Understanding the impact of racism—a social determinant of health—on the scope of the co-occurrence of mental health and cardiometabolic challenges in high-disparity racial/ethnic minority populations

这一多样性补充将建立在我作为社会流行病学家的培训基础上，将 寻求了解结果差异的复杂驱动因素和机制的流行病学研究 与并存的心脏代谢和精神健康状况有关，实施科学和社会 决定因素。心脏代谢综合征(CMetS)和焦虑是非常普遍和复杂的处理 当它们同时出现时，它们会相互影响，导致更大的残疾和医疗保健利用率和成本。如此多- 当共病与种族不平等和社会决定因素相交时，共病变得更加具有挑战性 健康最终导致不良后果的风险增大。成功的疾病管理在 必须实现个人和社区的交叉，以减少差异和最佳 治疗必须在与文化相关的干预中处理CMets和精神健康障碍的各个方面。 这份多样性增刊的总体目标是确定战略，以加强 通过利用社区调查数据开展父项目，并指导制定反种族主义干预措施和 在精神健康和心血管/代谢疾病并存领域的实施战略。 针对总体目标的培训目标和研究目标如下： 培训目标1(TG1)：培养将“大数据”与社区研究相结合的专门知识 心理健康和心血管/代谢疾病共病的识别和社会决定因素 培训目标2(TG2)：掌握轨道模型的干预开发翻译基础 将行为和社会科学纳入新的反种族主义干预措施和实施战略，以解决三重问题 社会、行为和临床挑战的复杂性。 培训目标3(TG3)：获得计算模拟建模(例如系统动态建模)方面的培训 研究潜在干预策略对复杂系统的影响(例如，初级保健) 主要研究目标：了解社区成员对成功的障碍和促进者的看法 弱势群体心脏代谢与心理健康共病的疾病管理 美国南部的少数群体，包括反种族主义和其他健康的社会决定因素。 研究目标1a(RA1a)。使用基于社区的参与性研究(CBPR)方法进行重点研究 解决社区关切并将社区观点纳入未来大规模活动的团体 制定和设计社区调查以指导评估过程。 研究目标1b(RA1b)。开展试点社区调查，以确定成功的障碍和促进者 心血管/代谢和精神健康状况并存的疾病管理 医疗保健服务。

This diversity supplement will build upon my training as a social epidemiologist to connect the dots between the epidemiologic research that seeks to understand the complex drivers and mechanisms of disparities in outcomes related to comorbid cardiometabolic and mental health conditions, implementation science and social determinants. Cardiometabolic syndrome (CMetS) and anxiety are highly prevalent and complicate management of each other when they co-occur, leading to greater disability and healthcare utilization and costs. Such multi- comorbidity becomes even more challenging when it intersects with racial inequities and social determinants of health culminating in amplified risk of adverse outcomes. Successful disease management that works at the intersection of the individual and the community must be implemented to mitigate disparities and optimal treatment must address aspects of both CMetS and mental health disorders in a culturally relevant intervention. The overall goal of this diversity supplement is to identify strategies to enhance the systems science map of the parent project by utilizing community survey data, and to guide the development of antiracism interventions and implementation strategies in the domain of comorbid mental health and cardiovascular/metabolic conditions. Training goals and Research Aims to address the overall objective are as follows: Training Goal 1 (TG1): Develop expertise in integrating “big data” and community-based studies for the identification of and social determinants for comorbid mental health and Cardiovascular/ Metabolic conditions Training Goal 2 (TG2): Gain mastery in the ORBIT model of intervention development to translate basic behavioral and social science into new antiracism interventions and implementation strategies to address triple complexities of social, behavioral, and clinical challenges. Training Goal 3 (TG3): Obtain training in computational simulation modeling (e.g systemic dynamic modeling) to study the effects of potential intervention strategies on a complex system (eg. Primary care) Primary Research Aim: Understand community member perspectives on barriers and facilitators to successful disease management of comorbid cardiometabolic and mental health conditions among underserved ethnic minorities in the Southern United States including antiracism and other social determinants of health. Research Aim 1a (RA1a). Use a community based participatory research (CBPR) approach to conduct focus groups to address community concerns and incorporate community perspectives into future large scale community survey development and design to guide the assessment process. Research Aim 1b (RA1b). Conduct a pilot community survey to identify barriers and facilitators to successful disease management of comorbid cardiovascular/metabolic and mental health conditions and to accessing health care services.