Rural Patient Risks and Exposures for Diabetes ConTrol (Rural PREDICT)

项目总结/摘要 约6000万美国人生活在农村地区，2型糖尿病（T2 DM）的负担更高 然而，与城市地区相比，关于T2 DM风险因素和干预措施的信息很少， 加强T2 DM一级预防。Dugani博士是一名学术医院学家和早期研究者， 致力于改善农村地区T2 DM的一级预防。他的长期目标是 一个独立的临床研究者正在通过开发一种新的治疗方法来减少农村人群中T2 DM的健康差异。 以患者为中心的干预措施，以更好地进行T2 DM一级预防。本提案的短期目标 熟练掌握数据科学，定性/混合方法，健康差异研究，以及 通过公共卫生硕士学位进行临床试验研究设计;导师制;以及领导技能， 建立并领导一个独立的研究项目，以推进T2 DM护理。这项研究将在 在马约诊所，它有强大的基础设施和设备，以病人为导向的研究。杜加尼医生会 利用来自疾病控制和预防中心（Aim 1）和马约诊所生物库（Aims 2和3）推进研究目标，并依靠一个专门的导师和顾问团队， T2 DM、流行病学、健康差异研究和卫生服务研究方面的专业知识。 博士杜加尼将通过小说《农村病人风险和暴露》实现他的短期目标， 糖尿病控制（农村预测）研究，他开发了该研究，以调查T2 DM的较高负担， 与城市人口相比，中西部农村人口。目前，关于风险因素的信息很少， 中西部农村人群中T2 DM，中西部农村人群中无T2 DM风险预测评分。 通过农村预测，杜加尼博士将解决这些知识差距。具体而言，在目标1中，他将 描述中西部农村地区糖尿病的发病率和时间趋势。在目标2中，他将 评估传统风险因素（例如，生活方式，社会经济地位）和新农村- 丰富的风险因素（例如，有机化学品、杀虫剂）与中西部农村发生的2型糖尿病有关。他将 直接与农村患者接触，探讨他们对高风险因素负担的看法。在Aim中 3，他将开发一种非侵入性（即，非实验室）农村5年T2 DM风险预测评分 这可能是农村人口面临的一个障碍。他将 让患者参与制定一份有意义的、非污名化的风险评分问卷，并探索 使用该风险评分的障碍。这些研究将构成NIH R 01（第4-5年）的基础 应用于中西部农村人群的T2 DM一级预防。他的研究目标与 国家少数民族和人类发展研究所的优先事项是减少包括农村社区在内的少数群体的健康差距。

PROJECT SUMMARY/ABSTRACT Rural areas, where ~60 million Americans live, have a higher burden of type 2 diabetes mellitus (T2DM) compared to urban areas, yet, there is sparse information on T2DM risk factors and interventions that improve T2DM primary prevention. Dr. Dugani, an academic hospitalist and early-stage investigator, is committed to improving the primary prevention of T2DM in rural areas. His long-term goal as an independent clinical investigator is to reduce health disparities for T2DM in rural populations by developing patient-centered interventions for better T2DM primary prevention. The short-term goals of this proposal are to acquire proficiency in data science, qualitative/mixed methods, health disparities research, and clinical trial study design through a Master of Public Health degree; mentorship; and, leadership skills to build and lead an independent research program to advance T2DM care. This research will be conducted at Mayo Clinic, which has robust infrastructure and facilities for patient-oriented research. Dr. Dugani will leverage data from the Centers for Disease Control and Prevention (Aim 1) and Mayo Clinic Biobank (Aims 2 and 3) to advance the research aims and also rely on a dedicated team of mentors and advisors with expertise in T2DM, epidemiology, health disparities research, and health services research. Dr. Dugani will accomplish his short-term goals through the novel Rural Patient Risks and Exposures for Diabetes ConTrol (Rural PREDICT) study, which he developed to investigate the higher burden of T2DM in Midwest rural compared to urban populations. At present, there is sparse information on risk factors for T2DM in Midwest rural populations and no T2DM risk prediction score for Midwest rural populations. Through Rural PREDICT, Dr. Dugani will address these knowledge gaps. Specifically, in Aim 1, he will characterize the incidence rate and temporal trend of diabetes in the rural Midwest. In Aim 2, he will evaluate the associations of traditional risk factors (e.g., lifestyle, socioeconomic status) and novel rural- enriched risk factors (e.g., organic chemicals, pesticides) with incident T2DM in the rural Midwest. He will directly engage rural patients to explore their perspectives regarding the high burden of risk factors. In Aim 3, he will develop a non-invasive (i.e., non-laboratory) 5-year T2DM risk prediction score for rural populations and obviate the need for laboratory testing, which may be a barrier for rural populations. He will engage patients to develop a meaningful, non-stigmatizing questionnaire for the risk score and explore barriers to the use of this risk score. These studies will form the basis for an NIH R01 (years 4-5) application to advance T2DM primary prevention in Midwest rural populations. His research goals align with NIMHD's priority to reduce health disparities in minority groups, including rural communities.