the Diabetes Research for Equity through Advanced Multilevel Science Center for Diabetes Translational Research (DREAMS-CDTR)

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Project Summary/Abstract Diabetes mellitus is a significant health burden in the U.S. and California leads the nation in incident cases and costs of Type 2 Diabetes. Individuals with low socioeconomic status, older adults, rural populations, and racial and ethnic minorities are at highest risk. The drivers of these disparities include a complex combination of interacting factors at the individual, family, community, health system, societal, and policy levels. Programs and policies that can effectively translate high-quality, evidence-based diabetes interventions into widespread practice across diverse communities, modes of delivery, and a range of settings are desperately needed. The Diabetes Research for Equity through Advanced Multilevel Science Center for Diabetes Translational Research (DREAMS-CDTR) aims to advance health equity science through the development and translation of: 1) innovations and structural changes to healthcare delivery systems that substantively reduce health inequalities, and 2) innovative, scalable interventions to alter the socioenvironmental drivers of the Type 2 Diabetes epidemic and associated disparities. Focusing on the northern California and Central Valley regions of California, the DREAMS-CDTR will conduct clinical research and interventions designed to inform practice and policy change at the health system, community and policy levels. The DREAMS-CDTR (formerly Health Delivery Systems) brings together translational science core faculty who have expertise in diverse, multi-level areas including: food insecurity, medication adherence, health communication, health IT, social policy, and cost effectiveness analysis. DREAMS-CDTR will involve four regional academic sites with a range of public and non-profit health systems that serve large and diverse populations: Kaiser Permanente Northern California’s Division of Research and the University of California at San Francisco, Merced and Davis. The DREAMS-CDTR activities include: an Administrative Core, Pilot and Feasibility Program, Enrichment Program, and three coordinated research cores - Health Equity & Action Translational (HEAT) core, Methods and Data Integration (MDI) translational core, and National Diabetes Policy Research Resource (DPR) core. The HEAT Core will employ a multi-level systems approach to designing rigorous action-oriented observational and interventional research. The MDI Core will systematically prepare and support DREAMS-CDTR members in harnessing novel advances in methods and data to achieve greater health equity in Type 2 Diabetes. Lastly, the novel National DPR Core will extend the reach of the DREAMS-CDTR expertise and resources beyond the primary institutions in five key areas of expertise: (1) natural experiments research,(2) health economics, including comparative effectiveness and cost-effectiveness analysis; (3) simulation modeling, (4) machine learning, and (5) communicating science to policy-making institutions, community partners, health departments, and human service organizations.