Early Intervention to Promote Cardiovascular Health of Mothers and Children (ENRICH) Multisite Resource and Coordinating Center

在美国，心血管健康状况不佳（CVH）导致高水平的发病率和死亡率， 种族/民族、社会经济地位和地理位置造成的巨大健康差异。持续改善 CVH需要2代策略，在那些处于不良CVH高风险的人已经接受 在乎循证家访（HV）提供了一个理想的环境，以减少健康差距，减少 产妇发病率，并促进CVH在婴儿和儿童的方式，可以持续整个生命 当然了之前的CVH干预有效性研究尚未测试HV模型中的干预， 整合了移动医疗和远程医疗等新兴技术，将HV与其他医疗服务相结合， 母亲和儿童接受护理的环境，公认的有效性调解人和调节人， 也没有使用单独和复合的孕产妇和儿童CVH指标来评估结果。早期干预 促进母婴心血管健康（ENRICH）计划旨在解决这些问题 局限性。它将测试一种常见的实施准备干预措施，以促进孕产妇和儿童CVH， 在多种循证HV模型的背景下减少CVH差异。成功的致富需要 一个资源和协调中心（RCC），拥有复杂的内容和方法专业知识和资源 支持研究设计和实施共同干预和研究方案， 个人、家庭和社区环境的异质性。约翰霍普金斯RCC多学科团队 结合了家庭访问应用研究合作组织（HARC）、约翰霍普金斯大学 临床试验和证据综合中心（CCTES）和约翰霍普金斯健康公平中心。 这个RCC团队提供了一个无与伦比的国家HV平台，健康公平的专业知识， 临床试验基础设施，以创建新的管理策略，组织概念和影响力 分析，以确保ENRICH发挥其潜力。我们的RCC包括：（1）由手持机制造的HV Precision 范式;（2）HV和CVH的内容专业知识和领导力;（3）设计和 实施共同协议，分析数据，传播结果，并将其转化为政策和实践（4） 先进的方法来评估“什么最有效，对谁有效，在什么情况下有效，为什么有效，如何有效？”并评估理想的 母亲和儿童的CVH指标;（5）与HV和CVH利益相关者的紧密联系;以及（6）专业知识 参与和培训早期研究者和HV专业人员。RCC将应用 三个JHU部门（公共卫生，医学和护理）的优势，以丰富产生有影响力的 关于ENRICH干预措施有效性的证据和关于可推广性的有力数据， 翻译. RCC将确保ENRICH充分发挥其潜力，并产生严谨，创新， 及时和可操作的新知识，以减少孕产妇发病率，促进CVH和减少CVH的差距 在母亲和幼儿身上。

Poor cardiovascular health (CVH) contributes to high levels of morbidity and mortality in the United States, with profound health disparities by race/ethnicity, socioeconomic status, and geography. Sustained improvement in CVH requires 2-generation strategies in settings where those at elevated risk for poor CVH already receive care. Evidence-based home visiting (HV) provides an ideal setting to reduce health disparities, reduce maternal morbidity, and promote CVH in infants and children in ways that can be continued across the life course. Prior studies of CVH intervention effectiveness have not tested interventions across HV models, incorporated emerging technologies such as mHealth and telehealth, combined HV with services in other settings where mothers and children receive care, acknowledged mediators and moderators of effectiveness, nor used individual and composite maternal and child CVH metrics to assess outcomes. The Early Intervention to Promote Cardiovascular Health of Mothers and Children (ENRICH) program aims to address these limitations. It will test a common implementation-ready intervention to promote maternal and child CVH and reduce CVH disparities in the context of multiple evidence-based HV models. The success of ENRICH requires a Resource and Coordinating Center (RCC) with sophisticated content and methods expertise and resources to support study design and implementation of a common intervention and research protocol attuned to heterogeneity in individual, family, and community context. The Johns Hopkins RCC multidisciplinary team combines the expertise of the Home Visiting Applied Research Collaborative (HARC), the Johns Hopkins Center for Clinical Trials and Evidence Synthesis (CCTES) and the Johns Hopkins Center for Health Equity. This RCC team offers an unparalleled combination of a national HV platform, expertise in health equity, and clinical trials infrastructure to create new management strategies, organization concepts and impactful analyses to assure that ENRICH achieves its potential. Our RCC includes: (1) stakeholder-built HV Precision Paradigm; (2) content expertise and leadership in HV and CVH; (3) state of the art methods to design and implement a common protocol, analyze data, disseminate results, and translate for policy and practice (4) advanced methods to assess “What works best, for whom, in which contexts, why and how?” and assess ideal CVH metrics for both mothers and children; (5) tight linkage with HV and CVH stakeholders; and (6) expertise in engaging and training Early Stage Investigators and HV staff professionals. The RCC will apply the strengths of three JHU divisions (Public Health, Medicine and Nursing) to ENRICH to generate impactful evidence on effectiveness of the ENRICH intervention and powerful data on generalizability to enhance translation. The RCC will assure that ENRICH achieves its full potential and generates rigorous, innovative, timely and actionable new knowledge to reduce maternal morbidity, promote CVH and reduce CVH disparities in mothers and young children.