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

整体 项目摘要 中大西洋心脏代谢健康公平中心（MACHE）的首要目标是测试 全面、综合和多层次循证战略的有效性， 在马里兰州的社会弱势群体中，使用社区- 基于参与式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健康公平方法， 与马里兰州大学巴尔的摩分校合作，并与摩根州立大学和 该地区的其他机构。MACCHE将包括3项独立但相关的干预研究， 心脏代谢疾病的差异; 3个综合核心（管理、研究者发展和 社区参与）;一个执行委员会;和一个社区咨询委员会。研究1是 一项比较基于证据的妊娠/产后健康有效性的随机试验 对常规家访服务进行指导/家访干预，以减少产后体重保持 在黑人和拉丁裔妇女中，心脏代谢健康差异的风险较高;研究2是一项随机试验 探讨问题解决训练、社区卫生工作者、社区卫生服务人员、 (CHW)与社区设施建立伙伴关系，加强患有 低社会经济地位、糖尿病、肥胖和无症状心功能不全;研究3是一组- 一项随机试验，测试多水平干预措施与自我监测血压相联系的有效性 (BP)通过远程监护，药剂师和CHW的团队护理以及提供者级别的干预措施， 与加强常规护理相比，改善社会弱势成人的BP控制， 不受控制的高血压加糖尿病或慢性肾病。行政核心将执行 赠款的全面管理，为数据协调、管理和 和分析，患者招募和保留，以及干预措施的适应和实施。的 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 指导网络和社区的试点项目获奖者，以支持创新的研究有关的慢性 疾病差异。社区参与核心将实施一个共享的治理结构， 加强利益相关者的领导和所有权;推进，促进和评估MACHE的社区- 参与研究和调查人员发展倡议;并采用以社区为中心的战略， 翻译、传播和维持MACCHE倡议。MACHE将推动科学的发展 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

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.