The Mid-Atlantic Center for Cardiometabolic Health Equity (MACCHE)

总体来说 项目总结 大西洋中部心脏代谢健康公平中心(MACCHE)的首要目标是测试 全面、综合和多层次循证战略的有效性，以改善 马里兰州社会弱势人群的心脏代谢健康结果，使用社区- 基于参与性研究和以患者为中心的结果研究原则，并将其转化为 临床和公共卫生实践和政策。我们将利用约翰·霍普金斯大学现有的基础设施 健康公平中心，10多年来一直采用全面的方法来实现健康公平， 与巴尔的摩马里兰大学的合作伙伴关系，以及与摩根州立大学和 该地区的其他机构。MACCHE将包括3项独立但相关的干预研究，涉及 心脏代谢性疾病的差异；3个综合核心(管理、研究人员开发和 社区参与)；一个执行委员会；以及一个社区咨询委员会。研究1是一项 比较循证妊娠/产后健康有效性的随机试验 对常规家访服务的辅导/家访干预减少产后体重滞留 在黑人和拉丁裔女性中，心脏代谢健康差异的高危人群；研究2是一项随机试验 社区卫生工作者开展多层次问题解决培训的效果考察 (CHW)支持并与社区设施建立伙伴关系，以增强患有以下疾病的成年人的心肺健康 低社会经济地位、糖尿病、肥胖和无症状性心脏功能障碍；研究3是一组- 随机试验测试自我监测血压的多水平干预的有效性 (BP)通过远程监测、药剂师和社区卫生工作者的团队护理以及提供者级别的干预 与加强日常护理相比，改善社会弱势成年人的血压控制 失控的高血压加上糖尿病或慢性肾脏疾病。行政核心将执行 全面管理赠款，为数据统一、管理提供基础设施和支助 和分析，患者招募和保留，以及干预适应和实施。这个 调查员开发核心将为早期调查人员建立一个试点项目计划，并创建一个 为试点项目获奖者提供指导网络和社区，以支持与慢性病相关的创新研究 疾病差异。社区参与核心将实施共享治理结构，以 加强利益相关者的领导和所有权；推进、促进和评估MACCHE的社区- 参与研究和调查员发展倡议；并采用以社区为中心的战略来 翻译、传播和支持MACCHE计划。MACCHE将推进 心脏代谢性疾病差异，并促进将其转化为临床和公共卫生实践 政策。

OVERALL PROJECT SUMMARY The overarching goal of the Mid-Atlantic Center for Cardiometabolic Health Equity (MACCHE) is to test the effectiveness of comprehensive, integrated, and multi-level evidence-based strategies for improving cardiometabolic health outcomes among socially disadvantaged populations in Maryland, using community- based participatory research and patient-centered outcomes research principles, and translate them into clinical and public health practice and policy. We will leverage the existing infrastructure of the Johns Hopkins Center for Health Equity, which has applied a comprehensive approach to health equity for over 10 years, a partnership with the University of Maryland Baltimore, and collaborations with Morgan State University and other institutions in the region. MACCHE will include 3 separate, but related intervention studies addressing disparities in cardiometabolic disease; 3 integrated cores (Administrative, Investigator Development, and Community Engagement); an Executive Committee; and a Community Advisory Board. Study 1 is a randomized trial comparing the effectiveness of an evidence-based pregnancy/postpartum health coaching/home visiting intervention to usual home visiting services in reducing postpartum weight retention among Black and Latinx women at high risk for cardiometabolic health disparities; Study 2 is a randomized trial examining the effectiveness of a multi-level intervention of problem-solving training, community health worker (CHW) support and partnership with community facilities for enhancing cardiorespiratory fitness in adults with low socioeconomic status, diabetes, obesity and asymptomatic cardiac dysfunction; and Study 3 is a cluster- randomized trial testing the effectiveness of a multi-level intervention linking self-monitored blood pressure (BP) with telemonitoring, team-based care with pharmacists and CHWs, and provider-level interventions compared to enhanced usual care, for improving BP control among socially disadvantaged adults with uncontrolled hypertension plus diabetes or chronic kidney disease. The Administrative Core will carry out the overall administration of the grant, providing infrastructure and support for data harmonization, management and analysis, patient recruitment and retention, and intervention adaptation and implementation. The Investigator Development Core will establish a pilot project program for early-stage investigators and create a mentoring network and community for pilot project awardees, to support innovative research related to chronic disease disparities. The Community Engagement Core will implement a shared governance structure to reinforce stakeholder leadership and ownership; advance, facilitate, and evaluate MACCHE’s community- engaged research and investigator development initiatives; and employ community-centered strategies to translate, disseminate, and sustain MACCHE initiatives. The MACCHE will advance the science of cardiometabolic disease disparities and facilitate its translation into clinical and public health practice and policy.