式和各种环境中开展实践。的 通过糖尿病转化高级多层次科学中心进行糖尿病公平研究 研究（DREAMS-CDTR）旨在通过发展和翻译健康公平科学， 1）医疗保健提供系统的创新和结构变化，大大减少了健康 2）创新的、可扩展的干预措施，以改变2型糖尿病的社会环境驱动因素 糖尿病流行病和相关的差距。 以北方加州和加州的中央谷地区为重点，DREAMS-CDTR将进行 临床研究和干预措施旨在为卫生系统的实践和政策变化提供信息， 社区和政策层面。DREAMS-CDTR（以前的健康交付系统）汇集了 翻译科学核心教师谁拥有不同的，多层次的领域，包括专业知识：粮食不安全， 药物依从性、健康沟通、健康IT、社会政策和成本效益分析。 DREAMS-CDTR将涉及四个区域学术中心以及一系列公共和非营利卫生系统 服务于庞大而多样化的人群：凯撒医疗机构北方加州的研究和 位于旧金山弗朗西斯科、默塞德和戴维斯的加州大学。 DREAMS-CDTR的活动包括：行政核心、试点和可行性方案、 计划，以及三个协调的研究核心-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核心将采用多层次系统方法来设计严格的面向行动的观测系统。 和介入性研究。MDI核心将系统地准备和支持DREAMS-CDTR成员 利用方法和数据的新进展来实现2型糖尿病的更大健康公平性。最后， 新的“国家DPR核心”将把“梦想-CDTR”的专业知识和资源扩展到 主要机构在五个关键领域的专业知识：（1）自然实验研究，（2）卫生经济学， 包括比较效果和费用效果分析;（3）仿真建模;（4）机器 （5）向决策机构、社区合作伙伴、卫生部门和其他机构传播科学知识， 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.