ACHIEVE GreatER: Addressing Cardiometabolic Health Inequities by Early PreVEntion in the Great LakEs Region

实现更大目标：通过早期预防解决五大湖地区心脏代谢健康不平等问题

• 批准号: 10494173
• 负责人: Phillip David Levy
• 金额: $ 361.8万
• 依托单位: WAYNE STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-24 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10494173
• 关键词: Address; Affect; Age; Area; Biological Specimen Banks; Black Populations; Black race; Cardiometabolic Disease; Cardiovascular Diseases; Cause of Death; Censuses; Characteristics; Chronic; Cities; Clinical; Collaborations; Communities; Community Health Aides; Community Outreach; Coronary heart disease; Custom; Data; Data Collection; Databases; Development; Diverse Workforce; Electronic Health Record; Ensure; Environment; Evidence based intervention; Fostering; Future; Geographic Locations; Goals; Grant; Great Lakes Region; Health; Health Services Accessibility; Health system; Heart; Heart Diseases; Heart failure; Home; Hypertension; Incidence; Inequality; Infrastructure; Ingestion; Institution; Interruption; Intervention; Life; Life Style; Location; Longevity; Mentors; Methods; Michigan; Mobile Health Units; National Institute on Minority Health and Health Disparities; Ohio; Participant; Pathogenesis; Pathway interactions; Persons; Pharmacists; Phase; Pilot Projects; Policy Maker; Poverty Areas; Practical Robust Implementation and Sustainability Model; Prevention; Public Health; Reach Effectiveness Adoption Implementation and Maintenance; Reduce health disparities; Research; Research Design; Research Personnel; Resources; Risk; Risk Factors; Savings; Scientist; Social Behavior; Statistical Data Interpretation; System; Training; Universities; University Hospitals; Vision; Work; biological specimen archives; black patient; blood pressure elevation; built environment; cardiometabolic risk; cardiometabolism; career; cloud based; cohort; collaborative care; community engagement; comorbidity; cost effective; data management; data warehouse; density; design; disease disparity; epidemiology study; evidence base; health disparity; health inequalities; high risk population; implementation intervention; improved; informatics tool; outreach; programs; recruit; remediation; social health determinants; social vulnerability; virtual

ABSTRACT Building upon the strength of existing collaborations and leveraging the intellectual resources and infrastructure across three major research institutions, two in Detroit (Wayne State University and the Henry Ford Health System) and one in Cleveland (Case Western Reserve University/University Hospitals), the ACHIEVE GREATER Center will, i) increase reach in areas with extreme social vulnerability by deploying a suite of community engagement resources in census tracts with heightened social vulnerability, ii) implement, evaluate and maintain an upscaled version of an evidence-based community health worker intervention to control multi-comorbid chronic cardiometabolic diseases by addressing multiple levels of influence across different domains, and iii) foster a diverse workforce of well-trained, early-career stage investigators who collectively focus on alleviating chronic cardiovascular disease disparities that drive U.S. lifespan inequality. In addition to conducting a pilot grants program across the three partnering institutions, ACHIEVE GREATER will perform three distinct but closely related special projects that focus on interrupting early stages of pathogenesis in different contexts (e.g., mobile health units versus fixed community locations). Importantly, this work will be nested in a larger epidemiologic study of multi-level cardiometabolic risk factors. Our team will develop a distributed Cloud-based database complete with a customized set of informatics tools that will enable investigators in the heart of each city to robustly profile multi-level risk factors across different domains using both publicly available information and investigator- generated data. Our evidence-based intervention pathways are designed to control risk factors, especially elevated blood pressure, which is the most important modifiable contributor to heart disease - far and away the leading cause of death in our region. By increasing reach in census tracts with increased social vulnerability where lifespan disparities and uncontrolled cardiometabolic risk factors are most prevalent, our study design optimizes both recruitment opportunities and potential intervention impact. Moreover, the alignment of resources across three institutions will efficiently enhance regional coordination, while increasing the number and diversity of research participants and highly trained early-career stage disparities investigators. If we are successful and cost-effective, then we will have demonstrated a scalable means of improving future lifespan equality by prioritizing risk factor control in high-risk populations from areas with extreme social vulnerability.

抽象的 基于现有合作的实力并利用智力资源和基础设施 在三个主要的研究机构中，两个在底特律（韦恩州立大学和亨利·福特健康 系统），一个在克利夫兰（Case Western Reserve University/University Hospitals），实现 更大的中心，i）通过部署一套套件来增加具有极端社会脆弱性的地区的覆盖范围 社区参与资源在人口普查中，社会脆弱性增加， ii）实施，评估和维护基于证据的社区健康的高扫描版本 通过解决多个级别的多个级别 跨不同领域的影响，iii）培养了训练有素的早期阶段的多样化劳动力 集体专注于减轻驱动美国的慢性心血管疾病差异的调查人员 寿命不平等。除了在三个合作机构中开展飞行员赠款计划外， 实现更大的将执行三个不同但密切相关的特殊项目，这些项目集中于 关于在不同情况下中断发病机理的早期阶段（例如，移动健康单位与固定单位 社区位置）。重要的是，这项工作将嵌套在多层次的更大的流行病学研究中 心脏代谢危险因素。我们的团队将开发一个基于云的分布式数据库 定制的一组信息学工具，将使每个城市中心的调查人员能够牢固概况 使用公共可用信息和研究者的不同领域的多层次风险因素 生成的数据。我们的循证干预途径旨在控制风险因素，尤其是 血压升高，这是导致心脏病的最重要的改变 - 我们地区的主要死亡原因。通过增加人口普查区的覆盖范围随着社会脆弱性的增加而 在寿命差异和不受控制的心脏代谢危险因素最普遍的地方，我们的研究设计 优化招聘机会和潜在的干预影响。而且，对齐 三个机构的资源将有效增强区域协调，同时增加数量 以及研究参与者的多样性和训练有素的早期阶段差异研究人员。如果是 成功且具有成本效益，然后我们将展示一种可扩展的方法来改善未来 寿命平等通过优先考虑来自具有极端社会领域的高风险人群的风险因素控制 脆弱性。