ACHIEVE GreatER: Addressing Cardiometabolic Health In Populations Through Early Prevention in the Great Lakes Region

ABSTRACT Building upon the strength of existing collaborations and leveraging the intellectual resources and infrastructure across three major research institutions, two in Detroit (Wayne State University and the Henry Ford Health System) and one in Cleveland (Case Western Reserve University/University Hospitals), the ACHIEVE GREATER Center will increase reach into two largely Black communities with an outsized burden of cardiometabolic risk by deploying resources to targeted census tracts; leverage community health workers and pharmacists to help control multiple chronic cardiometabolic diseases; and support the development of early-career stage investigators who are focused on improving chronic cardiovascular disease disparities that are known to exist for Black populations. In addition to conducting a pilot grants program across the three partnering institutions, ACHIEVE GREATER will perform four distinct but closely related special projects that focus on interrupting early stages of pathogenesis in different contexts (e.g., mobile health units versus fixed community locations). Importantly, this work will be nested in a larger epidemiologic study of multi-level cardiometabolic risk factors. Our team will develop a distributed Cloud-based database complete with a customized set of informatics tools that will enable investigators in the heart of each city to robustly profile multi-level risk factors across different domains using both publicly available information and investigator-generated data. Our evidence-based intervention pathways are designed to control risk factors, especially elevated blood pressure, which is the most important modifiable contributor to heart disease - far and away the leading cause of death in our region. By increasing reach in census tracts where uncontrolled cardiometabolic risk factors are most prevalent, our study design optimizes both recruitment opportunities and potential intervention impact. Moreover, the alignment of resources across three institutions will efficiently enhance regional coordination, while increasing the number of research participants and highly trained early-career investigators. If successful, we will have demonstrated a cost-effective and scalable means of reducing health disparities in high risk Black populations through better control multiple chronic diseases.