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

项目摘要/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病例和 2型糖尿病的费用。社会经济地位低的个人、老年人、农村人口和种族 少数民族是风险最高的群体。这些差距的驱动因素包括复杂的 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、循证的糖尿病干预措施转化为广泛的政策 人们迫切需要在不同的社区、交付方式和一系列环境中进行实践。这个 通过先进的多层次糖尿病翻译科学中心进行的糖尿病公平研究 研究(DREAMS-CDTR)旨在通过开发和翻译来促进健康公平科学 1)医疗保健提供系统的创新和结构变化，大幅减少健康 不平等，以及2)创新的、可扩展的干预措施，以改变2型患者的社会环境驱动因素 糖尿病流行及相关差异。 聚焦于加州北部和加州中央山谷地区，DREAMS-CDTR将进行 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(以前的医疗服务系统)汇集在一起 翻译科学核心教员，在不同的、多层次的领域拥有专业知识，包括：粮食不安全， 用药依从性、健康沟通、健康信息技术、社会政策和成本效益分析。 梦想-CDTR将涉及四个地区性学术网站，以及一系列公共和非营利性医疗系统 为大量和多样化的人群服务：Kaiser Permanente北加州研究和 加州大学旧金山分校，默塞德和戴维斯分校。 DREAMS-CDTR的活动包括：行政核心、试点和可行性方案、充实 计划，以及三个协调研究核心--健康公平和行动翻译(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。 热核将采用多层次系统方法来设计严格的面向行动的观测 和干预性研究。MDI核心将系统地准备和支持DREAMS-CDTR成员 在利用方法和数据方面的新进展，以实现2型糖尿病更大的健康公平性。最后， 新的国家DPR核心将扩展梦想-CDTR专业知识和资源的覆盖范围 初级机构在五个关键的专门领域：(1)自然实验研究，(2)卫生经济学， 包括比较效益和成本效益分析；(3)仿真建模；(4)机器 学习，以及(5)向决策机构、社区合作伙伴、卫生部门 各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.