All of Us Pennsylvania

我们所有人宾夕法尼亚州

• 批准号: 10327863
• 负责人: Oscar C. Marroquin
• 金额: $ 1200万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-02-08 至 2023-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10327863
• 关键词: Adult; Affect; Aging; Agriculture; Amish; Biomedical Research; Cancer Center; Caring; Catchment Area; Chemicals; Child; Clinic; Clinical; Clinical Data; Clinical Sciences; Clinical Trials Network; Collaborations; Communication; Communities; Community Services; Consent; Data; Decision Making; Diagnosis; Disease; Eagles; Education; Elderly; Electronic Health Record; Electronic Mail; Emergency Situation; Enrollment; Ensure; Environmental Exposure; Evaluation; Exposure to; Federally Qualified Health Center; Funding; Genetic; Group Processes; Health; Health Planning Organizations; Health care facility; Health system; Hospitals; Human; Industry; Infrastructure; Inpatients; Institutes; Laboratories; Latino; Life Style; Link; Location; Long-Term Care; Medical center; Mennonite; Methods; Mining; Multimedia; Neighborhood Health Center; Operative Surgical Procedures; Outpatients; Participant; Patients; Pediatric Hospitals; Pediatrics; Pennsylvania; Persons; Pharmaceutical Preparations; Pharmacy facility; Phase; Population; Population Group; Population Heterogeneity; Population Research; Precision Medicine Initiative; Procedures; Process; Provider; Registries; Rehabilitation therapy; Research; Research Institute; Resources; Rural; Sampling; Services; Site; Statistical Data Interpretation; Steel; Structure; System; Test Result; Thinking; Translational Research; United States National Institutes of Health; Universities; Visit; Woman; aging population; base; cohort; community organizations; data warehouse; demographics; design; dietary; disability; experience; follow-up; health disparity; human old age (65+); implementation process; infancy; medical specialties; member; novel; operation; preference; programs; recruit; rural counties; social media; tool

The PA Cares for Us Research Program (PA Cares) at the University of Pittsburgh (Pitt)/UPMC (University of Pittsburgh Medical Center) is a regional medical center (RMC) enrollment site for the NIH All of Us (AoU) Precision Medicine Initiative. As of November 13, 2017, we piloted an array of engagement methods, launched 3 enrollment strategies, and during the AoU beta phase fully enrolled 2005 participants who closely match our originally projected demographic distribution. We will now further leverage the continually expanding clinical footprint of UPMC and the infrastructure created by our NIH-funded Clinical and Translational Science Institute (CTSI), which we direct, to fully enroll at least 111,002 AoU participants to achieve a retained cohort of ≥93,000 participants with:  Sufficient diversity to enable AoU’s million person cohort to achieve adequate power for evaluation of common disorders from infancy to old age. We will leverage UPMC’s expanding clinical operations in western and central Pennsylvania, our CTSI Community PARTners Core’s focus on eliminating health disparities, and our comprehensive PA Cares engagement plan that we designed with our stakeholders. Examples of resources that we will leverage to enroll adults, and eventually children, include: o 37 UPMC hospitals and >600 points of service across western and central Pennsylvania o 23 UPMC Senior Communities serving >2900 older adult residents o Hillman Cancer Center plus a network of >60 community cancer centers o >90 rehabilitation and long-term care facilities plus a planned disability hospital o Pitt/UPMC Aging Institute and partner organizations o Giant Eagle Pharmacy (219 locations throughout Pennsylvania) o >150 community organizations actively partnering with the CTSI Community PARTners Core, including close collaborations with the Urban League of Greater Pittsburgh, FOCUS Pittsburgh, and several Latino organizations o PA Cares Stakeholder Advisory Board (SAB) representing diverse groups, including those underrepresented in biomedical research (UBR), and participant partners o 14 UPMC hospitals located in rural counties (e.g., UPMC Altoona, UPMC Bedford, recently acquired Susquehanna Health System) o UPMC Children’s Hospital of Pittsburgh (FY17: 12,333 inpatient stays; 9,693 observation stays; 146,748 emergency/express care visits; 23,389 surgeries; >1M outpatient visits) o UPMC Children’s Community Pediatrics network (>40 practices, >200 providers, >200,000 patients) o UPMC Magee Women’s Hospital (>11,000 deliveries annually)  Intentional and directed over-sampling of populations historically underrepresented in biomedical research to enable AoU to have sufficient power for statistical analyses in order to help understand the specific health conditions and disparities affecting these population groups. We will use novel tools, design thinking approaches, targeted messaging, and nimble PA Cares enrollment methods, such as: o Pitt+Me Research Participant Registry (>134,000 consented participants who receive study invitations based on electronic health record (EHR) data, demographics, and preferences; >9,500 new Registry enrollees in past 2 months alone) o NIH/NCATS Accrual to Clinical Trials (ACT) network of linked EHRs to target specific demographic groups (across 37 UPMC hospitals & >600 offices and deployment by at least 18 AoU RMC sites by 2019) o TrialSpark (social media tool for targeting specific demographics) o UPMC Altoona and Bedford Hospitals with expansion to UPMC Susquehanna and Pinnacle Health Systems (rural and urban central PA) and UPMC Northwest, Horizon, and Hamot Hospitals (rural and urban northwestern PA) o Nimble pop-up engagement and enrollment teams to reach Community Health Centers, Federally Qualified Health Centers, Free Clinics, and other specialty care venues that care for UBR populations  A broad range of genetic backgrounds, dietary, lifestyle, and environmental exposure assessments. We will capitalize on the demographics of western and central Pennsylvania, including: o UPMC’s diverse catchment area (Figure 1) o Stable aging population with longitudinally documented exposure to mining, steel, chemical, manufacturing, agriculture, and other industries o Large Mennonite and Amish communities serviced by our providers  A broad array of clinical and laboratory information via EHR, not limited to any single disease through: o UPMC EHR, which contains comprehensive in- and outpatient data collected since 2004 o CTSI Research Data Warehouse, which comprises structured clinical data for each patient that has been aggregated from UPMC’s EHR systems and includes demographics, diagnoses, procedures, medications, and laboratory test results  An engagement, recruitment and implementation process that ensures a high follow-up rate and comparable follow up rates across diverse population groups. Our retention plans are based on the concept of providing value to participants and leverages our previous experiences. We will: o Deploy our Pitt+Me recruitment framework for mail/email communications with PA Cares participants o Be guided by our SAB (we embrace an inclusive decision-making process to develop and adjust methods to meet participants’ needs) o Leverage the MyUPMC health portal, which can be used to engage and recruit from among >540,000 patient users and provide general education about types of results returned by AoU o Leverage UPMC Health Plan communications with its 3.2 million members o Employ multi-media engagement and retention tools created by Wondros based on a human-centered design approach o Employ efficient project management with guidance from The Chartis Group (process management)

匹兹堡大学(匹兹堡)/UPMC(宾夕法尼亚大学)的PA关怀我们研究项目(PA关怀) 匹兹堡医疗中心)是美国国立卫生研究院所有人(AOU)的地区医疗中心(RMC)注册网站 精准医学计划。截至2017年11月13日，我们试行了一系列交战方式，推出 3个注册策略，并在AOU测试版阶段完全注册了2005年与我们的 最初预测的人口分布。我们现在将进一步利用不断扩大的临床 UPMC的足迹和我们由NIH资助的临床和转化科学创建的基础设施 学院(CTSI)，我们指导，充分招收至少111,002名AOU参与者，以实现保留队列 ≥93,000名参与者中有： 有足够的多样性，使AOU的百万人队列能够获得足够的能力来评估 从婴儿期到老年的常见疾病。我们将利用UPMC不断扩大的临床业务 宾夕法尼亚州西部和中部，我们的CTSI社区合作伙伴核心关注消除健康 差异，以及我们与利益相关者共同设计的全面的PA关怀参与计划。 我们将利用资源来招收成年人，并最终招收儿童，这些资源包括： O宾夕法尼亚州西部和中部的37家UPMC医院和600个服务点 O 23 UPMC老年社区为2900名老年居民提供服务 O希尔曼癌症中心加上由&gt；60个社区癌症中心组成的网络 O&gt；90个康复和长期护理设施，外加一家规划中的残疾医院 O PIT/UPMC老龄研究所和伙伴组织 O巨鹰药房(宾夕法尼亚州219家门店) O&gt；150个社区组织积极与CTSI社区合作伙伴核心合作，包括 与大匹兹堡城市联盟、匹兹堡焦点和几个拉丁裔密切合作 组织 O PA关心利益相关者咨询委员会(SAB)，代表不同的团体，包括 在生物医学研究(UBR)和参与伙伴中代表性不足 O位于农村县的14家UPMC医院(例如UPMC Altoona、UPMC Bedford，最近收购 Susquehanna医疗系统) O匹兹堡UPMC儿童医院(17财年：住院12,333人次；观察9,693人次；146,748人次 紧急/快速护理就诊；23,389次手术；&gt；100万次门诊就诊) O UPMC儿童社区儿科网络(&gt；40家诊所，&gt；200家提供者，&gt；200,000名患者) O UPMC Magee妇女医院(&GT；每年11,000次分娩) 对生物医学中历史上代表性不足的人群进行有意和定向的过度抽样 研究使AOU有足够的能力进行统计分析，以帮助理解 影响这些人口群体的具体健康状况和差异。我们将使用新的工具， 设计思维方法、有针对性的消息传递和灵活的PA关怀登记方法，例如： O PIT+Me研究参与者注册(&gt；134,000名同意接受学习邀请的参与者 基于电子健康记录(EHR)数据、人口统计数据和偏好；&gt；9,500个新注册表 仅在过去两个月内注册的人数) O NIH/NCATS注重临床试验(ACT)的相关EHR网络，以针对特定人群 集团(覆盖37家UPMC医院和600个办事处，到2019年至少部署18个AOU RMC站点) O TrialSpark(针对特定人群的社交媒体工具) O UPMC Altoona和Bedford医院，扩展到UPMC Susquehanna和Pinnacle Health 系统(PA农村和城市中心)和UPMC西北医院、Horizon医院和Hamot医院(农村和 宾夕法尼亚州西北部城市) O灵活的弹出式参与和注册团队，以联邦方式到达社区卫生中心 符合条件的健康中心、免费诊所和其他为UBR人群提供护理的特殊护理场所 广泛的遗传背景、饮食、生活方式和环境暴露评估。我们 将利用宾夕法尼亚州西部和中部的人口统计数据，包括： O UPMC的多样化集水区(图1) O稳定的老龄化人口，纵向接触采矿、钢铁、化学品、 制造业、农业和其他行业 O由我们的供应商提供服务的大型门诺派和阿米什人社区 通过电子病历提供广泛的临床和实验室信息，不限于通过以下方式获得的任何单一疾病： O UPMC EHR，包含自2004年以来收集的全面住院和门诊数据 O CTSI研究数据仓库，其中包含每个患者的结构化临床数据 汇总自UPMC的EHR系统，包括人口统计、诊断、程序、药物、 和实验室检测结果 确保高跟随率的接洽、招聘和实施流程，以及 不同人群的随访率具有可比性。我们的留任计划基于 为参与者提供价值的理念，并利用我们以前的经验。我们会： O部署我们的PIT+Me招聘框架，用于与PA关怀参与者进行邮件/电子邮件通信 O以我们的SAB为指导(我们接受包容性的决策过程，以开发和调整方法 以满足参与者的需求) O利用MyUPMC健康门户，该门户可用于从540,000人中进行招聘 患者用户并提供有关AOU返回的结果类型的一般教育 O利用UPMC健康计划与其320万成员的沟通 O采用Wondros基于以人为本创建的多媒体参与和保留工具 设计方法 O在查迪斯集团的指导下实施高效的项目管理(流程管理)