Rural Patient Risks and Exposures for Diabetes ConTrol (Rural PREDICT)

项目摘要/摘要 农村地区约有6000万美国人居住，2型糖尿病(T2 DM)的负担更重 然而，与城市地区相比，关于T2 DM风险因素和干预措施的信息很少 提高2型糖尿病一级预防水平。杜加尼博士是一名学术住院医生和早期研究员， 致力于提高农村地区2型糖尿病的一级预防水平。他的长期目标是 独立的临床研究人员将通过发展以下方法减少农村人口中T2 DM的健康差距 以患者为中心的干预措施，以更好地进行T2 DM一级预防。这项提议的短期目标是 精通数据科学、定性/混合方法、健康差距研究，以及 通过公共卫生硕士学位、指导和领导技能进行临床试验研究设计 建立并领导一个独立的研究计划，以促进T2 DM的护理。这项研究将进行 在梅奥诊所，该诊所拥有强大的基础设施和以患者为导向的研究设施。杜加尼博士将 利用来自疾病控制和预防中心(AIM 1)和梅奥诊所生物库(AIMS)的数据 2和3)推进研究目标，并依赖于一支专注的导师和顾问团队， 在2型糖尿病、流行病学、健康差距研究和卫生服务研究方面的专业知识。 杜加尼博士将通过小说《农村患者的风险和暴露》来实现他的短期目标 糖尿病控制(农村预测)研究，他开发这项研究是为了调查T2 DM在 与城市人口相比，中西部农村人口。目前，有关疾病风险因素的信息很少 中西部农村人群中存在T2 DM，中西部农村人群中没有T2 DM风险预测得分。 通过农村预测，杜加尼博士将解决这些知识差距。具体地说，在目标1中，他将 描述中西部农村地区糖尿病的发病率和时间趋势。在《目标2》中，他将 评估传统风险因素(例如，生活方式、社会经济地位)与新农村- 中西部农村地区发生T2 DM的风险因素(如有机化学品、杀虫剂)丰富。他会的 直接与农村患者接触，探讨他们对高风险因素负担的看法。在AIM 3，他将为农村地区开发一种非侵入性(即非实验室)5年T2 DM风险预测评分 并消除了实验室检测的需要，而实验室检测可能是农村人口的障碍。他会的 让患者为风险评分制定一个有意义的、非污名化的问卷，并探索 使用此风险分值的障碍。这些研究将构成NIH R01(4-5年)的基础 在推进中西部农村人群2型糖尿病一级预防中的应用。他的研究目标与 NIMHD的优先事项是减少包括农村社区在内的少数群体的健康差距。

PROJECT SUMMARY/ABSTRACT Rural areas, where ~60 million Americans live, have a higher burden of type 2 diabetes mellitus (T2DM) compared to urban areas, yet, there is sparse information on T2DM risk factors and interventions that improve T2DM primary prevention. Dr. Dugani, an academic hospitalist and early-stage investigator, is committed to improving the primary prevention of T2DM in rural areas. His long-term goal as an independent clinical investigator is to reduce health disparities for T2DM in rural populations by developing patient-centered interventions for better T2DM primary prevention. The short-term goals of this proposal are to acquire proficiency in data science, qualitative/mixed methods, health disparities research, and clinical trial study design through a Master of Public Health degree; mentorship; and, leadership skills to build and lead an independent research program to advance T2DM care. This research will be conducted at Mayo Clinic, which has robust infrastructure and facilities for patient-oriented research. Dr. Dugani will leverage data from the Centers for Disease Control and Prevention (Aim 1) and Mayo Clinic Biobank (Aims 2 and 3) to advance the research aims and also rely on a dedicated team of mentors and advisors with expertise in T2DM, epidemiology, health disparities research, and health services research. Dr. Dugani will accomplish his short-term goals through the novel Rural Patient Risks and Exposures for Diabetes ConTrol (Rural PREDICT) study, which he developed to investigate the higher burden of T2DM in Midwest rural compared to urban populations. At present, there is sparse information on risk factors for T2DM in Midwest rural populations and no T2DM risk prediction score for Midwest rural populations. Through Rural PREDICT, Dr. Dugani will address these knowledge gaps. Specifically, in Aim 1, he will characterize the incidence rate and temporal trend of diabetes in the rural Midwest. In Aim 2, he will evaluate the associations of traditional risk factors (e.g., lifestyle, socioeconomic status) and novel rural- enriched risk factors (e.g., organic chemicals, pesticides) with incident T2DM in the rural Midwest. He will directly engage rural patients to explore their perspectives regarding the high burden of risk factors. In Aim 3, he will develop a non-invasive (i.e., non-laboratory) 5-year T2DM risk prediction score for rural populations and obviate the need for laboratory testing, which may be a barrier for rural populations. He will engage patients to develop a meaningful, non-stigmatizing questionnaire for the risk score and explore barriers to the use of this risk score. These studies will form the basis for an NIH R01 (years 4-5) application to advance T2DM primary prevention in Midwest rural populations. His research goals align with NIMHD's priority to reduce health disparities in minority groups, including rural communities.