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

项目总结/摘要 饮食行为是避免心血管疾病（CVD）的主要可改变风险因素， 发病率，死亡率和残疾率在美国（US）。尽管国家和地方采取措施， 健康的饮食行为，不健康的饮食仍然是一个困难的，令人困惑的人口健康问题， 在社区和人口层面的倡议和解决办法。在投资实施之前，卫生 从业者和决策者--通常在有限的资源下工作--需要比较人口健康状况 不同的粮食政策和计划的影响，然后确定优先事项。这个项目的目标， 通过预测对心血管疾病的长期影响评估政策 模拟（APPLE CDS），比较食品政策和项目对CVD相关结果的影响 和成人的医疗保健费用。这将有助于帮助地方政府和社区组织， 优先事项的确定和决策。政策和方案评估将通过结合代理- 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， 营养学、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，找出可用于改善饮食行为的现实途径。具体 目的是：（1）建立一个基于主体的模型来评估和比较替代性粮食政策的影响 以及不同地区的饮食行为、血压、体重指数（BMI）和糖尿病项目。 在纽约市的社区和（2）链接基于代理的模型与完善，验证纽约市CVD 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）、质量调整生命年（QALs）和健康 护理费用。我们将利用纽约市政府收集的关于饮食行为的丰富的社区健康数据， 卫生和心理卫生部（DOHMH）对模型进行参数化和验证。另外我们 与NYC DOHMH和全市广泛的社区组织建立了密切的伙伴关系 将确保模拟结果将用于选择和优化最具成本效益的， 社区特定的食品政策和方案，以改善人口健康。最后，NYC体验 可以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定和项目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.