Assessment of Policies through Prediction of Long-term Effects on Cardiovascular Disease Using Simulation (APPLE CDS)

项目摘要/摘要 饮食行为是避免心血管疾病(CVD)的关键可改变的危险因素，心血管疾病是主要原因 美国(US)的发病率、死亡率和残疾。尽管国家和地方采取了促进 健康的饮食行为，不健康的饮食仍然是一个难题，困扰着人们的健康要求 社区和人口层面的倡议和解决方案。在投资实施之前，健康 从业者和政策制定者--通常使用有限的资源--需要比较人口健康 不同的食品政策和计划的影响，然后确定优先事项。这个项目的目标是， 通过预测心血管疾病的长期影响来评估政策 模拟(Apple CDS)，是比较食品政策和计划对心血管疾病相关结果的影响 以及成年人的医疗保健费用。这将有助于帮助当地政府和社区组织 优先次序的设定和决策。政策和计划评估将结合以下代理进行- 基于已建立的健康结果模型的建模。我们组建了一个心血管疾病专家团队， 营养、公共卫生、卫生经济学、卫生政策和计算机模拟建模 共同努力确定可以用来改善饮食行为的现实途径。具体的 目标是：(1)开发一个基于代理的模型来评估和比较替代食品政策的影响 以及关于饮食行为、血压、体重指数(BMI)和糖尿病的不同项目 纽约市的社区和(2)将基于代理的模型与完善的、经过验证的纽约市CVD联系起来 预测不同食品政策和计划对心血管疾病的长期影响的政策模型 结果(例如，高血压、冠心病、中风)、质量调整寿命年(QALY)和健康 护理费用。我们将利用纽约市收集的关于饮食行为的丰富的社区健康数据 卫生和精神卫生部(DOHMH)对该模型进行参数化和验证。此外，我们的 与纽约市DOHMH和全市范围广泛的社区组织建立密切合作伙伴关系 将确保模拟结果将用于选择和优化最具成本效益的实施， 针对社区的食品政策和计划，以改善人口健康。最后，纽约的经历 可作为其他地方卫生部门和社区组织的榜样 为自己的优先事项设置和计划实施做出更明智的决定。

Project Summary/Abstract Dietary behaviors are key modifiable risk factors in averting cardiovascular disease (CVD), the leading cause of morbidity, mortality, and disability in the United States (US). Despite national and local initiatives to promote healthy dietary behaviors, unhealthy diets remain a difficult, perplexing population health problem requiring initiatives and solutions at the community and population levels. Prior to investing in implementation, health practitioners and policymakers—often working with limited resources—need to compare the population health impact of different food policies and programs to then determine priorities. The goal of this project, Assessment of Policies through Prediction of Long-term Effects on Cardiovascular Disease Using Simulation (APPLE CDS), is to compare the effects of food policies and programs on CVD-related outcomes and health care costs for adults. This will be useful to aid local government and community organizations in priority setting and decision-making. Policy and program assessment will be conducted by combining agent- based modeling with an established health outcomes model. We assembled a team of experts in CVD, nutrition, public health, health economics, health policy, and computer simulation modeling who are committed to working together to identify realistic pathways that can be used to improve dietary behaviors. The Specific Aims are to: (1) develop an agent-based model to assess and compare the impact of alternative food policies and programs on dietary behaviors, blood pressure, body mass index (BMI), and diabetes across different neighborhoods in NYC and (2) link the agent-based model with the well-established, validated NYC CVD Policy Model to project the long-term impact of different food policies and programs on cardiovascular disease outcomes (e.g., hypertension, coronary heart disease, stroke), quality-adjusted life years (QALYs), and health care costs. We will leverage the rich community-level health data on dietary behaviors collected by the NYC Department of Health and Mental Hygiene (DOHMH) to parameterize and validate the model. In addition, our close partnerships with the NYC DOHMH and a broad range of community-based organizations across the city will ensure that simulation results will be used to select and optimize implementation of the most cost-effective, neighborhood-specific food policies and programs to improve population health. Finally, the NYC experience can serve as an example by which other local health departments and community-based organizations may make more informed decisions for their own priority setting and program implementation.