DREAMS - Enrichment Program

项目摘要/摘要 糖尿病在美国是一个严重的健康负担。2型糖尿病的患病率正在上升 迅速；加州在糖尿病的发病病例和成本方面领先于全国。社会经济状况较差的个人 老年人、农村人口以及种族和族裔少数群体处于最高风险。这些问题的驱动因素 差异包括个人、家庭、社区、健康等相互作用因素的复杂组合 制度层面、社会层面和政策层面。能够有效地将高质量的证据- 以糖尿病干预措施为基础，在不同的社区、交付方式和 迫切需要一系列的设置。通过先进的多层次研究糖尿病患者的权益 糖尿病转化研究科学中心(DREAMS-CDTR)旨在促进健康公平 通过发展和转化科学：1)医疗保健的创新和结构变化 实质性减少健康不平等的提供系统，以及2)创新、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。 以加利福尼亚州北部及其中央山谷地区为重点，DREAMS-CDTR将进行临床 旨在为卫生系统、社区和社区的实践和政策变化提供信息的研究和干预措施 政策层级。DREAMS-CDTR(前身为Health Delivery Systems)汇集了翻译科学 核心教员，其中一半来自科学界代表性不足的群体，他们在多样化、多种多样的 水平领域包括：粮食不安全、服药依从性、卫生沟通、卫生信息技术、社会政策、 和成本效益分析。Dreams-CDTR将涉及四个地区性学术站点，包括 服务于大量不同人群的公共和非营利性卫生系统：Kaiser Permanente Northern 加州研究部和加州大学旧金山分校、默塞德分校和戴维斯分校。 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核心。这个 热芯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 利用方法和数据方面的新进展，实现2型糖尿病患者更大的健康公平性。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 梦想--CDTR五个主要专长领域的专长和资源：(1) 自然实验研究；(2)保健经济学，包括比较效益和成本效益 分析；(3)模拟建模；(4)机器学习；(5)向决策传递科学 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.