This application develops a Transdisciplinary Collaborative Center (TCC) for Health Disparities Research on Chronic Disease Prevention within the DHHS-defined Region 5 titled The Flint Center for Health Equity Solutions (FCHES). Core Academic Faculty and their community partners bring significant research and practical expertise in health equity efforts, behavioral health interventions and epidemiology, geography and the effects of built environment on health, and physical fitness and healthy eating in economically distressed, minority- majority communities. The TCC targets its initial activities within Flint, Michigan, with plans to extend the scope and reach of Center activities more generally across the state and nation. Our long-range goal is to eliminate disparities in physical and behavioral health developing, implementing and disseminating community-based multilevel interventions and creating sustainable health equity solutions in partnership with a broad cross-section of multi-sectorial stakeholders. The Methodology Core will be responsible for development of consistent definitions, theoretical frameworks, key approaches, and analytic methods for multilevel chronic disease prevention for the TCC. The core includes expertise in epidemiology, sampling, geospatial methods, longitudinal and clinical trials data analyses, and health economics (include cost and cost-effectiveness analyses). The Core will conduct a comprehensive needs and assets assessment in the community including social stratification, community ecological context, cultural factors, and environmental factors. Multimodal methods will be used to triangulate findings and identify the underlying mechanisms of disparities within Flint, Michigan and across Region 5, including the development of a Regional Database to assess and monitor health disparities and structural factors related health inequities. The Core will also provide statistical and cost-effectiveness analyses for Center research projects. The theoretical model supporting the multilevel chronic disease prevention model is grounded in the social ecological theory and maps onto the analytic plan to address the interventions impact on individual- level and contextual factors, the interaction between them and how they influence each other dynamically.
The Specific aims of the Methodology Core are to: (1) Formulate a theoretical framework, study design, data analysis plan, and assessment of community-based multilevel interventions that supports TCC activities; (2) Create an accountability structure that ensures the overall success of the TCC and consistency across Cores; (3) Identify the unit of intervention and the unit of analysis to address the research questions of the TCC; and (4) Provide a systematic appraisal of costs and benefits of community-based multilevel interventions.