Enrichment Program Supplement

糖尿病是一个巨大的和不断增长的负担，病人的痛苦和社会成本，以及影响 少数群体和农村资源匮乏社区中患这种疾病的人数不成比例。在 特别是，亚拉巴马黑带和密西西比三角洲地区的糖尿病和肥胖率最高， 美国的需要针对农村人口进行研究， 少数民族和低社会经济地位是迫切需要更好地了解健康差距的基础 并确定有效的糖尿病治疗和预防干预措施。 有了这个修订申请，UAB糖尿病研究中心（DRC）重新致力于我们的中心，以改善 我们南方腹地糖尿病患者的健康为了扩大我们的科学范围，我们将建立一个 在亚拉巴马和密西西比三角洲的农村黑带县的初级保健临床网络作为一项研究 资源，将提供刚果民主共和国及其成员的伙伴关系和基础设施， 在最需要的患者中进行转化和临床研究。我们的具体目标是： 目标1：在亚拉巴马的农村黑带地区建立糖尿病初级保健联盟。建筑 根据正在进行的项目，我们将在亚拉巴马农村建立初级保健诊所网络，并最终扩大 到密西西比三角洲。该联盟将以可持续的伙伴关系，社区参与为特色 卫生工作者，以及用于与初级保健诊所人员、教育 与患者的消息传递以及适合于医疗记录系统的数据捕获。 目标2：整合初级保健联盟和临床网络，作为刚果民主共和国的研究资源。 临床网络将由干预和翻译核心促进，资源将可访问 所有研究人员在我们的刚果民主共和国以及其他在我们的合作中心和学术机构。其他DRC 将对核心进行调整，以便于利用这一资源进行有效的假设检验。 目标3：对创新生活方式方案（远程保健+社区保健）进行试点研究 工人）与和不二甲双胍预防糖尿病。这项试点试验旨在巩固和 改善初级保健联盟的运作，并为更大规模的随机试验开发数据 评估一种涉及创新生活方式的新型可持续糖尿病预防方法 干预联合二甲双胍。 目前的修订申请强调了刚果民主共和国对伙伴关系和研究的承诺， 旨在改善我们社区糖尿病和心脏代谢疾病患者的健康状况， 特别强调农村社区的保健差距。初级保健联盟的目的是 强大的资源，研究机制负责慢性疾病的差异和发展 在这些高危人群中，干预措施是唯一有效的。

Diabetes is responsible for a huge and growing burden of patient suffering and social costs, and the impact of this disease is shared disproportionately by minorities and in rural resource-challenged communities. In particular, the Alabama Black Belt and the Mississippi delta have the highest rates of diabetes and obesity in the United States. The need for research targeted to rural populations characterized by a heavy preponderance of minorities and low socioeconomic status is acutely needed to better understand the basis for health disparities and to identify effective interventions for diabetes treatment and prevention. With this revision application, the UAB Diabetes Research Center (DRC) re-dedicates our center to improving the health of our patients with diabetes in the Deep South. To extend our scientific reach, we will establish a primary care clinical network in rural Black Belt counties of Alabama and in the Mississippi delta as a research resource that will provide the DRC and its members with opportunities for partnership and the infrastructure to conduct translational and clinical research in those patients with the greatest need. Our specific aims are: Aim 1: Establish a Diabetes Primary Care Coalition in the rural Black Belt region of Alabama. Building upon ongoing projects, we will establish a network of primary care clinics in rural Alabama and eventually expand to the Mississippi delta as well. The coalition will feature sustainable partnerships, engagement of community health workers, and a telehealth system for communication with primary care clinic personnel, education, messaging with patients, and data capture adapted to medical records systems. Aim 2: Integrate the Primary Care Coalition and clinical network as a research resource in the DRC. The clinical network will be facilitated by the Interventions & Translation Core, and the resource will be accessible to all investigators in our DRC as well as others in our partnering centers and academic institutions. Other DRC cores will be adapted to facilitate effective hypothesis testing using this resource. Aim 3: Conduct a pilot study of an innovative lifestyle program (telehealth + community health workers) with and without metformin for diabetes prevention. This pilot trial is intended to consolidate and refine operations within the primary care coalition, and to develop data for a larger scale randomized trial evaluating a novel and sustainable approach for diabetes prevention that involves an innovative lifestyle intervention combined with metformin. The current revision application underscores the commitment of the DRC to partnerships and research that is directed at improving health in patients with diabetes and cardiometabolic disease in our communities with a particular emphasis on health disparities in rural communities. The primary care coalition is designed as a powerful resource for the study of mechanisms responsible for chronic disease disparities and developing interventions uniquely effective in these high-risk populations.