Comprhensive Center of Excellence in Health Disparities

提交这一卓越中心(COE)是为了解决我们对前列腺癌(PCA)预后差异的认识上的重大差距，并开发可用于减少费城非裔(AA)和欧洲(EA)美国人之间的这些差异的干预措施。拟议中心的任务是(1)开展研究，确定影响PCA结果的生物、行为、社会、环境、地理空间、物理环境和医疗保健因素，以及(2)整合、评估并向费城社区的高危人群传播这些信息。这些因素包括个人和区域级别的上下文(例如，邻里)变量。我们预计，这种方法的原则最终将在其他社区实施，以减少PCA差异。 这个COE建立在我们现有的多学科研究的基础上，以具体了解生物标记物、护理模式、地理空间环境和PCa诊断后的肥胖的作用。这项研究需要跨多个学科的跨学科协作，由参与此COE的研究人员代表。拟议的COE旨在促进在识别具有最大风险的不良前列腺癌结果的男性方面进行必要的改进，以改善获得适当的PCA治疗的机会，具体目标如下：目标1：开展三个高度相关的跨学科、转化性研究项目，旨在解决前列腺癌的差异：a)项目1：评估肥胖在确定不利的前列腺癌结果中的作用(C.Zeigler-Johnson，PI)；项目2：开发预测模型，以了解预测前列腺癌结果的生物标记物、地区层面的背景因素和个人风险因素(T.Rebbeck，PI)；项目3：确定有经验的和潜在的卫生保健途径和质量的差异是否有助于局部前列腺癌男性患者治疗的种族差异(K·阿姆斯特朗，PI)。目标2.创建专门的共享资源核心，以满足这些项目和中心的需要，包括行政核心(T.Rebbeck，主任)、研究核心(J.Holmes和C.Branas，联席主任)和社区核心(K.Glanz，主任)。目标3：开展不同层次的跨学科培训，培养下一代健康差距研究人员。通过这项研究、社区推广和培训，我们将制定一项计划，确定那些前列腺癌预后不良的风险最高的群体，并开发可用于将不良预后和由此导致的不平等降至最低的方法，这些差距给再障男性带来了不适当的负担。

This Center of Excellence (COE) is being submitted to address significant gaps in our knowledge about disparities prostate cancer (PCa) outcomes, and to develop interventions that can be applied to reduce these disparities between African (AA) and European (EA) Americans in Philadelphia. The mission of the proposed center is to (1) undertake research that will identify biological, behavioral, social, environmental, geospatial, physical environmental, and health care factors that influence PCa outcomes, and (2) integrate, evaluate, and disseminate this information to at-risk populations in Philadelphia communities. These factors include both individual and area-level contextual (e.g., neighborhood) variables. We anticipate that the principles of this approach will ultimately be implementable in other communities to reduce PCa disparities. This COE builds on our existing multidisciplinary research to specifically understand role of biomarkers, patterns of care, geospatial environment, and obesity after the diagnosis of PCa. This research requires transdisciplinary collaboration across multiple disciplines represented by the investigators participating in this COE. The proposed COE intends to catalyze needed improvements in the identification of men at greatest risk of unfavorable PCa outcomes to improve access to appropriate PCa treatment with the following Specific Aims: Aim 1: To conduct three highly interrelated transdisciplinary, translational research projects aimed at addressing prostate cancer disparities: a) Project 1: Evaluate the role of obesity in determining unfavorable prostate cancer outcomes (C. Zeigler-Johnson, PI); Project 2: Develop predictive models for understanding biomarkers, area-level contextual factors, and individual risk factors in predicting prostate cancer outcomes (T. Rebbeck, PI); Project 3: Determine whether variation in experienced and potential health care access and quality contributes to racial differences in treatment among men with localized prostate cancer (K. Armstrong, PI). Aim 2. To create specialized shared resource cores to serve the needs of these projects and the Center, including an Administrative Core (T. Rebbeck, Director); a research core (J. Holmes and C. Branas, co-Directors); and a community core (K. Glanz, Director). Aim 3: To develop transdisciplinary training at a variety of levels to train the next generation of health disparities researchers. Through this research, community outreach, and training, we will develop a program that can identify those groups at greatest risk for an unfavorable prostate cancer outcome, and develop approaches that can be used to minimize poor outcomes and the resulting disparities that unduly burden AA men.