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The authors' review of the health services literature since the release of the landmark Report of the Secretary's Task Force Report of Black and Minority Health in 1985 revealed significant differences in access to medical care by race and ethnicity within certain disease categories and types of health services. The differences are not explained by such factors as socioeconomic status (SES), insurance coverage, stage or severity of disease, comorbidities, type and availability of health care services, and patient preferences. Under certain circumstances when important variables are controlled, racial and ethnic disparities in access are reduced and may disappear. Nonetheless, the literature shows that racial and ethnic disparities persist in significant measure for several disease categories and service types. The complex challenge facing current and future researchers is to understand the basis for such disparities and to determine why disparities are apparent in some but not other disease categories and service types.

Objective: Morehouse School of Medicine, a collaborative partner in the National Research Mentoring Network, established the Mentoring Academy Institutional Plan­ning Forum (MA Forum) to help minority-serving institutions (MSI) optimize research mentoring. In this commentary, we describe the policy workshop and review survey data from six MSIs to assess the current state of organizational policies and activities that advance research mentoring.Participants: Twenty-eight institutional leaders, representing six MSIs, participated in an MA Forum between May 20, 2016 and May 11, 2017.Methods: After describing the MA Forum's background, design and recruitment strat­egy, we present a synthesis of institutional summaries built from responses to a 45-item survey that explored existing mentoring infrastructure, policies, and activities at each institution.Results: There is a heavy reliance on extra­mural funds to facilitate research mentoring initiatives. Mentoring policies and activities were most often governed by individual programs rather than the institution. Thus, the research mentoring expertise was concentrated at the local level, which may prevent opportunities for future scalability and optimization.Conclusions: Given these findings, we offer recommendations to help MSIs establish a mentoring culture backed by institutional policy. Ethn Dis. 2019;29(Suppl 2): 371- 376; doi:10.18865/ed.29.S2.371.

Health 360x is a mobile health application and social platform that integrates self-monitoring and decision support for preventive health. We studied 240 diabetic patients in primary care practices and a church community in metropolitan Atlanta. Health coaches were trained on the Health 360x curriculum, which was adapted from the American Association of Diabetes Educators. Participants worked with the health coaches to set goals for diabetes self-management. The intervention included weekly coaching for 12 weeks and online peer networking. Outcome variables included blood pressure, physical activity, and blood glucose that showed significant improvement at 12 weeks and 12 months compared to baseline. Focus group testing revealed that references for empowerment and engagement were associated with positive clinical outcomes. Barriers to adoption and use of the technology were inability to use the internet and concern about privacy and security of health data. Future efforts will integrate a multidisciplinary training dashboard with considerable attention to education on security features including data encryption and sign-on verification.

Objective: We describe the implementa­tion, clinical outcomes and participant perspectives for e-Healthystrides©.Setting: Three independent ambulatory clinics and an historic African American (AA) church.Participants: Adults with diagnosed diabe­tes mellitus type 2.Interventions: e-Healthystrides© health coach facilitated interventionPrimary outcome: Acquisition of three new self-management behaviors.Secondary outcomes: Blood pressure, blood glucose, A1c, attrition rate and par­ticipant perspectives of e-Healthystrides©Methods: A convergent parallel mixed method design was used in both pilot stud­ies.Results: Two hundred and sixty-four par­ticipants, aged ~62±16 years, enrolled. At­trition at 52 weeks varied 50%-90% by site. Low engagement users were defined mainly by anxiety with putting health information online. The primary outcome was achieved in 36% of our participants, with the top 3 self-management behaviors acquired be­ing: reducing risk (24.5%); healthy eating (23.7%); and monitoring (16.4%). Problem solving had the lowest rate of achievement (.91%). Blood pressure improved signifi­cantly at all sites at 12 weeks and at clinics A,B,C at 52 weeks. Blood glucose im­proved at 12 weeks: clinic A (P=.0001), B (P=.003), C (P=.001) and D (P=.03); but, at 52 weeks, only clinics A (P=<.0001) and B (P=.0001). Participants felt empowered by features of e-Healthystrides©. Engage­ment with health coaches and peers was highly valued.Conclusions: e-Healthystrides© is effec­tive for self-management behavior change. Participants showed the best success with healthy coping, healthy eating, and moni­toring behaviors. They felt empowered by access to health information and valued interaction with coaches and peers. Our findings support strong relational/social network strategy with a role for coaches as guides (apomediaries) who facilitate skill acquisition using technology. Ethn Dis. 2019;29(Suppl 2):393-404; doi:10.18865/ed.29.S2.393.

Objective: The biomedical/behavioral sciences lag in the recruitment and ad­vancement of students from historically underrepresented backgrounds. In 2014 the NIH created the Diversity Program Consortium (DPC), a prospective, multi-site study comprising 10 Building Infrastructure Leading to Diversity (BUILD) institutional grantees, the National Research Mentor­ing Network (NRMN) and a Coordination and Evaluation Center (CEC). This article describes baseline characteristics of four incoming, first-year student cohorts at the primary BUILD institutions who completed the Higher Education Research Institute, The Freshmen Survey between 2015-2019. These freshmen are the primary student cohorts for longitudinal analyses comparing outcomes of BUILD program participants and non-participants.Design: Baseline description of first-year students entering college at BUILD institu­tions during 2015-2019.Setting: Ten colleges/universities that each received <$7.5mil/yr in NIH Research Project Grants and have high proportions of low-income students.Participants: First-year undergraduate stu­dents who participated in BUILD-sponsored activities and a sample of non-BUILD stu­dents at the same BUILD institutions. A total of 32,963 first-year students were enrolled in the project; 64% were female, 18% His­panic/Latinx, 19% African American/Black, 2% American Indian/Alaska Native and Na­tive Hawaiian/Pacific Islander, 17% Asian, and 29% White. Twenty-seven percent were from families with an income <$30,000/yr and 25% were their family's first generation in college.Planned Outcomes: Primary student outcomes to be evaluated over time include undergraduate biomedical degree comple­tion, entry into/completion of a graduate biomedical degree program, and evidence of excelling in biomedical research and scholarship.Conclusions: The DPC national evaluation has identified a large, longitudinal cohort of students with many from groups histori­cally underrepresented in the biomedical sciences that will inform institutional/ national policy level initiatives to help diversify the biomedical workforce.Ethn Dis. 2020;30(4):681-692; doi:10.18865/ed.30.4.681

The Research Centers in Minority Institu­tions (RCMI) program was established by the US Congress to support the develop­ment of biomedical research infrastructure at minority-serving institutions granting doctoral degrees in the health professions or in a health-related science. RCMI institu­tions also conduct research on diseases that disproportionately affect racial and ethnic minorities (ie, African Americans/Blacks, American Indians and Alaska Natives, His­panics, Native Hawaiians and Other Pacific Islanders), those of low socioeconomic sta­tus, and rural persons. Quantitative metrics, including the numbers of doctoral science degrees granted to underrepresented stu­dents, NIH peer-reviewed research funding, peer-reviewed publications, and numbers of racial and ethnic minorities participat­ing in sponsored research, demonstrate that RCMI grantee institutions have made substantial progress toward the intent of the Congressional legislation, as well as the NIH/NIMHD-linked goals of addressing workforce diversity and health disparities. Despite this progress, nationally, many challenges remain, including persistent disparities in research and career develop­ment awards to minority investigators. The continuing underrepresentation of minority investigators in NIH-sponsored research across multiple disease areas is of concern, in the face of unrelenting national health inequities. With the collaborative network support by the RCMI Translational Research Network (RTRN), the RCMI community is uniquely positioned to address these chal­lenges through its community engagement and strategic partnerships with non-RCMI institutions. Funding agencies can play an important role by incentivizing such col­laborations, and incorporating metrics for research funding that address underrep­resented populations, workforce diversity and health equity.Ethn Dis. 2019;29(Suppl 1):135-144; doi:10.18865/ed.29.S1.135.

The Research Centers in Minority Institutions (RCMI) program was established by the US Congress to support the development of biomedical research infrastructure at minority-serving institutions granting doctoral degrees in the health professions or in a health-related science. RCMI institutions also conduct research on diseases that disproportionately affect racial and ethnic minorities (ie, African Americans/Blacks, American Indians and Alaska Natives, Hispanics, Native Hawaiians and Other Pacific Islanders), those of low socioeconomic status, and rural persons. Quantitative metrics, including the numbers of doctoral science degrees granted to underrepresented students, NIH peer-reviewed research funding, peer-reviewed publications, and numbers of racial and ethnic minorities participating in sponsored research, demonstrate that RCMI grantee institutions have made substantial progress toward the intent of the Congressional legislation, as well as the NIH/NIMHD-linked goals of addressing workforce diversity and health disparities. Despite this progress, nationally, many challenges remain, including persistent disparities in research and career development awards to minority investigators. The continuing underrepresentation of minority investigators in NIH-sponsored research across multiple disease areas is of concern, in the face of unrelenting national health inequities. With the collaborative network support by the RCMI Translational Research Network (RTRN), the RCMI community is uniquely positioned to address these challenges through its community engagement and strategic partnerships with non-RCMI institutions. Funding agencies can play an important role by incentivizing such collaborations, and incorporating metrics for research funding that address underrepresented populations, workforce diversity and health equity.