Center for Rural Health Care Delivery Science

项目摘要/摘要 这项生物医学研究卓越中心(COBRE)提议建立一个农村健康中心 达特茅斯-希区柯克健康中心(D-HH)的护理交付科学，这是最农村的学术医疗中心之一 在美国。近20%的美国人生活在非大都市地区，健康状况较差 结果，但关于农村卫生保健的研究一直受到相对较小的挑战的限制 和地理上分散的种群。因此，我们的中心将专注于理解和 解决与在农村地区提供卫生保健相关的挑战，重点放在一个社区-- 从事研究的方法。Cobre的首要目标是建立一个多学科的研究 农村保健提供科学方案，并提供专家指导和基础设施，以培训和 支持大批早期临床医生和科学家过渡为独立研究人员 致力于减少农村社区的医疗保健差距。为实现这一目标，该中心将 追求以下四个具体目标：(1)整合研究专业知识、指导和社区 参与建立农村卫生保健提供科学中心；(2)加强农村早期保健服务的过渡 职业临床医生-科学家通过强有力的研究支持和敬业精神成为独立的研究人员 指导；(3)通过执行严格的 方案评估计划；以及(4)利用共享资源支持农村卫生保健中心 交付科学作为一个自给自足的科学社区。拟建的中心将带来一个创新和 关注农村卫生的根本原因，研究农村卫生服务提供的有效途径 不同系统和程序之间的差异，以及解决阻碍疾病检测的障碍， 在农村人口中特别普遍的保健服务和卫生条件管理。这个 最初的四个研究项目负责人将讨论疾病预防和筛查(项目1)、数字健康 疾病管理技术(项目2)，以及社会经济因素和卫生政策 影响复杂疾病的管理(项目3)和临终关怀的提供(项目4)。这个 该中心的科学核心将通过以下方式支持该中心：(1)加强#年的力学研究方法 农村人口；和(2)为扩大和加强关键关系提供所需资源 通过以社区为基础的参与性研究，促进研究人员和主要利益攸关方之间的合作。科布雷基金， 再加上大量的机构资金和承诺在 第一阶段，将为一个充满活力的中心的发展奠定坚实的基础。总而言之， 拟建中心将支持在农村地区建立一个自给自足的多学科研究方案 D-HH的医疗保健提供科学。

PROJECT SUMMARY/ABSTRACT This Centers of Biomedical Research Excellence (COBRE) proposal establishes a Center for Rural Health Care Delivery Science at Dartmouth-Hitchcock Health (D-HH), one of the most rural academic medical centers in the United States. Nearly 20% of Americans live in non-metropolitan areas and experience poorer health outcomes, but research on rural health care has been limited by challenges associated with relatively small and geographically dispersed populations. Accordingly, our Center will concentrate on understanding and solving challenges associated with the provision of health care in rural areas, focusing on a community- engaged approach to research. The overarching goal of this COBRE is to establish a multidisciplinary research program in rural health care delivery science and to provide expert mentorship and infrastructure to train and support a critical mass of early-career clinician-scientists as they transition into independent researchers dedicated to decreasing health care disparities in rural communities. To achieve this goal, the Center will pursue the following four specific aims: (1) Integrate research expertise, mentorship, and community engagement to establish a Center for Rural Health Care Delivery Science; (2) Enhance the transition of early- career clinician-scientists into independent researchers through strong research support and dedicated mentoring; (3) Assure accountability and achievement of milestones through the implementation of a rigorous program evaluation plan; and (4) Leverage shared resources to support the Center for Rural Health Care Delivery Science as a self-sustaining scientific community. The proposed Center will bring an innovative and impactful approach to rural health care delivery research by focusing on the fundamental causes of rural health disparities across systems and processes, as well as addressing barriers that impede disease detection, access to care, and management of health conditions that are particularly prevalent in rural populations. The initial four Research Project Leaders will address disease prevention and screening (Project 1), digital health technologies for disease management (Project 2), as well as socio-economic factors and health policy that impact the management of complex conditions (Project 3) and the provision of end-of-life care (Project 4). The Center's Scientific Cores will support the Center by: (1) Strengthening methodology for mechanistic studies in rural populations; and (2) Providing needed resources for expanding and strengthening critical relationships between researchers and key stakeholders via community-based participatory research. COBRE funding, coupled with substantial institutional funding and a commitment to hire additional faculty members during Phase I, will provide an outstanding foundation for the development of a vibrant Center. In summary, the proposed Center will support the establishment of a self-sustaining, multidisciplinary research program in rural health care delivery science at D-HH.