Center for Reduce CVD Disparities: Genes, Clinics, and Communities

心血管疾病（CVD）的风险因素不成比例地影响低收入和少数民族人群。 北卡罗来纳州的卡米尔县是该州最贫穷的县之一，位于“中风带”，心脏病、中风和肥胖率相对于该州水平显著升高，已经远远高于全国平均水平。与此同时，该县是许多临床和公共卫生工作的所在地。我们提出了一套综合的三个跨学科的研究，在巴蒂尔县：1）确定与心血管疾病风险相关的遗传因素; 2）了解多层次的决定因素，健康状况不佳的结果和潜在的社会和社区资本，可以支持可持续的变化; 3）与社区领导人，卫生专业人员，和公民应用这些理解，以改善高血压的实践为基础的管理和以社区为中心的生活方式管理，并在700名参与者中测试对改善结果和减少心血管健康差异的影响。这将包括与非营利呼叫中心Connect Inc.的创新合作伙伴关系，在他们目前关注的工作，就业和福利咨询中增加生活方式和药物依从性指导组件; 4）测试 临床、社区一级和政策干预措施的影响、范围、采用和可持续性，包括经济发展潜力; 5）制定和实施战略，将基于临床和社区一级的干预措施转化和传播到其他服务不足的地区。这项工作将得到健康促进和疾病预防中心（CDC资助的预防研究中心，重点是基于社区的参与性研究）的行政核心的支持。其他内核包括：1）基因组生物信息学核心可用于该项目和其他PSO程序，以分析遗传/基因组数据和其他感兴趣的途径;以及2）社会 决定因素/经济发展/传播核心，以了解贫穷与健康之间的相互关系，并探讨有可能在促进健康的同时创造就业机会的战略。对数据收集，社区参与和经济发展的额外核心支持将通过NCCTSA（NC TraCS）和未来的社区校园伙伴关系来利用，这是全州范围内评估的结果，导致该系统的总裁（16个校园）“以产生一个更积极响应的大学，专注于迎接未来20年国家的挑战。"

Risk factors for cardiovascular disease (CVD) disproportionately affect low income and minority populations. Lenoir County, North Carolina is among the poorest in the state and situated in the "stroke belt" with significantly elevated heart disease, stroke, and obesity rates relative to state levels already well above the national average. At the same time, this county is home to many clinical and public health efforts on which to build. We propose an integrated set of three interdisciplinary studies in Lenoir County to: 1) determine genetic factors associated with CVD risk; 2) understand the multilevel determinants of poor health outcomes and the potential social and community capital that can support sustainable change; 3) work with community leaders, health professionals, and citizens to apply these understandings to improved practice-based management of hypertension and community-centered lifestyle management, and test the impact on improving outcomes and reducing disparities in cardiovascular health among 700 participants. This will include an innovative partnership with a nonprofit call center, Connect Inc, adding a lifestyle and medication adherence coaching component to their current focus on jobs, employment, and benefits counseling; 4) test the impact, reach, adoption, and sustainability of clinical, community-level, and policy interventions , including economic development potential; and 5) develop and implement strategies for translation and dissemination of the clinic-based and community-level interventions to other underserved regions. This work will be supported by an administrative core housed in the Center for Health Promotion and Disease Prevention (a CDC funded Prevention Research Center with a focus on community-based participatory research). Additional cores include: 1) a Genomic Bioinformatics Core available to this project and other PSO programs to analyze genetic/genomic data and other pathways of interest; and 2) a Social Determinants/Economic Development/Dissemination Core to understand the interface between poverty and health, and explore strategies with the potential to create jobs while promoting health. Additional core support for data collection, community engagement, and economic development will be leveraged through the UNC CTSA (NC TraCS) and the Community-Campus Partnership for Tomorrow, which is the result of a statewide assessment led to the President of the UNC (16 campus) system to "to produce a more proactively responsive University focused on meeting the challenges of the state over the next 20 years."