Center to Improve Chronic disease Outcomes through Multi-level and Multi-generational approaches Unifying Novel Interventions and Training for health EquitY (The COMMUNITY Center)

摘要： 尽管在治疗慢性病方面取得了医学进展，流行病学调查结果也确定了慢性病的危险因素， 慢性疾病，仍然存在由健康的社会决定因素驱动的重大持续健康差距 （SDoH）。我们已经走到一起，通过改善慢性病中心来解决这些差异 通过多层次和多代方法取得的成果， 健康公平培训（社区中心）。我们的愿景植根于公共卫生，认识到， 医学进步本身只能部分减轻疾病负担， 慢性病需要改善个人、家庭、社区和社会的健康和福祉 在生活中。我们寻求在我们所服务的社区内实现这一愿景，这些社区是世界上最高的社区之一。 在美国，大约三分之二的非白人，三分之一的外国出生的，五分之一的生活在联邦贫困线以下 线社区中心的使命是减少纽约地区慢性病的健康差异。 通过严格的测试，传播和维持干预措施， 个人、人际、社区和社会方法的影响程度。我们设计了三个 协同增效项目，解决由下列群体确定的慢性病，并对他们的声音和关切作出回应： 我们所服务的社区，每个社区都涉及采用社区卫生工作者（CHW）的新干预措施 研究的入组和/或保留模型，同时还将参与者与基于以下内容的服务联系起来 SDoH的五个领域（住房不稳定、粮食不安全、交通问题、公用事业帮助需求和 保险登记）。这三个项目是：1）社区卫生工作者联合起来减少结直肠癌 高风险人群中的心血管疾病（CHURCH）; 2）解决睡眠持续时间，规律性和效率：A 多维睡眠健康干预减少心脏代谢疾病差异（DREAM）; 3)对iM的干预可同等地证明依从性（IMPACT试验）。除了这三个研究项目外， 该中心通过研究者发展核心（IDC）资助健康公平学者和试点项目 以及通过社区核心（称为CONNECTOME）资助的社区项目。的 行政核心（ADMIN），其中包括在生物统计学，实施科学， 数据协调和生物医学信息学。社区中心涉及强有力的合作 研究人员，社区组织，临床医生和医疗保健系统，公共卫生机构和 其他利益相关者和合作伙伴哥伦比亚大学欧文医学中心（CUIMC）和威尔康奈尔医疗 中心（WCM）通过大纽约长老会（NYP）医院系统与纽约市立大学（City University of 纽约（CUNY）和纽约医师联盟（PAGNY）。独特的合作是蓄势待发 创建可持续的公共卫生解决方案，从而带来促进卫生公平的系统层面变革。

ABSTRACT: Despite medical advances in treating chronic diseases and epidemiological findings identifying risk factors for chronic diseases, there remain major persistent health disparities driven by the Social Determinants of Health (SDoH). We have come together to address these disparities through the Center to Improve Chronic disease Outcomes through Multi-level and Multi-generational approaches Unifying Novel Interventions and Training for health EquitY (COMMUNITY Center). Our vision is rooted in public health which recognizes that medical advances alone can only partially reduce the burden of disease and that reducing health disparities in chronic diseases requires improving the health and wellness of individuals, families, communities and societies throughout life. We seek to realize this vision within the communities we serve that are among the most highly diverse in the U.S. with approximately 2/3 non-white, 1/3 foreign-born, and 1/5 living below the Federal poverty line. The mission of the COMMUNITY Center is to reduce health disparities in chronic diseases in the New York City Region through rigorous testing, disseminating and sustaining of interventions that incorporate the multiple levels of influence from individual, interpersonal, community and societal approaches. We have designed three synergistic projects that address chronic conditions identified by and responsive to the voice and concerns of the communities we serve and each involve novel interventions employing the community health worker (CHW) model for enrollment and/or retention into the studies while also connecting participants to services based on five domains of SDoH (housing instability, food insecurity, transportation problems, utility help needs and insurance enrollment). The three projects are 1) Community Health workers United to Reduce Colorectal cancer and CVD among people at Higher risk (CHURCH); 2) Addressing Sleep Duration, Regularity, and Efficiency: A Multidimensional Sleep Health Intervention for Reducing Disparities in Cardiometabolic Disease (DREAM); and 3) Intervention to iMProve AdherenCe equiTably (IMPACT TRIAL). In addition to the three research projects, the Center supports Health Equity Scholars and pilots funded through the Investigator Development Core (IDC) and community projects funded through the Community Core (known as the CONNECTOME). The Administrative Core (ADMIN) which includes faculty with expertise in biostatistics, implementation science, and data harmonization and biomedical informatics. The COMMUNITY Center involves strong collaborations between researchers, community organizations, clinicians and healthcare systems, public health agencies and other stakeholders and partners Columbia University Irving Medical Center (CUIMC) and Weill Cornell Medical Center (WCM) joined through the greater New York Presbyterian (NYP) Hospital System with City University of New York (CUNY) and the Physician Affiliate Group of New York (PAGNY). The unique collaborative is poised to create sustainable public health solutions that will result in system-level changes that promote health equity.