Comprhensive Center of Excellence in Health Disparities

该卓越中心（COE）正在提交，以解决我们对前列腺癌（PCa）结果差异的认识存在的重大差距，并制定可用于减少费城非洲（AA）和欧洲（EA）美国人之间差异的干预措施。拟议中心的使命是：（1）开展研究，确定影响PCa结果的生物学、行为学、社会学、环境学、地理空间学、物理环境学和医疗保健因素;（2）整合、评估并向费城社区的高危人群传播这些信息。这些因素包括个人和地区层面的背景（例如，邻居）变量。我们预计，这种方法的原则最终将在其他社区实施，以减少PCa的差距。 该COE建立在我们现有的多学科研究基础上，专门了解PCa诊断后生物标志物，护理模式，地理空间环境和肥胖的作用。本研究需要参与本COE的研究者所代表的多个学科之间的跨学科协作。所提议的COE旨在促进在识别处于不利前列腺癌结果的最大风险的男性方面所需的改进，以改善获得适当的前列腺癌治疗的途径，具体目的如下：目的1：进行三个高度相关的跨学科转化研究项目，旨在解决前列腺癌差异：a）项目1：评估肥胖在确定不利前列腺癌结果中的作用（C. Zeigler-Johnson，PI）;项目二：开发预测模型，以了解生物标志物，地区水平的背景因素和预测前列腺癌结局的个体风险因素（T。Rebbeck，PI）;项目三：确定经验丰富和潜在的医疗保健机会和质量的变化是否会导致局限性前列腺癌男性治疗的种族差异（K。Armstrong，PI）。目标2.创建专门的共享资源核心，以满足这些项目和中心的需求，包括行政核心（T。Rebbeck，主任）;一个研究核心（J.霍姆斯和C。Branas，联合董事）;和一个社区核心（K。Glanz，Director）。目标3：在不同层次开展跨学科培训，培养下一代健康差距研究人员。通过这项研究，社区外展和培训，我们将制定一项计划，可以确定那些最有可能出现不利前列腺癌结局的人群，并制定可用于最大限度地减少不良结局和由此产生的不平等的方法。

This Center of Excellence (COE) is being submitted to address significant gaps in our knowledge about disparities prostate cancer (PCa) outcomes, and to develop interventions that can be applied to reduce these disparities between African (AA) and European (EA) Americans in Philadelphia. The mission of the proposed center is to (1) undertake research that will identify biological, behavioral, social, environmental, geospatial, physical environmental, and health care factors that influence PCa outcomes, and (2) integrate, evaluate, and disseminate this information to at-risk populations in Philadelphia communities. These factors include both individual and area-level contextual (e.g., neighborhood) variables. We anticipate that the principles of this approach will ultimately be implementable in other communities to reduce PCa disparities. This COE builds on our existing multidisciplinary research to specifically understand role of biomarkers, patterns of care, geospatial environment, and obesity after the diagnosis of PCa. This research requires transdisciplinary collaboration across multiple disciplines represented by the investigators participating in this COE. The proposed COE intends to catalyze needed improvements in the identification of men at greatest risk of unfavorable PCa outcomes to improve access to appropriate PCa treatment with the following Specific Aims: Aim 1: To conduct three highly interrelated transdisciplinary, translational research projects aimed at addressing prostate cancer disparities: a) Project 1: Evaluate the role of obesity in determining unfavorable prostate cancer outcomes (C. Zeigler-Johnson, PI); Project 2: Develop predictive models for understanding biomarkers, area-level contextual factors, and individual risk factors in predicting prostate cancer outcomes (T. Rebbeck, PI); Project 3: Determine whether variation in experienced and potential health care access and quality contributes to racial differences in treatment among men with localized prostate cancer (K. Armstrong, PI). Aim 2. To create specialized shared resource cores to serve the needs of these projects and the Center, including an Administrative Core (T. Rebbeck, Director); a research core (J. Holmes and C. Branas, co-Directors); and a community core (K. Glanz, Director). Aim 3: To develop transdisciplinary training at a variety of levels to train the next generation of health disparities researchers. Through this research, community outreach, and training, we will develop a program that can identify those groups at greatest risk for an unfavorable prostate cancer outcome, and develop approaches that can be used to minimize poor outcomes and the resulting disparities that unduly burden AA men.