REDUCING DISPARITIES IN HEALTH FOR VULNERABLE POPULATIONS IN NH & VT (CATEGORY 2)

描述（由申请人提供）：拟议中的达特茅斯人口健康研究中心（DPHRC）的使命是与社区和国家合作伙伴合作，在整个生命周期中显著减少差距并改善心血管健康。提出这一建议的动机是对持续存在的差异的可改变原因的共同理解：临床和公共卫生活动不协调；社区领导成功变革的能力有限；未能充分评估卫生规划；以及不断上涨的医疗成本。我们的建议建立在最近的区域发展和达特茅斯的新承诺，以实现最健康的人口可能，并将创造一个新的机会来克服这些障碍。该中心最初将与三个社区卫生联盟合作，发展一个行动学习协作机制，使联盟能够确定其卫生优先事项，并确定、实施和评估干预措施。利用达特茅斯学院的领导力和改进教育项目，该中心将开发培训项目，以加强合作成员领导和维持项目改进的能力，并开展以社区为基础的预防研究。该中心将开展两个试点研究项目。一个是以社区为基础的参与性研究项目（见随附的研究提案），该项目以一项成功的健康促进干预措施（InSHAPE）为基础，旨在预防严重精神疾病患者的过早死亡和过度发病。该项目将与新罕布什尔州曼彻斯特的联盟合作，首先针对患有重度精神障碍的居民，然后针对社区确定的新的弱势群体，调整、实施和评估InSHAPE计划。第二个项目建立在达特茅斯决定收集全系统、患者报告的健康风险和健康状况措施的基础上。该项目由达特茅斯资助，将与新罕布什尔州基恩健康联盟合作，测试社区范围内的个人健康评估。通过这些和其他项目，达特茅斯人口健康研究中心将与社区和地区合作伙伴合作，测试针对国家健康问题的方案和政策解决方案。相关性（见说明）：拟议中的预防研究中心将支持佛蒙特州和新罕布什尔州的地方和区域努力，更好地整合研究、教育、临床和公共卫生项目，以改善心血管健康，减少弱势群体的差距。试点研究项目包括关注严重精神疾病患者和新罕布什尔州曼彻斯特高危社区的居民。

DESCRIPTION (provided by applicant): The mission of the proposed Dartmouth Population Health Research Center (DPHRC) is to work with community and state partners to measurably reduce disparities and improve cardiovascular health across the lifespan. The proposal is motivated by a shared understanding of modifiable causes of persistent disparities: poor alignment of clinical and public health activities; limited community capacity to lead successful change; failure to adequately evaluate health programs; and rising health care costs. Our proposal builds on recent regional developments and Dartmouth's new commitment to achieve the healthiest population possible and will create a novel opportunity to overcome these barriers. Working initially with three community health coalitions, the Center will develop an action learning collaborative that will enable coalitions to determine their health priorities and identify, implement and evaluate interventions. Drawing on Dartmouth's educational programs in leadership and improvement, the Center will develop training programs to strengthen collaborative members' capacity to lead and sustain program improvements and to conduct community-based prevention research. The Center will carry out two pilot research projects. One is a community-based participatory research project (see accompanying research proposal) that builds on a successful health promotion intervention (InSHAPE) designed to prevent premature mortality and excess morbidity among persons with serious mental illness (SMI). The project will work with the coalition in Manchester, NH to adapt, implement and evaluate the InSHAPE program first for residents with SMI and then for a new vulnerable population identified by the community. The second project builds on Dartmouth's decision to collect system-wide, patient-reported health risk and health status measures. This project, funded by Dartmouth, will work with the Keene, NH health coalition to test community-wide collection of individual health appraisals. Through these and other projects, the Dartmouth Population Health Research Center will work with community and regional partners to test programmatic and policy solutions to national health problems. RELEVANCE (See instructions): The proposed Prevention Research Center will support local and regional efforts in Vermont and New Hampshire to better integrate research, educational, clinical and public health programs to improve cardiovascular health and reduce disparities in vulnerable populations. The pilot research project includes a focus on persons with serious mental illness and residents of high-risk neighborhoods in Manchester, NH.