DREAMS - Enrichment Program

项目总结/摘要 糖尿病是美国的一个重大健康负担。2型糖尿病的患病率正在增长 迅速;加州在糖尿病发病率和费用方面领先全国。社会经济地位低的人 老年人、农村人口以及少数种族和族裔的风险最高。这些驱动程序 不平等包括个人、家庭、社区、健康、 制度、社会和政策层面。能够有效地将高质量的证据转化为 基于糖尿病的干预措施在不同的社区、交付模式和 一系列的设置是迫切需要的。糖尿病公平性的多水平研究 糖尿病转化研究科学中心（DREAMS-CDTR）旨在促进健康公平 科学通过发展和翻译：1）创新和结构变化，以医疗保健 实质性减少健康不平等的交付系统，以及2）创新的，可扩展的干预措施，以改变 2型糖尿病流行的社会环境驱动因素及相关差异。 以北方加州及其中央谷地区为重点，DREAMS-CDTR将开展临床 研究和干预措施，旨在为卫生系统、社区和 政策层面。DREAMS-CDTR（原健康交付系统）汇集了转化科学 核心教师，其中一半来自科学代表性不足的群体，他们拥有多样化，多学科的专业知识， 水平领域包括：粮食不安全，药物依从性，卫生传播，卫生信息技术，社会政策， 成本效益分析。DREAMS-CDTR将涉及四个区域学术网站， 为众多不同人群服务的公共和非营利卫生系统：凯撒医疗机构北方 加州研究部和加州大学弗朗西斯科分校，默塞德和戴维斯。 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核心。的 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，以实现2型糖尿病的更大健康公平。最后， 新的国家糖尿病政策研究资源核心（国家DPR核心）将扩大 DREAMS-CDTR在五个关键专业领域的专业知识和资源超出了主要机构： 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）模拟建模，（4）机器学习，（5）将科学与决策沟通 机构、社区合作伙伴、卫生部门和人类服务组织。

Project Summary/Abstract Diabetes mellitus is a significant health burden in the U.S. The prevalence of Type 2 Diabetes is growing rapidly; California leads the nation in incident cases and costs of 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 its Central Valley region, 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, half of whom are from groups under-represented in science, 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 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 Diabetes Policy Research Resource Core (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.