Duke Center for REsearch to AdvanCe Healthcare Equity (REACH EQUITY)

摘要-总体 种族和民族的健康差异无处不在，导致发病率和死亡率过高， 与大量的医疗费用有关。这些差异甚至存在于 获得类似护理的机会，这表明提供者和卫生系统（如NIMHD所示） 这些因素是造成健康差距的重要因素。然而，大多数干预研究， 减少差异的重点是改变患者的行为和知识， 有效干预措施的证据基础存在差距，以减少医疗保健提供方面的差距。 在本申请中，我们建议将杜克研究中心用于AdvanCe Healthcare 股权REACH Equity将通过关注质量来解决当前差距研究中的差距 在临床医疗机构中提供医疗服务的种族和民族差异， 都有详细的记录REACH Equity的总体主题是：开发和测试干预措施， 通过提高以病人为中心的护理质量，减少种族和民族在健康方面的差异， 通过更好的提供者沟通，高质量的人际交往过程， 护理和共同决策。而不是专注于单一疾病，REACH公平将 支持适用于并可在诊断、护理环境 疾病的各个阶段，以及整个生命过程。 REACH Equity的具体目标是：（1）创建一个保护伞， 跨学科的健康差异研究，延伸到整个校园和卫生系统。（二） 催化和支持与中心的相关，严格，可重复的研究计划， 主题. (3)通过一项研究，开发下一代跨学科的健康差异调查人员。 研究教育和培训管道计划，包括本科生，医学和 研究生、博士后实习生和早期职业教师。(4)使健康差距多样化 通过有意识地识别，指导和发展代表性不足的少数民族来研究劳动力 (URM)调查员、领导者和榜样。(5)发展互惠伙伴关系， 社区和利益相关者参与中心，并确保广泛传播 研究结果。REACH Equity将利用大型卫生系统的巨大资源， 全国排名的培训计划，研究密集型学术医疗中心和社区 利益攸关方伙伴关系，以促进科学知识，这将对世界产生实际影响， 以病人为中心的护理和最终的健康结果中的种族和民族差异。该中心将 还应处理国家优先事项，培训健康差距调查人员， 研究人员。

ABSTRACT—Overall Racial and ethnic health disparities are ubiquitous, lead to excess morbidity and mortality, and are associated with substantial healthcare costs. These disparities are present even among those with similar access to care, suggesting that providers and health systems (as indicated in the NIMHD framework) are important contributors to health disparities. Yet most studies of interventions to reduce disparities have focused on changing patient behavior and knowledge, leaving substantial gaps in the evidence base of effective interventions to reduce disparities in healthcare delivery. In this application, we propose The Duke Center for REsearch to AdvanCe Healthcare Equity. REACH Equity will address gaps in current disparities' research by focusing on the quality of healthcare delivery in the clinical encounter—a setting where racial and ethnic disparities in care are well-documented. The overall theme of REACH Equity is to: develop and test interventions that reduce racial and ethnic disparities in health by improving the quality of patient-centered care in the clinical encounter through better provider communication, high quality interpersonal processes of care, and shared decision making. Rather than focusing on a single disease, REACH Equity will support research which is applicable to and can be replicated across diagnoses, settings of care, stages of illness, and throughout the life course. The Specific Aims of REACH Equity are to: (1) Create an umbrella for the integration of transdisciplinary health disparities research that extends across the campus and health system. (2) Catalyze and support a program of relevant, rigorous, reproducible research related to the Center's theme. (3) Develop the next generation of transdisciplinary health disparities investigators through a research education and training pipeline program which includes undergraduates, medical and graduate students, postdoctoral trainees, and early-career faculty. (4) Diversify the health disparities research workforce by intentionally identifying, mentoring, and developing underrepresented minority (URM) investigators, leaders, and role models. (5) Develop reciprocal partnerships which facilitate community and stakeholder engagement in the Center and ensure widespread dissemination of research findings. REACH Equity will leverage the vast resources of a large health system, nationally ranked training programs, research-intensive academic medical center, and community stakeholder partnerships, to advance scientific knowledge which will have a real-world impact on racial and ethnic disparities in patient-centered care and ultimately health outcomes. The Center will also address national priorities in training health disparities investigators and increasing diversity in the research workforce.