Center for the Elimination of Minority Health Disparities

2006 Progress Reports

MENTORING & TRAINING RESEARCHER DEVELOPMENT PROJECTS

Lani V. Jones: Enhancing Psychosocial Competence of Drug-Abusing Black Women

A. SPECIFIC AIMS
All small grant projects, including the present one, are characterized by a commitment to a participatory research orientation, which involves affected parties in actively examining together current action in order to change and improve a situation that they see as problematic. Participatory action research recognizes community as a unit of identity; builds on strengths and resources within the community; facilitates collaborative, equitable involvement of all partners in all phases of the research; integrates knowledge and intervention for mutual benefit of all partners; promotes a co-learning and empowering process that attends to social inequalities; involves a cyclical and iterative process; addresses health from both positive and ecological perspectives; disseminates findings and knowledge gained to all partners; and involves long-term commitment by all partners (Israel et al., 2003).

This project seeks to enhance the functional capacity of Black women suffering from both drug abuse and psychiatric disabilities. The project is intended to improve services, reduce treatment disparity, and improve agency cultural sensitivity. It uses a psychosocial competency framework and this research on this framework offers a unique opportunity to determine its applicability to African-American service recipients.

B. STUDIES AND RESULTS
IRB approval for the project was successfully obtained in 2005. Professor Jones, a junior faculty member, succeeded in recruiting female subjects suffering from a dual diagnosis. As an experienced facilitator, she played the role of the moderator for all focus groups. Each focus group was audio-taped but not video taped. Dr. Jones followed standard state-of-the-art procedures for managing focus groups. After a warm-up session and briefings regarding confidentiality, she initiated discussion of the focal topics through a series of open ended-questions, assuring participants that there were no right or wrong answers. Dr. Jones monitored the group for nonverbal behaviors that suggested unstated issues that needed to be addressed. She asked probing and follow-up questions to make sure that all relevant issues were adequately explored. At the close of the session she expressed her thanks to the group and generally indicated the significance of the effort for the small town female community.

C. SIGNIFICANCE
This participatory action project is intended to improve the effectiveness of mental health services to Black females in Albany and to develop a treatment manual for this group of women and provide validation of The Psycho-social Competence Framework

D. PLAN
In fall 2006, Dr. Jones (with the assistance of her CEMHD mentor) will:

meet with her graduate student researchers to generate relevant themes, categories and patterns in order to assess what was believed to be known and is confirmed or contested by her research; what was suspected or hypothesized and was confirmed or contested by her research; and what revealed or suggested that is new and was not previously suspected.
make decisions about what additional data she needs from her original and other sources
attempt to initiate program development to meet unmet Black female psychiatric service needs;
present the preliminary results of her research efforts in a Noon Mentoring and Training Brown Bag Session attended by all CEMHD faculty and associates and community agency participants.
Dr. Jones and her mentor will prepare a final written report in the format of peer review journals, such as Health Psychology, Journal of Community Health, Public Health Reports, Patient Education and Counseling, Education Model of Health Care, American Journal of Health Promotion, and Sociology of Health and Illness.

E. PUBLICATIONS
None to date

F. PROJECT- GENERATED RESOURCES
None to date

Janine Jurkowski: Social Determinants of Disease and Screening Practices among Latinas

Latinas are less likely to obtain risk factor screenings for two of the leading causes of death, cardiovascular diseases (CVD) and diabetes, compared to non-Hispanic White and non-Hispanic Black women. Research on the reasons for this is relatively scarce and as a result, current health promotion campaigns targeting these women will be limited in their efficacy. Four 90 minute focus groups were conducted in collaboration with Centro Civico in the community. The focus group questions were guided by the Theory of Planned Behavior and the Health Belief Model, both of which are commonly used in public health research.

B. STUDIES AND RESULTS
IRB approval for the project was obtained in 2005. Professor Jurkowski, a junior faculty member, in partnership with members of a local Latino community organization successfully recruited Latinas through Centro Civico, a Latino community Center in Amsterdam , to participate in focus group discussions. As an experienced facilitator, she played the role of the moderator for all focus groups. A trained member of the community co-facilitated the focus groups with Professor Jurkowski. Each focus group was audio-taped but not video taped. Dr. Jurkowski followed standard state-of-the-art procedures for managing focus groups. After a warm-up session and briefings regarding confidentiality, she initiated discussion of the focal topics through a series of open ended-questions, assuring participants that there were no right or wrong answers. Dr. Jurkowski monitored the group for nonverbal behaviors that suggested unstated issues needing to be addressed. Dr. Jurkowski asked probing and follow-up questions to make sure that all relevant issues were adequately explored. At the close of the session she expressed her thanks to the group and generally indicated the significance of the effort for the small town Latina community. She provided a $20 gift card to a local grocery store as compensation. This process and incentive were approved by the University at Albany IRB.

C. SIGNIFICANCE
This participatory action research project seeks to improve chronic disease screening practices among Latinas living in Albany , New York by examining cultural beliefs that influence chronic disease screening practices using the (a) Theory of Planned Behavior and (b) The Health Belief Model as a guide. This research contributes to the scarcity of health promotion and health care utilization research among Latinas living in small cities in the Northeast.

D. PLANS
In fall, 2006, Dr. Jurkowski (with the assistance of her CEMHD mentor) will follow the best practices guidelines for interpreting the results of focus groups:

Summarize the discussions following her focus group sessions;
Have audiotapes of focus groups transcribed by a transcriptionist, and analyze transcripts through highlighting categories of the transcript rather than through use of transcript coding software;
Find relevant themes, categories and patterns and adopt a final coding guide;
Develop reasoning for the categories;
Weight and score information in the transcripts;
Reassess central questions, refine the focus, and recode as necessary;
Review analyses in order to assess (i) what was believed to be known and is confirmed or contested by the focus groups; (ii) what was suspected or hypothesized and was confirmed or contested; and (iii) what the focus groups revealed or suggested that is new and was not previously suspected;
Prepare a report giving preliminary results. This report will be both quantitative and qualitative in nature i.e., percentage will be reported and the report will make site anonymous verbatim comments;
Make decisions about what additional data, from focus groups or other sources, are needed to flush out surprising findings;
Attempt to initiate program development to meet unmet Latina social service needs;
Present the preliminary results of her research efforts in a Noon Mentoring and Training Brown Bag Session attended by all CEMHD faculty and associates and community agency participants;
Along with her mentor, prepare a final written report in the format of peer review journals, such as Health Psychology, Journal of Community Health, Public Health Reports, Patient Education and Counseling, Education Model of Health Care, American Journal of Health Promotion, and Sociology of Health and Illness.

E. PUBLICATIONS
None to date.

F. PROJECT -GENERATED RESOURCES
None to date.

Robert Miller and Edwina Dorch and Dwight Williams: Identification of Barriers to HIV/AIDS Care for African-Americans

A. SPECIFIC AIMS:
All small grant projects, including the present one, are characterized by a commitment to a participatory research orientation, which involves affected parties in actively examining together current action in order to change and improve a situation that they see as problematic. Participatory action research r recognizes community as a unit of identity; builds on strengths and resources within the community; facilitates collaborative, equitable involvement of all partners in all phases of the research; integrates knowledge and intervention for mutual benefit of all partners; promotes a co-learning and empowering process that attends to social inequalities; involves a cyclical and iterative process; addresses health from both positive and ecological perspectives; disseminates findings and knowledge gained to all partners; and involves long-term commitment by all partners (Israel et al., 2003). This project utilizes focus groups; it is qualitative, non-experimental, developmental and exploratory.

The objectives of this research were to determine if compliance with physician prescribed AIDS health care regimens varies with ethnic identity profiles. Additionally, identified key informants are answering open-ended questions related to the availability, accessibility, acceptability and quality of health care services. Following a series of fixed response questionnaires, focus group participants answered a series of open-ended questions designed to reveal structural and systemic barriers and provider behavior.

B. STUDIES AND RESULTS
IRB approval for the project was obtained in Spring 2006. Professors Williams, Miller and Dorch, all junior faculty members, then succeeded in recruiting groups of male and female HIV patients from two treatment agencies in the Capital District. Both groups completed a series of five questionnaires regarding ethnic identity; knowledge of HIV/AIDS, health insurance provider, level of education, and type of income. Subsequently, they participated in focus group sessions focused on the quality of their health care. The PIs and a graduate student they were mentoring served as the moderators for all focus groups. Each focus group was audio-taped, but not video taped. The PIs followed standard state-of-the-art procedures for managing focus groups. After a warm-up session and briefings regarding confidentiality, the investigators initiated discussion of the focal topics through a series of open ended-questions, assuring participants that there were no right or wrong answers. The small grant PIs monitored the group for nonverbal behaviors that suggested unstated issues that needed to be addressed and asked probing and follow-up questions to make sure that all relevant issues were adequately explored. At the close of the session PIs Miller, Dorch and MSW Williams expressed their thanks to the participants and generally indicated the significance of the research for the small city Black American community.

C. SIGNIFICANCE
This participatory action research project is intended to help Albany physicians predict which patients are at high risk of non-compliance with their HIV health care regimen and to discover healthcare loopholes and validation of Helms Ethnic Identity Theory and an AIDS Knowledge Questionnaire

D. PLAN
In fall 2006, Professors Dorch, Miller and Williams (with the assistance of their CEMHD mentor) will follow the best practices guidelines for interpreting the results of focus groups and:

Summarize the discussions following the eight focus group sessions.
Have audiotapes transcribed by a transcriptionist (i.e., not by the researcher);
Analyze transcripts through highlighting of important dimensions (rather than using coding software);
Meet with their assigned graduate student to find relevant themes, categories and patterns; to develop consensus on coding; to generate new codes; and, to develop and adopt a final coding guide;
Develop reasoning for the categories;
Weight and score information in the transcripts;
Reassess central questions, refine their focus, and recode as necessary;
Review analyses in order to assess (i) what was believed to be known and is confirmed or contested by the focus groups; (ii) what was suspected or hypothesized and was confirmed or contested; and (iii) what the focus groups revealed or suggested that is new and was not previously suspected;
Prepare a report giving preliminary results. This report will be qualitative in nature; no numbers or percentage will be reported and the report is expected to make extensive use of (anonymous) verbatim comments;
Make decisions about what additional data, from focus groups or other sources, are needed to flush out surprising findings;
Initiate program development to respond to HIV/AIDS patients’ unmet social service needs;
Present the preliminary results of their research efforts in a Noon Mentoring and Training Brown Bag Session attended by all CEMHD faculty and associates and community agency participants;
Along with their mentor, prepare a final written report in the format of peer review journals, such as Health Psychology, Journal of Community Health, Public Health Reports, Patient Education and Counseling, Education Model of Health Care, American Journal of Health Promotion, and Sociology of Health and Illness.

E. PUBLICATIONS
None to date

F. PROJECT-GENERATED RESOURCES
None to date

Annis Golden: Promoting the Use of Reproductive Health Care Services

A. SPECIFIC AIMS:
All small grant projects, including the present one, are characterized by a commitment to a participatory research orientation, which involves affected parties in actively examining together current action in order to change and improve a situation that they see as problematic. Participatory action research recognizes community as a unit of identity; builds on strengths and resources within the community; facilitates collaborative, equitable involvement of all partners in all phases of the research; integrates knowledge and intervention for mutual benefit of all partners; promotes a co-learning and empowering process that attends to social inequalities; involves a cyclical and iterative process; addresses health from both positive and ecological perspectives; disseminates findings and knowledge gained to all partners; and involves long-term commitment by all partners (Israel et al., 2003). This project relies on individual interviews with community members, as well as focus groups; it is qualitative, non-experimental, developmental and exploratory.

This project focuses on communication between a non-profit community-based provider of reproductive healthcare services and low-income, African-American women in the community. The goa ls are to identify content and channe ls for communication by the healthcare provider that will result in increased utilization of the provider’s services by the African-American community. Using interviews and focus groups, with both current users of the health center and non-users, the study will document community members’ perceptions of the healthcare provider, their interpretations of messages used in the provider’s recent communication campaigns, and impediments they perceive to using the provider’s services.

B. STUDIES AND RESULTS
The process of obtaining IRB approval for the project from the University at Albany and the parent organization of the non-profit, community-based healthcare provider was initiated in December 2005, following the researcher’s notification of the small grant award, and was completed in mid-March 2006. Dr. Golden, a junior faculty member, collaborated with her partners at the community-based healthcare provider in the development of guides for individual interviews and focus groups. Upon obtaining IRB approval, Dr. Golden began recruiting subjects for individual interviews, both from among the healthcare provider’s current patient base, and from other members of the community. A total of 23 women have been interviewed to date, including 3 current patients, and 20 members of the community who are not currently patients of the healthcare center. Recruiting efforts in the remaining weeks of the data collection period will focus on increasing the number of current patients in the participant group in order to gather more information about their pathways to becoming patients at the healthcare center. Dr. Golden is also working with a community organizer to recruit participants for focus groups.

C. SIGNIFICANCE
This information can then be used to shape the content of messages and the choice of channe ls for communication by the healthcare provider to the community it seeks to serve. This project represents the first stage of a multi-stage process for designing more effective communication between a community healthcare provider and African American women in the small city of Hudson, New York. If the model represented by this project and its follow-up phases is effective, it has the potential to be extended to other healthcare centers operated by the community healthcare organization in different locations in New York State ’s capital region and possibly to other target minority communities (e.g., Hispanic women).

D. PLANS
This coming Fall 2006, Professor Golden (with the assistance of her CEMHD mentor) will follow the best practices guidelines for interpreting the results of the interviews and focus groups by:

using sensitizing concepts from the research literature, analyze transcripts of individual interviews and focus groups to identify relevant themes, categories and patterns; and develop and adopt a final coding guide.
refine central questions, refine her focus, and recode as necessary;
reviewing analyses in order to assess what was believed to be known and is confirmed or contested by the individual interviews and focus groups, what was suspected or hypothesized and was confirmed or contested; and what the individual interviews and focus groups revealed or suggested that is new and was not previously suspected;
preparing a report giving preliminary results. This report will be qualitative in nature and will make use of (anonymous) verbatim comments;
making decisions about what additional data, from focus groups or other sources, are needed to flush out surprising findings;
conferring with the community-based healthcare provider on the implications of the project’s findings for future communication campaigns and other outreach efforts to African American women in the community;
presenting the preliminary results of her research efforts in a Noon Mentoring and Training Brown
Bag Session attended by all CEMHD faculty and associates.
Along with her mentor, prepare a final written report in the format of peer review journals, such as Health Psychology, Journal of Community Health, Public Health Reports, Patient Education and Counseling, Education Model of Health Care, American Journal of Health Promotion, and Sociology of Health and Illness.

E. PUBLICATIONS
None to date.

F. PROJECT GENERATED RESOURCES
None to date.

Hayward Horton: Capitalize on Community

A conference, entitled "Faith-based Institutions and Voluntary Organizations in HIV Prevention in the Black Community," defined and launched the Capitalize on Community Project. The ultimate goal of the project is to improve HIV/AIDS prevention efforts in the Albany Capital District via collaboration, cooperation and coordination. It utilizes University students to organize an annual conference on HIV/AIDS and assist in the development of questions for focus groups and a region-wide survey. It attempts to inform, coordinate and organize the volunteer efforts of Black leadership including clergy, elected officia ls , medical practitioners, businessmen and women, social policy experts, and the media to meet the challenge of fighting AIDS in their local communities.

B. STUDIES AND RESULTS

IRB approval for the project was obtained in spring 2006. Dr. Horton, an associate level faculty member, then succeeded in recruiting a number of prominent religious leaders from black churches in the Capital District to participate in focus group discussions concerning potential ways to improve efforts to prevent and treat HIV/AIDS within the community. As an experienced facilitator, Dr. Horton played the role of the moderator for all focus groups. Each focus group was audio-taped but not video taped. Professor Horton followed standard state-of-the-art procedures for managing focus groups. After a warm-up session and briefings regarding confidentiality, Professor Horton initiated discussion of the focal topics through a series of open ended-questions, assuring participants that there were no right or wrong answers. He monitored the group for nonverbal behaviors that suggested unstated issues that needed to be addressed. He asked probing and follow-up questions to make sure that all relevant issues were adequately explored. At the close of the session he expressed his thanks to the group for their participation and generally indicated the significance of the project for the small town Black American community.

C. SIGNIFICANCE

This participatory action research project attempts to help Black church pastors in Albany collaborate with health care providers to prevent / reduce HIV and AIDS.

D. PLANS
In fall 2006, Professor Horton (with the assistance of his CEMHD mentor) will follow the best practices guidelines for interpreting the results of focus groups and will:

summarize the discussions following the eight focus group sessions;
have audiotapes transcribed by a transcriptionist (i.e., not by the researcher);
analyze the transcripts through highlighting rather than through use of coding software;
meet with student research teams to find relevant themes, categories and patterns; to develop consensus on coding; to generate new codes; and, to develop and adopt a final coding guide;
develop reasoning for the categories;
weight information in the transcripts;
refine his focus, and recode as necessary;
review analyses in order to assess what was believed to be known and is confirmed or contested by the focus groups; what was suspected or hypothesized and was confirmed or contested; and what the focus groups revealed or suggested that is new and was not previously suspected;
prepare a report giving preliminary results. This report will be qualitative in nature; no numbers or percentage will be reported and the report is expected to make extensive use of (anonymous) verbatim comments;
make decisions about what additional data, from focus groups or other sources, are needed to flush out surprising findings;
initiate program development to respond to HIV/AIDS patients’ unmet social service needs.; and
present the preliminary results of his research efforts in a Noon Mentoring and Training Brown Bag Session attended by all CEMHD faculty and associates;
Along with his mentor, prepare a final written report in the format of peer review journals, such as Health Psychology, Journal of Community Health, Public Health Reports, Patient Education and Counseling, Education Model of Health Care, American Journal of Health Promotion, and Sociology of Health and Illness.

E. PUBLICATIONS
None to date

F. PROJECT GENERATED RESOURCES
None to date