The Mid-Atlantic Center for Cardiometabolic Health Equity (MACCHE)

总体来说 项目总结 大西洋中部心脏代谢健康公平中心(MACCHE)的首要目标是测试 全面、综合和多层次循证战略的有效性，以改善 马里兰州社会弱势人群的心脏代谢健康结果。MACCHE将 包括处理心脏代谢性疾病差异的5个独立但相关的研究项目；3 综合核心(行政、调查人员发展和社区参与)；执行人员 委员会和社区咨询委员会。首批3个项目目前正在进行中，包括：项目 1(两人健康)，一项随机试验，比较循证治疗的有效性 孕期/产后健康指导/家访干预对平时家访服务的影响 黑人和拉丁裔分娩对心脏代谢健康具有高风险的人产后体重保留 项目2(卸载-心力衰竭)是一项随机试验，考察了多水平 问题解决培训的干预、社区卫生工作者(CHW)的支持以及与 提高低社会经济地位成年人心肺功能的社区设施 肥胖和无症状性心功能障碍；项目3(关联心脏)是一项整群随机试验 测试将自我监测的血压(BP)与 远程监控、药剂师和社区卫生工作者的团队护理，以及服务提供者级别的干预 加强日常护理，改善失控的社会弱势成年人的血压控制 高血压合并糖尿病或慢性肾脏疾病。另外两项拟议的研究包括： 两颗心，建立在两人健康的基础上，以解决在高血压方面的种族和民族差异 产后分娩人群，重点是两种有效的降压策略：低血压 盐/高果蔬饮食(包括送餐)和压力管理；以及Dash-Life，这将 对居住在健康食品中的成人高血压和2型糖尿病患者进行食物-药物干预试点 巴尔的摩的重点地区(食品沙漠)--心脏代谢健康不良的高危人群 结果。MACCHE将推动心脏代谢性疾病差异的科学研究，并促进其 转化为临床和公共卫生实践和政策。

OVERALL PROJECT SUMMARY The overarching goal of the Mid-Atlantic Center for Cardiometabolic Health Equity (MACCHE) is to test the effectiveness of comprehensive, integrated, and multi-level evidence-based strategies for improving cardiometabolic health outcomes among socially disadvantaged populations in Maryland. The MACCHE will include 5 separate, but related research projects addressing disparities in cardiometabolic disease; 3 integrated cores (Administrative, Investigator Development, and Community Engagement); an Executive Committee; and a Community Advisory Board. The first 3 projects are currently underway and include: Project 1 (Healthy for Two), a randomized trial comparing the effectiveness of an evidence-based pregnancy/postpartum health coaching/home visiting intervention to usual home visiting services in reducing postpartum weight retention among Black and Latinx birthing people at high risk for cardiometabolic health disparities; Project 2 (UNLOAD-Heart Failure) is a randomized trial examining the effectiveness of a multi-level intervention of problem-solving training, community health worker (CHW) support and partnership with community facilities for enhancing cardiorespiratory fitness in adults with low socioeconomic status, diabetes, obesity and asymptomatic cardiac dysfunction; and Project 3 (LINKED-HEARTS) is a cluster-randomized trial testing the effectiveness of a multi-level intervention linking self-monitored blood pressure (BP) with telemonitoring, team-based care with pharmacists and CHWs, and provider-level interventions compared to enhanced usual care, for improving BP control among socially disadvantaged adults with uncontrolled hypertension plus diabetes or chronic kidney disease. The 2 additional proposed studies include: Healthy for Two-Hearts which builds upon Healthy For Two, to address racial and ethnic disparities in hypertension in postpartum birthing people, with an emphasis on two effective strategies for blood pressure reduction: low salt/high fruit and vegetable diet (including food delivery) and stress management; and DASH-Life which will pilot a Food-is-Medicine intervention for adults with hypertension and type 2 diabetes residing in Healthy Food Priority Areas in Baltimore (`food deserts')—a population at high risk for adverse cardiometabolic health outcomes. The MACCHE will advance the science of cardiometabolic disease disparities and facilitate its translation into clinical and public health practice and policy.