Center to Improve Chronic disease Outcomes through Multi-level and Multi-generational approaches Unifying Novel Interventions and Training for health EquitY (The COMMUNITY Center)

摘要： 尽管在治疗慢性病方面取得了医学进步，流行病学研究结果也确定了慢性病的危险因素 慢性病方面，健康问题社会决定因素导致的健康差距依然存在 （SDoH）。我们齐心协力，通过改善慢性病中心来解决这些差异 通过多层次和多代方法取得的成果 将新颖的干预措施与 健康公平培训（社区中心）。我们的愿景植根于公共卫生，认识到 仅靠医疗进步只能部分减轻疾病负担，并且缩小不同地区的健康差距 慢性病需要改善个人、家庭、社区和社会的健康和福祉 一生。我们力求在我们所服务的社区中实现这一愿景，这些社区是最受高度评价的社区之一。 美国人口多元化，大约 2/3 为非白人，1/3 为外国出生，1/5 生活在联邦贫困线以下 线。社区中心的使命是减少纽约慢性病的健康差距 城市地区通过严格的测试、传播和维持包含多种措施的干预措施 个人、人际、社区和社会方法的影响程度。我们设计了三款 协同项目，解决由以下人士确定并响应他们的声音和关切的慢性病 我们服务的社区，每个社区都涉及雇用社区卫生工作者 (CHW) 的新颖干预措施 注册和/或保留研究的模型，同时还将参与者与基于以下内容的服务联系起来 SDoH 的五个领域（住房不稳定、粮食不安全、交通问题、公用事业帮助需求和 保险登记）。这三个项目是 1) 社区卫生工作者联合减少结直肠癌 高危人群中的心血管疾病（CHURCH）； 2) 解决睡眠持续时间、规律性和效率问题：A 减少心脏代谢疾病差异的多维睡眠健康干预（DREAM）；和 3) 公平地提高依从性的干预（影响试验）。除了这三个研究项目外， 该中心支持通过研究者发展核心 (IDC) 资助的健康公平学者和试点项目 以及通过社区核心（称为 CONNECTOME）资助的社区项目。的 行政核心 (ADMIN)，包括具有生物统计学、实施科学和 数据协调和生物医学信息学。社区中心涉及强有力的合作 研究人员、社区组织、临床医生和医疗保健系统、公共卫生机构和 其他利益相关者和合作伙伴 哥伦比亚大学欧文医学中心 (CUIMC) 和威尔康奈尔医疗中心 中心 (WCM) 通过大纽约长老会 (NYP) 医院系统与纽约城市大学加入 纽约 (CUNY) 和纽约医师附属组织 (PAGNY)。独特的协作已蓄势待发 创建可持续的公共卫生解决方案，从而实现系统层面的变革，促进健康公平。

ABSTRACT: Despite medical advances in treating chronic diseases and epidemiological findings identifying risk factors for chronic diseases, there remain major persistent health disparities driven by the Social Determinants of Health (SDoH). We have come together to address these disparities through the Center to Improve Chronic disease Outcomes through Multi-level and Multi-generational approaches Unifying Novel Interventions and Training for health EquitY (COMMUNITY Center). Our vision is rooted in public health which recognizes that medical advances alone can only partially reduce the burden of disease and that reducing health disparities in chronic diseases requires improving the health and wellness of individuals, families, communities and societies throughout life. We seek to realize this vision within the communities we serve that are among the most highly diverse in the U.S. with approximately 2/3 non-white, 1/3 foreign-born, and 1/5 living below the Federal poverty line. The mission of the COMMUNITY Center is to reduce health disparities in chronic diseases in the New York City Region through rigorous testing, disseminating and sustaining of interventions that incorporate the multiple levels of influence from individual, interpersonal, community and societal approaches. We have designed three synergistic projects that address chronic conditions identified by and responsive to the voice and concerns of the communities we serve and each involve novel interventions employing the community health worker (CHW) model for enrollment and/or retention into the studies while also connecting participants to services based on five domains of SDoH (housing instability, food insecurity, transportation problems, utility help needs and insurance enrollment). The three projects are 1) Community Health workers United to Reduce Colorectal cancer and CVD among people at Higher risk (CHURCH); 2) Addressing Sleep Duration, Regularity, and Efficiency: A Multidimensional Sleep Health Intervention for Reducing Disparities in Cardiometabolic Disease (DREAM); and 3) Intervention to iMProve AdherenCe equiTably (IMPACT TRIAL). In addition to the three research projects, the Center supports Health Equity Scholars and pilots funded through the Investigator Development Core (IDC) and community projects funded through the Community Core (known as the CONNECTOME). The Administrative Core (ADMIN) which includes faculty with expertise in biostatistics, implementation science, and data harmonization and biomedical informatics. The COMMUNITY Center involves strong collaborations between researchers, community organizations, clinicians and healthcare systems, public health agencies and other stakeholders and partners Columbia University Irving Medical Center (CUIMC) and Weill Cornell Medical Center (WCM) joined through the greater New York Presbyterian (NYP) Hospital System with City University of New York (CUNY) and the Physician Affiliate Group of New York (PAGNY). The unique collaborative is poised to create sustainable public health solutions that will result in system-level changes that promote health equity.