NY Community-Hospital-Academic Maternal Health Equity Partnerships (NY-CHAMP)

总体：项目摘要/摘要 纽约社区-医院-学术孕产妇健康公平伙伴关系(NY- Champ)是通过以下方式颠覆纽约市(NYC)和纽约州(NYS)的产妇保健生态系统 为以社区为中心的孕产妇健康科学建立可持续、高度协作的基础设施。 我们与我们的合作伙伴仔细地共同设计了研究、培训和社区参与议程， 将1)识别和解决连接不利社会决定因素的共病的生物和心理路径 健康(SDoH)与SMM和MM的差异；以及2)共同创建和实施可扩展的多层次战略 以反种族主义和赋权为基础，为我们城市和地区的系统和政策变化提供信息。纽约- CHAMP的背景是，SMM/MM的比率和差距持续居高不下 我们州的城市和农村地区一样，尽管有大量的医疗设施和资源。更有效 打破孤岛并利用我们不同社区的知识和优势的伙伴关系， 医院、学术机构和政府机构对于确保公平获得 文化契合，以患者为中心的护理，纠正SMM/MM不平等，并最大限度地发挥我们的集体 冲击力。我们召集了哥伦比亚大学和威尔·康奈尔医学，四个主要的社区组织(黑人 妇女蓝图、加勒比妇女健康协会、曼哈顿北部围产期伙伴关系以及 (大桥)，以及多部门行为者的广泛联盟，以实现3个协同总体目标。在目标1中，我们将 实施统一的、社区驱动的研究计划，该计划将：项目1)开发和实施 人工智能风险预测模型及由此产生的SMM临床决策支持系统 对于SDOH，偏向和公平。项目2)进行第一类混合有效性--一种新的 Doula提供的认知行为治疗计划全面设计，旨在解决CV、MH和SDoH 产后结局；建立了解创伤和增强能力的服务提供模式；以及 加强医院-社区护理联系。项目3)采用混合方法评估和 可归因于结构性种族主义和SMM/MM的超额费用以及两项政策干预的缓解效果 以减少孕产妇健康差距。在目标2中，我们将制定社区参与和政策 行动核心(CEPA)作为迭代社区输入、共同设计流程和 研究传播、能力建设和政策行动。在目标3中，我们将建立职业发展 和培训核心(CDTC)，以转变早期孕产妇健康研究的文化和渠道 调查人员在社区伙伴关系、跨学科、反种族主义、多样性和公平方面接受了专业培训， 包容和正义。我们的愿景与我们社区的优先事项、需求和资产完全一致 以及美国国立卫生研究院的改善计划。最终，NY-CHAMP将改变 在纽约市和纽约设立SMM/MM，并转变孕产妇保健研究领域的卓越科学范式。

OVERALL: PROJECT SUMMARY/ABSTRACT The broad goal of the New York Community-Hospital-Academic Maternal Health Equity Partnerships (NY- CHAMP) is to upend the maternal healthcare ecosystem in New York City (NYC) and New York State (NYS) by establishing a sustainable, highly collaborative infrastructure for community-centered maternal health science. We have carefully co-designed, with our partners, a research, training, and community engagement agenda that will 1) identify and address the comorbid biologic and psychologic pathways linking adverse social determinants of health (SDoH) to disparities in SMM and MM; and 2) co-create and implement scalable multi-level strategies grounded in anti-racism and empowerment to inform systems and policy change in our city and region. NY- CHAMP is set against the compelling backdrop of persistently high rates and disparities in SMM/MM across urban and rural parts of our state alike, despite a multitude of healthcare facilities and resources. More effective partnerships that break down siloes and leverage the knowledge and strengths of our diverse communities, hospitals, academic institutions, and government agencies are essential to assuring equitable access to culturally congruent, patient-centered care, redressing SMM/MM inequities, and maximizing our collective impact. We convene Columbia University and Weill Cornell Medicine, four lead community organizations (Black Women's Blueprint, Caribbean Women's Health Association, Northern Manhattan Perinatal Partnership, and The Bridge), and a broad coalition of multisector actors to address 3 synergistic Overall Aims. In Aim 1, we will implement a unified, community-driven research program that will: Project 1) Develop and implement novel artificial intelligence risk prediction models and a resulting clinical decision support system for SMM, accounting for SDoH, bias and fairness. Project 2) Conduct a Type 1 Hybrid Effectiveness-Implementation Trial of a novel doula-delivered cognitive behavioral therapy program holistically designed to address CV, MH, and SDoH outcomes during postpartum; build trauma-informed and empowerment-based service delivery models; and strengthen hospital-community care linkages. Project 3) Apply mixed methods to evaluate the effects of and excess costs attributable to structural racism and SMM/MM and the mitigating effects of two policy interventions for reducing maternal health disparities. In Aim 2, we will establish the Community Engagement and Policy Action Core (CEPA) to serve as an enduring platform for iterative community input, co-design processes, and research dissemination, capacity building, and policy action. In Aim 3, we will establish the Career Development and Training Core (CDTC) to transform the maternal health research culture and pipeline of early-stage investigators expertly trained in community partnerships, interdisciplinarity, anti-racism, and diversity, equity, inclusion, and justice. Our vision is perfectly aligned with the priorities, needs, and assets of our communities and with the NIH's IMPROVE initiative. Ultimately, NY-CHAMP will alter the underlying structural drivers of SMM/MM in NYC and NYS and shift the scientific paradigm for excellence in maternal health research.