Charleston Health Equity and Rural Outreach Innovation Center (HEROIC)

描述（由申请人提供）： 查尔斯顿健康公平和农村外展创新中心（HEROIC）的使命是通过消除地理、种族/民族和性别差异，改善所有退伍军人获得医疗保健的机会和公平性。我们强大的，不断增长的和有才华的VA卫生服务研究人员群体一直由VHA HSR&D计划持续资助超过8年，作为TREP（2004-2008）和REAP（2008年至今）在伦纳德Egede博士的领导下。在过去的8年中，查尔斯顿TREP和REAP取得了许多重大里程碑，包括（a）组建多学科的MD和PhD教师队伍（19名核心调查员和15名附属调查员），他们有效地使用定量和定性研究方法来推进VA卫生服务研究和开发以退伍军人为中心的干预措施;（B）吸引临床和业务合作伙伴，如退伍军人事务部农村卫生办公室、退伍军人事务部少数民族退伍军人中心、退伍军人事务部健康公平办公室和退伍军人事务部信息学和分析办公室;（c）为20多个由行政长官发起的Meri、QUERI和CDA提案获得资金;（d）透过超过60份出版物及25个简报会，传播研究成果，当中大部分直接与高铁及发展的使命一致;（e）在2004至2012年期间，促进增加弗吉尼亚高铁及发展的拨款;及（f）为本科生及研究生，普通内科研究员，实习医生，和博士后研究员。我们的多学科团队在卫生服务研究方面表现出科学领导力;领导了退伍军人创新干预措施的开发和严格测试;领导了实施研究和系统导向研究;并一直致力于研究农村和少数民族退伍军人的健康公平和准入。我们比许多其他计划小，但我们在研究重点，多学科化妆和科学领导的一致性使我们能够在相对较短的时间内实现公平和访问领域的国家和国际认可。 拟议的COIN的三个重点研究领域与我们的专业领域和HSR&D优先事项直接一致：健康公平，获取和农村 健康VHA是一个为500多万美国退伍军人提供“平等机会”的医疗保健系统。然而，尽管成功地消除了许多保健障碍，但保健方面的差距仍然很大。最近的审查继续记录所有临床内容领域的差异，我们的调查团队也记录了退伍军人健康结果的种族/民族，性别和地理差异。我们的COIN，与超过8年的研究一致，将开发和测试干预措施，以消除退伍军人临床结果的健康差异，并改善农村退伍军人的获得。我们将健康差异定义为退伍军人慢性医学和精神疾病健康结果的种族/民族，性别和地理（城乡）差异。我们的COIN的CREATE是与我们的合作伙伴合作构思的：弗吉尼亚州农村卫生办公室、弗吉尼亚州健康公平办公室、弗吉尼亚州少数族裔退伍军人中心以及弗吉尼亚州信息学和分析办公室，包括5个密切相关的CREATE项目，这些项目将推动我们重点研究领域的发展。我们的CREATE的标题是“农村和少数民族退伍军人获得循证干预措施”。“CREATE项目将与CHERP、VISN 7和国家创伤后应激障碍中心/太平洋岛屿VA的调查人员合作进行。除了来自我们的主办医疗中心的支持外，我们的学术附属机构南卡罗来纳州医科大学（MUSC）也为COIN提供了非常强大的机构支持，该大学承诺提供教师全职工作人员，空间和机构资源，以确保COIN的成功。

DESCRIPTION (provided by applicant): The mission of the Charleston Health Equity and Rural Outreach Innovation Center (HEROIC) is to improve access and equity in health care for all Veterans by eliminating geographic, racial/ethnic, and gender-based disparities. Our strong, growing and talented group of VA health services researchers has been continuously funded by the VHA HSR&D Program for more than 8 years, as a TREP (2004-2008) and as a REAP (2008-current) under the leadership of Dr. Leonard Egede. Over the past 8 years, the Charleston TREP and REAP have achieved many major milestones, including (a) assembling a multidisciplinary MD and PhD faculty (19 core investigators and 15 affiliate investigators) who have effectively used both quantitative and qualitative research methodology to advance VA health services research and develop Veteran-centric interventions; (b) engaging clinical and operations partners, such as the VA Office of Rural Health, the VA Center for Minority Veterans, the VA Office of Health Equity and the VA Office of Informatics and Analytics; (c) obtaining funding for over 20 investigator-initiated Meri, QUERI and CDA proposals; (d) disseminating research findings via over 60 publications and 25 presentations, the majority of which were directly in line with the mission of HSR&D; (e) fostering an increase in VA HSR&D funding between 2004 and 2012; and (f) providing extensive mentorship opportunities to undergraduate and graduate research students, general internal medicine fellows, interns, and post-doctoral fellows. Our multi-disciplinary team has demonstrated scientific leadership in health services research; has led development and rigorous testing of innovative interventions for Veterans; has led implementation research as well as systems-oriented research; and has been consistently dedicated to research on health equity and access for rural and minority Veterans. We are smaller than many other programs, but our consistency in research focus, multidisciplinary make-up, and scientific leadership have enabled us to achieve national and international recognition in the areas of equity and access in a relatively short period of time. The three focused areas of research for the proposed COIN fall directly in line with our areas of expertise and HSR&D priorities: health equity, access, and rural health. The VHA is an "equal access" healthcare system for over 5 million U.S. Veterans. Yet, disparities in health continue to be significant despite success in addressing many barriers to care. Recent reviews continue to document disparities across all clinical content areas and our investigative team also has documented racial/ethnic, gender, and geographic disparities in health outcomes among Veterans. Our COIN, consistent with over 8 years of research, will develop and test interventions to eliminate health disparities in clinical outcomes for Veterans and improve access for rural Veterans. We define health disparities as racial/ethnic, gender, and geographic (urban-rural) differences in health outcomes for chronic medical and mental illnesses among Veterans. The CREATE for our COIN was conceptualized in collaboration with our partners: the VA Office of Rural Health, VA Office of Health Equity, VA Center for Minority Veterans, and VA Office of Informatics and Analytics and includes 5 closely linked CREATE projects that will advance the field in our focused area of research. Our CREATE is entitled, "Access to Evidence-Based Interventions for Rural and Minority Veterans." The CREATE projects will be conducted in partnership with investigators from CHERP, VISN 7, and National Center for PTSD/Pacific Islands VA. In addition to support from our host medical center, we have very strong institutional support for the COIN from our academic affiliate, the Medical University of South Carolina (MUSC), which has made a commitment of faculty FTEs, space and institutional resources to ensure the success of the COIN.