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

大西洋中部心脏代谢健康公平中心 (MACCHE)

• 批准号: 10658894
• 负责人: LISA A COOPER
• 金额: $ 407.12万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-24 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10658894
• 关键词: Address; Adult; Baltimore; Black race; Cardiometabolic Disease; Chronic; Chronic Disease; Chronic Kidney Failure; Clinical; Cluster randomized trial; Collaborations; Communities; Community Health Aides; Complex; Development; Diabetes Mellitus; Disease Management; Disparity; Disparity population; Economics; Ethnic Origin; Fibrosis; Goals; Grant; Health; Health Policy; Heart Injuries; Heart failure; High Risk Woman; Home Blood Pressure Monitoring; Home visitation; Hypertension; Infrastructure; Institution; Intervention; Intervention Studies; Latinx; Leadership; Life Cycle Stages; Link; Maryland; Mentors; Morbidity - disease rate; Myocardial dysfunction; Obesity; Outcome; Outcomes Research; Ownership; Patient Recruitments; Patient-Focused Outcomes; Pharmacists; Phase; Pilot Projects; Policies; Postpartum Women; Pregnancy; Pregnant Women; Problem Solving; Provider; Public Health Practice; Quality of life; Race; Research; Research Personnel; Risk Factors; Science; Services; Structure; Testing; Training; Translating; Translations; United States; Universities; blood pressure control; cardiometabolic risk; cardiometabolism; cardiorespiratory fitness; community based participatory research; community center; community engaged research; community engagement; compare effectiveness; comparison intervention; data harmonization; disease disparity; disorder prevention; effectiveness evaluation; effectiveness testing; evidence base; fitness; geographic disparity; health disparity; health equity; improved; innovation; low socioeconomic status; mortality; multidisciplinary; patient retention; postpartum health; postpartum weight; programs; randomized trial; social disparities; socioeconomic disparity; team-based care; telemonitoring; treatment as usual

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.

全面的 项目概要 大西洋中部心脏代谢健康公平中心 (MACCHE) 的总体目标是测试 全面、综合、多层次的基于证据的策略的有效性 马里兰州社会弱势群体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的现有基础设施 健康公平中心十多年来一直采用全面的方法来实现健康公平， 与马里兰大学巴尔的摩分校的合作伙伴关系，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，旨在解决 心脏代谢疾病的差异； 3 个综合核心（行政、研究者发展和 社区参与）；执行委员会；和社区咨询委员会。研究 1 是 比较循证妊娠/产后健康有效性的随机试验 对常规家访服务进行辅导/家访干预，以减少产后体重滞留 黑人和拉丁裔女性存在心脏代谢健康差异的高风险；研究 2 是一项随机试验 检查解决问题培训、社区卫生工作者的多层次干预的有效性 (CHW) 支持并与社区设施建立伙伴关系，以增强患有成人心肺功能障碍的成年人的心肺健康 社会经济地位低下、糖尿病、肥胖和无症状心功能不全；研究 3 是一个集群- 随机试验测试与自我监测血压相关的多层次干预的有效性 (BP) 包括远程监控、药剂师和社区卫生工作者的团队护理以及提供者层面的干预 与加强常规护理相比，改善社会弱势成年人的血压控制 不受控制的高血压加上糖尿病或慢性肾脏病。行政核心将执行 赠款的整体管理，为数据协调、管理提供基础设施和支持 和分析、患者招募和保留以及干预措施的调整和实施。这 研究者发展核心将为早期研究者建立一个试点项目计划，并创建一个 试点项目获奖者的指导网络和社区，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 加强利益相关者的领导力和所有权；推进、促进和评估 MACCHE 社区 - 参与研究和研究者发展计划；并采用以社区为中心的策略 翻译、传播和维持 MACCHE 计划。 MACCHE 将推动科学发展 心脏代谢疾病的差异并促进其转化为临床和公共卫生实践 政策。