Center for the Elimination of Minority Health Disparities

2012 Center of Excellence
Progress Report

Progress Report Archive 




Schell, Lawrence M. (PI)

Note: The “Exploratory Center on Minority Health and Health Disparities in Smaller Cities” is known on campus as the Center for the Elimination of Minority Health Disparities. 

 A. SPECIFIC AIMS (unmodified from original)

This Center of Excellence, the Exploratory Center on Minority Health and Health Disparities in Smaller Cities, continues to work to support and promote research by several disciplines across the university in close and equal collaboration with community partners.  The overall goal is to better understand the multiple determinants of health disparities in smaller cities and to test ways to reduce them. This goal will be achieved through the activities of each core as stated in the Specific Aims of each. The specific aims of the Cores and research projects are unchanged.   

B. STUDIES AND RESULTS

All of the abstracts the Center submitted for poster presentations at the 2012 NIH Health Disparities Summit were accepted. In addition to all of the individual core research projects, the Center presented posters on how it is set up, an overview of the Research Core, and the Outreach Core’s Young Moms on a Mission program.

The Administrative Core increased its new project manager’s time to 80% with funding from the Vice President for Research in order for her to complete the expanded responsibilities of the position, which include assisting with transition planning, special projects, program tracking, continuing to improve communication among the cores, increased website management, and ongoing newsletter production.

The Administrative Core held regular meetings of the Program Executive Committee approximately bimonthly, and increased them to monthly for the fall of 2012 for transition planning purposes. The Program Advisory Committee met on September 28th 2012.  The university administration continues to be very supportive, and the Center moved into new office space in February of 2012.

The Research Training and Education and Administrative Cores hosted two presentations for students and faculty by Dr. Michelle Owens-Gary of the Centers for Disease Control on diabetes and depression among ethnic minorities. Her trip to the university included a separate presentation for students on career development in health disparities.

The Research Training Core has continued to engage undergraduate and graduate students and faculty in health disparities research issues. Students in the Educational Opportunity Program and the Honors College learn of the Center’s research through talks about minority health disparities and responsible research.

All three component research projects of the Research Core continue to make excellent   progress. Presentations and publications are being produced from all three projects. Projects 2 and 3 have been most active and now project 1 has matured and is submitting papers for publication also.  The Research Core continues to provide statistical support for these projects as well as for all Center associates. The Research Advisory Committee continues to meet. The Research core is now contributing to the development of projects on food environment and diabetes in nearby Schenectady and is providing technical assistance to the regional asthma coalition.

Project 1. “Overcoming Barriers to African American Women’s Reproductive Healthcare Seeking” made great strides training peer outreach workers this year, as well as holding additional community health events, where pre- and post-activity questionnaires are distributed to gauge impact and changes in perceptions. The project has now begun to analyze its data and has two journal articles out for review. 

Project 2. “Environmental contaminants and reproductive health of Akwesasne Mohawk Women” recruited 43 new participants, who have completed all aspects of the demanding data collection protocol. Laboratory analysis of samples continues to show that methods are effective and participant compliance with the data collection protocol is good with adequate supervision. New personnel at St. Regis have continued to increase recruitment success. The project had a two community meetings to present a portion of the current results, as well as a separate meeting with directors of the St. Regis Health Service to discuss ways forward with the results.  Two papers were published and two are ready for submission. Several conference presentations of research results were made.

Project 3. Decomposing Racial/Ethnic Disparities in Health, has completed analyses of the large data sets as planned. Three papers have been published and others presented at national meetings. Training of economics graduate students in statistical analysis of data pertaining to health disparities has been conducted and the students are enthusiastic and professional. One has graduated with her PhD.

Using university funds, the Center also funded five pilot research projects that show promise to develop, obtain external funding and contribute significant research in the area of health disparities.

The Community Outreach and Engagement Core continues to partner with health care organizations and community-based organizations to provide health information and plan future activities. One of the ongoing programs, “Young Moms on a Mission,” which addresses adolescent mothers’ health, has developed into such a strong program that it will now undergo a data collection/research phase so that it can be replicated elsewhere, with Schenectady specifically under consideration for this project. Additionally, the PI of the core presented at many national venues concerned with health disparities as an expert on community engagement and medical interpretation, and has joined the board of the Institute for Medicine.

C. SIGNIFICANCE

The Center continues to evolve and has become more established through an increasing number of research projects, effective community outreach and engagement, and involvement in training students and faculty.  The Center’s website traffic has been increasing as the result of views by community members in addition to university-related users.

D. PLANS

Each core will continue to execute activities to achieve its specific aims. The Administrative Core will concentrate on 1) fostering communication among cores and communities, and 2) developing processes to foster the center’s sustainability. The Research Core will continue its supportive role and increase participation in regional programs. The Community Outreach and Engagement Core will continue to provide expertise on matters of medical interpretation and community engagement, and will develop the “Moms on a Mission” program. The Research Training and Education Core will continue to increase communication with students, sponsor lectures, and support the development of new health disparity scholars through mentoring, funding and providing venues for research discussions.

E. PUBLICATIONS

Several articles have been published and several others have been submitted for publication. They are listed in the reports by individual cores and projects.

F. PROJECT-GENERATED RESOURCES

Research Project 1 continues to maintain the website it created in 2009. It is updated before and after every community health event. See: www.albany.edu/womenshealth. 

Administration Core

(Lawrence M. Schell - PI)

A. SPECIFIC AIMS

The specific aims of the Administration Core have not been modified. 

B. STUDIES AND RESULTS

In the fourth year the Administration Core continued to increase the efficiency of the Center’s administration, improve communication within the center and with local communities to maximize the efficiency of all of its activities. In February, the Center also moved into new office space created by the University.  The Administrative Core continued to provide monthly reports of expenditures to all core directors, and has made training in budget monitoring available to all core directors.

With the hiring of a program manager in July of 2011, the Center has improved its administrative organization, external communications, and coordination among the core projects. The design and content of the newsletter has been greatly improved and its circulation has doubled, increasing the Center’s visibility among students, faculty and members of the community. The Admin core has also created an administrative manual to standardize administrative procedures among all parts of the Center. Program and publication tracking systems have also been instituted in order to measure productivity. We have also reorganized the website to make it more user-friendly for community members and have improved the look of some of the pages, such as the photo gallery.  All of this will be useful to the Center as it begins the transition planning process.

The Center held regular Program Executive Committee (PEC) meetings with community partners (core co-directors) and university co-directors on a regular basis, and held its annual Program Advisory Committee (PAC) meeting in late September. For the 2012-2013 academic year, it has scheduled monthly PEC meetings for transition planning purposes. The at-large member of the PEC added last year has proven very effective in facilitating interaction between the community outreach and engagement core, the research core and the research training core. Additionally, one of the community partner co-directors, José Rossy-Millán, has resigned, and we are currently considering recommendations for his seat.           

The Center also added a new member to the PAC, Dr. Roberto Lewis-Fernandez, the Director of both the NYS Center of Excellence for Cultural Competence and the Hispanic Treatment Program at NYS Psychiatric Institute. He proved to be a very helpful presence at the yearly meeting.  Although Wilma Waithe retired from her position as Director of the Office of Minority Health she will remain on the PAC. We are also in discussion with the director of the Whitney M. Young Jr. Health Services Center to determine which person from that organization could join the PAC or PEC. The Whitney M. Young Jr. Health Services Center is a largely minority and immigrant-serving health center that has been a long-standing partner of the Center. It has undergone changes in leadership over the past year.  The new director has sought out the Center to continue our partnership and we look forward to continuing and expanding our relationship.

A goal for the Administration Core for year 4 was to increase interaction among cores and community task forces. Thus, in year 4 researchers of projects 1 and 2 presented descriptions of their projects to the Albany Minority Health Task Force via the Outreach and Community Engagement Core. In addition, researchers funded through the Health Disparities Research Development Program, a program of funding paid by the university and administered by this center, also presented the results of past research. New awardees described goals and methods to obtain community feedback. A major goal was to make the research more community-relevant in both aims and methods as well as to set the stage to return more research results to it. Task Force members were given the opportunity to evaluate the proposals as well.  In addition, this interaction provided community members with more information about the activities of the center, increased their involvement and brough the community closer to collaborating in research with the Center and other researchers.

Sustainability has become an important issue for the center and community stakeholders. Attention is focused on the NIH p-20 program and the timing of the next RFA.  In preparation for an opportunity to apply for funding, the Administration Core has begun to solicit support from the deans of the different academic units of the university that have traditionally supported the Center (School of Public Health, School of Social Welfare, College of Arts and Sciences and the School of Education), as well as from the Vice President for Research and the Provost, the chief academic officer of the university.  All have pledged their support to the greatest extent possible should NIH funding continue.

In addition, the PEC has begun soliciting pre-proposals from researchers across the campus working in partnership with community groups for projects that could be included in a P-20 application. We have begun the review of these pre-proposals according to criteria in use by NIH and the goals, themes and approaches of this center. 

C. SIGNIFICANCE

The Administrative Core has maintained its oversight and leadership roles over the Center’s activities. Through its efforts, the other cores are now working together in a more coordinated fashion. As the Center enters the transition planning process, it will hold monthly PEC meetings. 

D. PLANS (Specific activities planned for Year 4)

1.     Manage the Center budget, review allocation of funds, and decide, with the PAC and the PEC, on        changes to allocations if needed.
2.    Monitor activities of the other cores to ensure goals are being met and reports are filed,  and continue                    efforts to track programs and publications.
3.     Make annual the report to the sponsor.
4.    Facilitate interaction and coordination among cores.
5.     Be a point of contact and coordination with the public, media, sponsor, host and partners.
6.      Continually revise, maintain, and expand the content of the website.
7.     Maintain official status as a University at Albany research center.
9.     Act as a center for leadership and support of similar activities occurring on the smaller SUNY campuses in upstate NY in partnership with local, community groups concerned with health. The Center will promote this more actively through a conference in YR4.
10.   Appoint new co-directors for the Research and Research Training Cores.
11.   Do transition planning for continuation of activities beyond the end date of the current NIH funding.
12.  Apply for continuing NIH funding for the activities of the Center.  

E. PUBLICATIONS

None 

F. PROJECT-GENERATED RESOURCES

None

Research Core 

David Strogatz, Director 

A. SPECIFIC AIMS (unmodified from original)

1. To support the implementation of the proposed research projects

2. To support the development of additional applications for funding of studies that will address health disparities in small cities and towns and that are planned and conducted through collaboration between university-based and community-based partners

3. To provide expertise on statistical issues in designing and conducting studies, analyzing the data and interpreting and presenting the results

4. To increase interactions and exchanges across units of the University at Albany and between university-based and community-based groups to discuss the significance of health disparities and to identify new opportunities for multidisciplinary collaboration in research to understand and reduce health disparities

B. STUDIES AND RESULTS

            Regarding the first Specific Aim, the Research Core has continued quarterly meetings of the Principal Investigators for each project with the Core Director (Dr. Strogatz) and the Core Biostatistician (Dr. Yucel). The standard agenda includes review of accomplishments since the last meeting, discussion of problems in accomplishing project goals, a summary of goals to be achieved by the next Research Core meeting, and recommendations for how to address unresolved problems in project implementation. In addition, Dr. Strogatz has joined the monthly meetings of the Project 3 team and is collaborating with Project 3 team members on analyses of newly geo-coded data from the National Health Interview Survey to examine the separate and joint associations of race-ethnicity and rural-urban residence with trends in screening for cervical, breast and colorectal cancer. The abstract for these analyses has been accepted for presentation at the Health Disparities Summit in November 2012 and the findings will be submitted for publication in fall 2012. Dr. Yucel’s expertise in imputation methods has relevance for each project of the Center, given the ubiquitous challenge of incomplete data.

            The Research Core and the Training Core have both contributed to the second Specific Aim through support for Dr. Akiko Hosler’s research on diabetes in the Indo-Guyanese community of Schenectady. Dr. Hosler has funds from the Training Core to determine the feasibility of the internet and smartphones as channels for interventions to promote glycemic control in diabetics. The Research Core assisted on a more basic level by establishing the excessive prevalence of diabetes among the Indo-Guyanese compared to other racial and ethnic groups in Schenectady and determining if correlates and complications of diabetes are also unique among the Indo-Guyanese. Dr. Strogatz and colleagues from Ellis Hospital conducted a retrospective study of medical records in the Department of Family Medicine that provided the first empirical evidence for what had been anecdotal impressions of increased risk of diabetes and its complications among the Indo-Guyanese. The manuscript describing these results is being published by Ethnicity and Disease in fall 2012 and serves as important preliminary studies for Dr. Hosler’s applications for funding.

            Dr. Strogatz’s interaction with colleagues from the New York Center for Agricultural Medicine and Health has led to funding from the university-funded, Health Disparities Research Development Program managed by the Center, for focus groups and the review of clinical records and worker compensation claims. The results will form the basis for a proposal to evaluate an intervention to reduce occupational injury and illness in migrant dairy farm workers.

            For the third and fourth Specific Aims, Dr. Yucel provides statistical and methodological support for students and faculty from the College of Arts and Sciences and the Schools of Education, Public Health and Social Welfare on projects related to health disparities. He has served as the biostatistician on two doctoral dissertation committees addressing research questions on health disparities. The dissertation in epidemiology has already led to two peer-reviewed presentations at national meetings and will result in three manuscripts submitted for publication. Additional ongoing thesis and dissertation projects are at an earlier stage of development. Dr. Yucel is also collaborating with Dr. Schell on analyses of longitudinal data relating maternal and child weight gain and with faculty members in Epidemiology and research scientists from the New York State Cancer Registry on imputation methods for categorical data such as race and ethnicity. Dr. Yucel’s development of innovative statistical techniques for imputation have most recently been presented at the International Conference on Health Policy Statistics and published in Statistics in Medicine and the Journal of Biometrics and Biostatistics.

In support of the community dimension of the fourth Specific Aim, Dr. Strogatz has continued his role on the Advisory Board of the Asthma Coalition of the Capital Region, which is funded by the New York State Department of Health and led by the Whitney M. Young Jr. Health Center, a federally designated neighborhood health center and a primary partner of the CEMHD. Dr. Strogatz is responsible for guiding evaluation of the coalition’s efforts to engage community resources that will support self-management skills of adults and children with asthma. Dr. Strogatz is also actively involved in the Rural Minority Health Project of the Office of Minority Health and Health Disparities Prevention of the New York State Department of Health. Through his service on the Advisory Board of the HRSA-funded Empire State Public Health Training Center, Dr. Strogatz helped to secure funding for a graduate student internship for summer 2012 and the 2012-2013 academic year. With combined mentoring by Dr. Strogatz and the Office of Minority Health and Health Disparities Prevention, the intern has assisted the three funded projects (in Chenango, Jefferson and Sullivan Counties) in completing a needs and assets assessment for the minority population of these counties. During the 2012-13 academic year the intern will work with the counties to develop, implement and evaluate pilot interventions to improve access to and utilization of healthcare services by racial and ethnic minorities.

C. SIGNIFICANCE

Conclusions regarding significance from the previous progress report still apply: the existing and emerging research projects of the Center continue to focus on conditions (e.g. reproductive health, breast and cervical cancer, asthma, diabetes) that are major sources of health disparities and major concerns of the communities in which the projects are located. The Center’s projects include quantitative and qualitative research; studies addressing etiology and prevention of disease; the use of primary and secondary data; and disparities affecting a variety of racial and ethnic groups. This diversity is also a strength of the Center. 

D. PLANS

During the next year of funding, the Research Core will continue its support of the Center’s main research projects and new projects through regular meetings with the project Principal Investigators and through collaboration with the other Cores of the Center on activities to foster skills and interest for research on health disparities. Special emphasis will be placed on development and submission of manuscripts to document the accomplishments of the projects and their contribution to the literature on health disparities.

E. PUBLICATIONS

Back EE, Bachwani AS, Strogatz DS, Sherman ZMV. Profile of Diabetes Mellitus among Immigrants from Guyana: Epidemiology and Implications for Community Action. Ethnicity and Disease 2012; 22:473-478.

He Y, Yucel R, Raghunathan TE. A Functional Multiple Imputation Approach to Incomplete Longitudinal Data. Statistics in Medicine 2011; 30:1137-1156.

Yucel R. Random-Covariances and Mixed-Effects Models for Imputing Multivariate Multilevel Continuous Data. Statistical Modeling 2011; 11:351-70.

Yucel RM. Dissemination of Missing Data Techniques in Medical, Biomedical and Social Research. Journal of Biometrics and Biostatistics 2012;3:e105. Doi:10.4172/2155-6180. 1000e105.

F. PROJECT-GENERATED RESOURCES

None

Project 1: Overcoming Barriers to African American Women’s Reproductive Healthcare Seeking.
(Golden, Matsaganis, Pomerantz)

A. AIMS

Aims are unmodified from original

B. STUDIES AND RESULTS

1. Through October 19, the Project conducted 6 Community Health Education Events on women’s reproductive health issues. Venues and formats were varied to assess their effectiveness in engaging underserved women in the community. Assessment tools and measures include attendance numbers, pre- and post-event questionnaires measuring knowledge, attitudes, and behavioral intentions, qualitative interviews eliciting reactions to events, and number of women signing up to receive services (Year to date: 23 African American women and 4 white women; target for calendar year based on Aim 2 = 23).

2. The Project continued with two additional interventions to increase underserved women’s access to services related to reproductive health that were initiated in 2011, and which were collaboratively designed with community partners.

a. Monthly HIV/STD testing events were offered at the Project’s field office in collaboration with the AIDS Council of Northeastern New York (14 individuals tested to date).

b. In August 2011 the Project began a peer outreach assistant initiative, which has proved a successful strategy for engaging the community and building its health promotion capacity.  7 women are currently performing weekly reproductive/sexual health outreach activities and assisting at bi-monthly community health education events. They received training on outreach techniques and reproductive/sexual health knowledge from Upper Hudson Planned Parenthood (UHPP) and meet weekly with the Project Director and Community Outreach Associate. In 2012, the peers made 711 contacts with residents to date. Research interviews with peers also document positive impact of the experience on their own healthcare seeking practices and reproductive health knowledge

3. The Community Advisory Board met in May and is scheduled to meet again in November. The Board members represent community partners who participate in the health resource fairs. As local community members, they have provided valuable guidance about leveraging event participation around other community events and groups.

4. The research team engaged in a new wave of data collection, conducting a series of recorded interviews with 21 members of community-based organizations (CBOs) that have collaborated with the Project since 2009. The interviews gathered CBOs’ perceptions of the impact of the Project’s interventions on community residents, on the relationship between CBOs and community residents, and on their own practices; CBO members were also asked to identify which intervention(s) should be prioritized for sustaining beyond the life of the grant; they strongly favored the peer outreach initiative.

5. The research team continued to collect and analyze knowledge, attitude, and behavioral intention data using pre- and post-event questionnaires and qualitative interview data with participants. Post-testing interviews have been conducted and analyzed in connection with AIDS Council testing to collect participants’ perceptions of the importance of availability of on-site testing. Two conference presentations were made in 2012, two manuscripts are currently under review for publication, and 3 are planned for submission by December.

C.  SIGNIFICANCE

The 22 health education events and resource fairs, together with our more recent smaller scale interventions and analysis of the data gathered from them, have helped to identify effective strategies for planning and conducting community events, emphasizing peer outreach assistants and their social networks. In the peer initiative we have an intervention that contributes to the achievement of the Project’s aims and (a) is emergent from the Project’s engagement with community residents and the primary partner (UHPP) and therefore reflects their interests and commitments; (b) builds the health promotive capacity of the community through educating community members who diffuse health knowledge through their social networks and act as role models in healthcare seeking practices, while at the same time providing direct benefits to the primary participants; (c) serves as a potentially sustainable bridge between the local health and human service resources and community residents. The Project continues to maintain relationships with community organizations and promote women’s reproductive health as part of overall healthy lifestyle through its CAB and multi-organization health education events. In addition to encouraging women to seek services at UHPP and other CBOs, the Project continues to emphasize bringing services to the women via weekly outreach sessions and monthly on-site testing.

D. PLANS

For the remainder of the calendar year 2012:

1. Plan and conduct 2 additional community events: November 20, 2012, Mammography Night at Columbia Memorial Hospital in partnership with the CMH Medical Imaging Unit and the Columbia County Community Healthcare Consortium; December 2012, a multiple-CBO event including a health education/entertainment presentation.

2. Continue to gather and analyze quantitative outcome data and qualitative process data on experiences of peer outreach assistants.

3. Continue to collect and analyze qualitative (interview, ethnographic) and quantitative (pre- and post-questionnaire; attendance) data related to community health education events.

4. Complete 3 additional manuscripts and submit for publication review.

       For Year 5, 2013

1. Conduct 3 community health education events.

2. Continue to work with peer outreach assistants on community activities, partnering with agencies such as UHPP, Healthcare Consortium, and the AIDS Council, and gather quantitative outcome data and qualitative process data on their experiences.

3. Identify possibilities for transferring management and funding of the peer initiative to one or more community organizations.

4. Complete 3 additional manuscripts and submit for publication review.

E. PUBLICATIONS
     none

F. PROJECT-GENERATED RESOURCES

· Project website www.albany.edu/womenshealthproject (established 2009 and updated before and after each event). Includes information about community events, community advisory board, taxi voucher program, and peer outreach assistant program.  

Project 2: Toxicants in the Ecology of Reproductive Health.
(Schell, Gallo) 

A. SPECIFIC AIMS (unmodified from original) 

Our project seeks to test the relationship between PCBs and certain other toxicants, and menstrual cycle characteristics of young adult women of the Akwesasne Mohawk Nation.  Our target sample size is 180 women. We are in the data collection phase of the project at this time and plan to be so until the middle of year 5. 

B. STUDIES AND RESULTS 

1.    Since the beginning of year 4 we have enrolled 51 additional women making the total who have signed informed consents at 214. Fifty-one is 15 more women than our enrollment target of 36 for the entire 2012 year. In 2012, three hundred and thirty one (331) women were approached to participate in the study, of these 65% were ineligible (on birth control, outside age range, on thyroid medication, pregnant or nursing), 17 were uninterested or unavailable due to time constraints, and 32 were unreachable after initial contact. Of the 51 who signed the consent form, 14 withdrew before completing project requirements resulting in 45 women who completed all requirements of the project in 2012. This number includes 6 women that signed up in 2011 but completed requirements of the project in 2012. 

2.    Since the project began, there are 155 women who have completed all aspects of data collection as of 10/16/2012, and 37 who have provided partial data, and much of this is suitable for analyses.  The 155 participants who have completed all aspects of data collection for the study is an increase of 46 persons above the 109 completed as of January 3, 2012, the start of year 4.  As our yearly target has been 36 persons, having 46 persons complete all aspects of data collection is a considerable success and represents excellent effort by our Akwesasne partners at the St. Regis Health Service. 

3.    At this time 124 of 155 participants’ saliva samples have been analyzed for estradiol and progesterone.  All participants’ serum samples have been analyzed by the PCB laboratory.  Clinical assay data (hormone levels and lipid panel) are complete on 182 participants. Thus, we some have laboratory results on women who did not complete all aspects of the project. 

      Clinical assay results have been returned to all 182 participants. Results on the levels of persistent organic pollutants will be returned to all the participants before the end of October 2012. We have twice presented preliminary descriptive results to the Akwesasne participants on their clinical chemistries. 

4.    In preparation for data analysis we have entered non-dietary data on 201 participants and verified these data on 173. The dietary data is more complicated to enter and check, and to date 187 dietary data records have been both entered and checked.  We expect a preliminary analysis will be accomplished by the end of year 4. 

An unforeseen and unfortunate development is the closure of Dr. David Carpenter’s laboratory that has been performing the analyses of participants’ serum for PCBs and other persistent organic pollutants.  We expect to send samples to the New York State Department of Health Laboratory that is certified to return results to participants’ physicians. The laboratory is currently doing such work for other investigators and the state, and is well qualified for our purposes.  Thus, recruitment of additional participants and analyses of sera can continue in year 5. 

C. PLANS (Specific activities for Year 5): 

1.    We plan to recruit new participants to reach our target of 180 participants with complete data by the middle of year 5. 

2.    Towards the beginning of Year 5, we will be planning presentations of our preliminary findings to the health providers. Following this consultative process, we will communicate with study participants, by letter and in person, to share results and address any questions.  In addition, following dissemination of individual results to participants, we will conduct public meetings at Akwesasne to discuss non-confidential results (hypothesis testing) that pertains to the community as a whole.  

E. PUBLICATIONS IN 2012 

Schell LM, Gallo MV, Nelder KR, DeCaprio AP, Jacobs A, 2012. Akwesasne Task Force on the Environment. Relationship between testosterone levels in adolescent males and polychlorinated biphenyls, dichlorodiphenyldichloroethylene, hexachlorobenzene, and lead. (Under Review) 

Schell LM. 2012. The perils of modern environments and how do we judge if environments are good or bad? In: Zuckerman MK, editor. Are modern environments bad for human health? Revisiting the second epidemiological transition: Wiley-Blackwell. (In Press, not peer-reviewed). 

Schell LM, Burnitz KK, Gallo MV. 2012. Growth as a mirror: Is endocrine disruption challenging Tanner's concept? In: Ann Hum Bio. Volume 39, Issue 5. Sept 2012. PMID:22780455. 

Schell LM, Gallo MV. 2012. Overweight and obesity among North American Indian infants, children, and youth. Am J Hum Biol 24(3):302-313. PMID:22378356. 

Schell LM, Gallo MV, Cook K. 2012. What's NOT to Eat--Food Adulteration in the Context of Human Biology. Am J Hum Biol 24(2):139-148. PMCID:PMC3275668 

F. PROJECT-GENERATED RESOURCES

none

Project 3. Decomposing Racial/Ethnic Disparities in Health
(Lahiri, Chatterji) 

A. SPECIFIC AIMS (unmodified from original)

1. To estimate and compare quality of health by racial/ethnic group; by state; by community size; and to examine trends over time in quality of health

2. To estimate within-group total and income-related health inequalities and their decomposition

3. To decompose between-group health inequalities into their determinants with special emphasis on the role of community size. 

B. STUDIES AND RESULTS

In 2012, Project 3 published three papers that pertain to Aims 1 and 2.  In sum, the studies provide evidence of: (a) racial/ethnic disparities in the development of and awareness of diabetes and hypertension; (b) emerging trends in racial/ethnic and education-related disparities in adequate control of diabetes; and (c) trends and mechanisms leading to income-related inequality in child health in the U.S.  We also have a paper under review at the Journal of Human Capital which focuses on education-related disparities in chronic disease prevalence and diagnosis. 

We have several new manuscripts in various stages of completion.  In order for us to obtain data on community size that can be linked with the National Health Interview Survey (NHIS), we are collaborating with Dr. Sandra Decker at the National Center for Health Statistics.  We have pooled several recent years of the NHIS to investigate racial/ethnic disparities in cancer screening.  We focus on African-Americans, Latinos, and non-Latino whites since small sample sizes do not allow analysis of Asians and other ethnic/racial groups. Our initial results show little evidence of racial/ethnic disparities in cancer screening.  However, disparities may vary by city size. To study this issue, we are merging into the NHIS data on Rural-Urban Commuting Area (RUCA) codes, which is a measure of community size.  We are now examining whether disparities change when we assess them by community size. This paper addresses the latter part of Aim 3 related to community size. 

We also have the following manuscripts in draft form:

· Early health and disparities in academic outcomes (Chatterji, Kim & Lahiri)

· New analyses of effects of mental disorders on labor market outcomes using MIMIC models (Chatterji, Banerjee & Lahiri)

· Racial/ethnic differences in income-related child health inequality in the US (Chatterji, Lahiri & Song)

· State-level income inequality and health: An analysis using the BFRSS (Lahiri & Zhang)

· Income-related health inequality among the elderly in the US, China, and India (Chatterji, Lahiri & Xu)

· Racial/ethnic differences in concordance of reports of hypertension (Chatterji, Joo & Lahiri)           

C. SIGNIFICANCE

As a group, these papers provide new evidence regarding mechanisms of disparities in chronic disease among the elderly and disparities in children’s health.              

D. PLANS

· Continue merging community information from the Area Resource File as well as RUCA codes into recent years of the BRFSS.  The Area Resource File includes supply side factors that may affect cancer screening, such as the availability of medical specialists in a county. 

· Continue recently-initiated examination of racial/ethnic disparities in cancer screening by city size, as well as supply side factors that may explain the rural/urban differences that are emerging.     

· Publish some papers as NBER working papers when they are under review at academic journals to allow for some early dissemination of findings prior to final publication. 

E. PUBLICATIONS 

  1. “Beware of being unaware: Racial/ethnic disparities in chronic illness in the US” Chatterji, Pinka; Joo, Heesoo; and Kajal Lahiri. Accepted at Health Economics, June 2012.
  2. “The dynamics of income related health inequality among US children” Chatterji, Pinka;  Lahiri, Kajal; and Jingya Song.  Accepted at Health Economics, March 2012.
  3. “Racial/Ethnic and Education-Related Disparities in Control of Risk Factors for Cardiovascular Disease among Individuals with Diabetes.” Chatterji, Pinka; Lahiri, Kajal; and Heesoo Joo. Diabetes Care, 35, 2012, 305-312. 

F. PROJECT-GENERATED RESOURCES
none

Research Training and Education Core

Robert L. Miller, Director

a.  Specific aims

            The specific aims of the Research Training and Education Core (RTEC) have not been modified. 

B.STUDIES AND RESULTS
               The RTEC conducted a two-day conference entitled, “Health Disparities in Sexual Minorities Along the Life Cycle: A Beginning Community Discussion.”  Additional support came from other units of the university, especially the School of Social Welfare, community groups, and the New York State Department of Health.

               The four conference goals were: (1) to illuminate the health disparity challenges experienced by sexual minorities in the upstate New York region, (2) to create an informative dialogue between the presenters and the local stakeholders to substantially frame the salient issues, (3) to create opportunities for local researchers and community stakeholders to identify community-based research collaborations, and (4) to compile the presentations resulting in the development of a special edition of a health disparities or sexual minorities journal.

Eight researchers from across the US presented empirical studies reflecting the various health and psychosocial challenges LGBT subpopulations experience across the life cycle.  Breakout sessions followed the presentations for in-depth conversation.   Several EOP (Educational Opportunity Program) and Honors College students were selected to act as moderators and note takers for the informal sessions.

            The conference had over 122 attendees. These included students, faculty, community members (including people of color who are sexual minorities from various psycho-social and health related community based organizations); personnel from local and state departments of health; other community leaders; community-based and health-related agency personnel; and various social science researchers. 

            The RTEC collaborated with and supported the work of the University’s Sexual Orientation and Gender Identity (SOGI) Project.  Students from the Honors College and the EOP attended eight workshops and three, full day training events. It also collaborated with the Department of Africana Studies to produce a seminar called Health in the Black Community.

            The RTEC continued the statistical consultative support for graduate students and untenured faculty. The statistical support and discussion groups happen during an eight hour block of time. The appointments were in 30 minute increments. In the last academic year, 136 different appointments were scheduled and filled. This represents 48 unduplicated users of the consultation services. The consultations are held on the downtown campus of The University where graduate and professional schools are located. This service is available to the entire University community.  We have continued this service during this academic year. 

C. SIGNIFICANCE

            The conference netted several benefits.  It increased the exposure of The Center on the University Campus as well as at the regional, state and national levels.  The conference keynote speaker was the Deputy Commissioner for the New York State Department of Health.  The eight presenters have both national and international reputations. This was the first conference in the history of The University at Albany examining health disparities in sexual minorities.  Moreover, it is also the first time that the University at Albany hosted a conference focused on people of color who are sexual minorities and all of the researcher/presenters were both people of color and sexual minorities. Most importantly, the formal and informal conference presentations provided many opportunities for the EOP and Honors College students to engage with minority health and health disparities researchers. 

            Additionally, the collaboration with The SOGI expands the presence of the Center in the University community.  The SOGI Project is housed in the School of Social Welfare with partners in the College of Arts and Sciences as well as the School of Public Health. This collaboration results in several opportunities for the EOP and Honors College students to interact with each other, as well as other members in the University Community interested in underserved populations that experience health disparities.

            The RTEC is deepening its penetration in the University Community, as indicated by the collaborations and increased lecture opportunities.  Members of the University community are contacting the Research Training and Education Core.  This is a change from the period of time when the Research Training and Education Core personnel were initiating all of the contacts with The University and the community. 

D.  PLANS  - Specific activities for Year 5:

  1. Continue to provide seminars on conducting responsible research.  We will invite faculty from The University at Albany community. Faculty members from the Philosophy Department have agreed to provide seminars on bio-ethics consistent with conducting responsible research.
  2. Continue providing statistical support in conjunction with Research Core.
  3. Develop a new effort to support Specific Aim 2, by hiring a consultant who will develop a writing group.  This resource will support graduate students and untenured faculty who are engaged in writing to complete their doctoral studies or writing for submission for peer-review journal submissions.  Several doctoral students are engaged in research consistent with the goals of the Center. This resource will provide an additional support for their efforts.
  4. Continue to support the Health Disparities Certificate Program.
  5. Reach out to University at Albany faculty who are engaged in mentoring minority students.  (A faculty member in the department of Psychology was given national recognition for her work with minority students who were psychology majors.) 

E. PUBLICATIONS
None 

F. PROJECT-GENERATED RESOURCES

None

Outreach and Community Engagement.

Wilma Alvarado-Little (Director)

A. SPECIFIC AIMS

            The specific aims have not been modified. 

B. STUDIES AND RESULTS

            The Community Engagement/Outreach Core (Outreach) continues to engage and empower communities, build trust, provide resources for access to healthcare and healthcare information, and encourage collaboration with researchers and health agencies. It has also been improving lines of communication between the university and the community. 

            To fulfill Aim 1, development and dissemination of general and Center-specific health information, the Core co-directors gave many presentations to State and local organizations, including talks at local colleges and public schools, webinars presented through the New York State Office of Mental Health   and as featured guests on local TV and radio programs. Additionally, the project “Young Moms on a Mission” developed by the Outreach Core’s Amsterdam Minority Health Task Force, was featured in a segment on the PBS/WMHT American Graduate Project, American Day Broadcast on September 20,2012. Participation in local college and university events included the following: (A full list of presentations is available in the Appendix). The Center has also provide the NYS Attorney General’s Office with information on its work.

· A discussion of CEMHD and the Health Disparities Certificate Program at a health careers networking event at the U Albany School of Public Health (SPH);

· A presentation, “The Role of Culture and Language in Health Care” at an SPH event;

· A formal overview of the CEMHD for American Council on Education (ACE) Fellow Dr. Robert Hill; A presentation entitled “Introduction to Health Professions ”at Russell Sage College;

· Dissemination of information at the UAlbany NAACP Health Fair;

· Presentation on the work of the CEMHD to Doctors 4 Hope, a group of UAlbany Pre-med and public health students; and

· An interview about and presentation of CEMHD work at a Siena College WVCR 88.3 radio program called The Saint Change Makers.

            As in Year 3, the Outreach Committee continues to partner with health care organizations, community organizations and individuals to maintain a robust network of supporters who provide direct or indirect health-related support services to minority communities. The CEMHD presence in the Capital District region is instrumental in the dissemination of information and is represented in the following capacity:

· National/Federal level: Institute of Medicine Health Literacy  Roundtable Advisory Board; HHS Office of Minority Health; National Project Advisory Committee for the Revision of CLAS Standards; National Quality Health Care Diversity Rx Advisory Board; National Council on Interpreting in Health Care;

· State Level: Family Planning Advocates of NY State; NY State Office of Mental Health Bureau of Cultural Competency;  NY State Language Access Task Force;

· Local Level: Albany County Leadership Transition Team Health Task Force Subcommittee; Albany Network of Hispanic Service Providers; and Capital District Latinos.

            To fulfill Aim 2, encourage and equip the community for participation and partnership in research studies and interventions, the Core continues to meet regularly with the Albany and Amsterdam Minority Health Task Forces and arranges for CEMHD-affiliated researchers and grant applicants to present their research results or grant proposals to the Albany Task Force.  

            The Outreach Core continues to build relationships and identify potential community partners and supporters, growing to include the following organizations: Black Child Development Institute of Albany, NY, Macedonia Baptist Church, Sigma Pi Phi/Beta Psi Boule, Trinity Alliance/SNUG and PBS/ WMHT.  The Outreach Task Force groups continue to bridge communication between the university and the community. They are instrumental in providing an environment for UAlbany faculty to present current and potential research projects and obtain community feedback. The Amsterdam Minority Health Task Force has been active with the development of the adolescent pregnancy prevention project aimed at addressing Latina Youth reproductive health issues and will continue this work in Year 5.

            During Year 4, the Outreach Core collaborated with the following community organizations: SNUG Anti-Violence Program; Albany Medical College’s Standardized Patient Case Project; the Society of Teachers of Family Medicine; Capital Region Refugee Roundtable (including a presentation, “Interpretation in Health Care Settings: Rights, Realities, Realities, Resources and Recourse);” YMCA Black and Latino Achievers Program in East Greenbush and Albany; St. Peter’s Hospital/Catholic Health East Language Access Plan Implementation; the Albany City School District Dad Take Your Child to School Day Initiative; and Community Cradle Healthy 4 Life Teen Mom program implementation. The Core also assisted two organizations with their research initiatives: The NYS Center for Popular Democracy’s “Equal Access to Services: Equitable & Effective Government Initiative” project; and Make the Road New York Y’s Community Health Worker Initiative.

            In Year 4, the Core sponsored the following events with the goal of empowering the communities to address health disparities: Mentoring for Your Health: How Mentoring Can Address Health Equity: A Dialogue with Mentoring and Health Advocates; New York State Office of Mental Health Town Hall Meetings; and the Albany Chapter of the Black Child Development Institute: Mentoring, Fatherhood and Gang Violence.

In addition, in order to continue to build a trusting and non-judgmental environment with the Latina community, the Amsterdam Minority Health Task Force developed a series of workshops aimed at providing information on healthy practices. This workshop series aimed at empowering the community called “Young Moms on a Mission”, include the following workshop titles: Reproductive Health Practices: What’s Myth? What’s Fact?; Addressing Domestic Violence: You are an Important Person!; Self- Esteem, Self-Care and Your well-being; Good Communication Leads to Success! Communicating with your Provider; Oral Health: How does your smile affect you, your relationships, opportunities and overall health? The first workshop was aimed at females and their partners who dropped out of school due to pregnancy and have encountered lack of adequate health care for themselves and their infant. The workshops, conducted in Spanish and English, are in their third year and the number of participants has doubled. Some participants have enrolled in Certified Nursing Assistant programs and GED classes after attending the workshops.

C. SIGNIFICANCE

            Partnerships are key components of the dissemination of information. The Core has deepened its engagement with the Albany and Amsterdam Minority Health Task Forces, and communities are now identifying their own projects to promote their health  and well-being. In Year 4, it also expanded into new areas, including partnering with a local violence prevention program, SNUG, and the local public television station, WMHT. In Year 4 it provided health information at the local, regional and national levels.

D. PLANS (Specific activities for Year 4). Clarify community needs for health education and information among various age groups.

· Build partnerships serving K-12 populations, health care and faith-based organizations.

· Involve CEMHD researchers in regularly scheduled task force meetings.

· Ensure target community collaboration with Research Core studies to increase the likelihood of it accepting and benefiting from the research being carried out. 

· Continue to identify healthcare concerns within the Black and Latino communities and present them to the Research and Research Training and Education Cores.

· Continue to promote the Health Disparities Certificate Program.

E. PUBLICATIONS

None

F. PROJECT-GENERATED RESOURCES

None

2011 Progress Report

SUMMARY

Note: The “Exploratory Center on Minority Health and Health Disparities in Smaller Cities” is known on campus as the Center for the Elimination of Minority Health Disparities.

A.    SPECIFIC AIMS (unmodified from original) This Center of Excellence, the Exploratory Center on Minority Health and Health Disparities in Smaller Cities, continues to work to support and promote research by several disciplines across the university in close and equal collaboration with community partners. 

The overall goal is to better understand the multiple determinants of health disparities in smaller cities and to test ways to reduce them. This goal will be achieved through the activities of each core as stated in the Specific Aims of each. The specific aims of the Cores and research projects are unchanged.

B. STUDIES AND RESULTS

The Administrative Core hired a new project manager (half time). This will improve communication among cores, website management, and newsletter production. The addition of the co-director of the Community Engagement Core to the Program Executive Committee created far better representation of the Albany minority community in Center decision making.  Another member has been added to the Program Advisory Committee to better represent minority communities and issues in mental health disparities.

The Center (Administrative and the Research Training Cores) hosted a conference on health disparities among sexual minorities to increase research on the campus and in the community. The Administrative Core has held regular meetings of the Program Executive Committee approximately bimonthly. The Program Advisory Committee met on September 19th 2011.  

The University administration is very supportive. The Center moves to its new offices this December. All three component research projects of the Research Core are making phenomenal progress. Presentations are flowing from all three projects, and publications are in the pipeline, with projects 2 and 3 most active.

The Research Core continues to provide statistical support for these projects and Center associates. The Research Advisory Committee continues to meet. The Core is now contributing to the development of projects on food environment and diabetes in nearby Schenectady and is providing technical assistance to the regional asthma coalition. The core also helped host outside speakers pertinent to the research mission of the Center. Researc.

Project 1. “Overcoming Barriers to African American Women’s Reproductive Healthcare Seeking” has again conducted 5 community health education events to date with more scheduled through 2011. These events, held at various locations for maximum accessibility, combine education, health screening and appointments for reproductive health care. Pre and post questionnaires are distributed at these events to gauge impact and changes in perceptions. It also expanded its range of interventions designed to increase access and attractiveness of services, and added a peer outreach program staffed by local community women. The project continues to collect data on the effectiveness of the interventions and present the results of this work at national fora. 

Project 2. “Environmental Contaminants and Reproductive Health of Akwesasne Mohawk Women” has dramatically increased recruitment to 101 and now has 82 participants who have completed all aspects of the demanding data collection protocol. This represents a doubling of participants in one year owing to diligent and enthusiastic recruitment efforts.  Laboratory analysis of samples has shown that methods are effective and participant compliance with the data collection protocol is good with adequate supervision. New personnel at St. Regis will maintain or increase recruitment success. Meetings with community leaders and public meetings are planned for recruitment and dissemination/discussion of results to date. One paper was published and two are in press or near ready for submission. Several presentations of research results were made.

Project 3. "Decomposing Racial/Ethnic Disparities in Health," has completed some analyses of the large data sets as planned.  Three papers: Beware of being unaware: racial/ethnic disparities in awareness of chronic disease (Specific Aims 1 and 2); (2) Child health inequality and its dynamics through adolescence (Specific Aim 3); and (3) Early health conditions and disparities in academic achievement.  The papers have been presented in national fora. Their submission is expected in the next grant year. 

Training of graduate students statistical analysis of data pertaining to health disparities has been conducted and the students are enthusiastic and professional.  In the next year, the investigators have arranged to employ community level data to examine effects of community size and community attributes at a more disaggregated level.

The Research Training Core has successfully engaged undergraduate and graduate students as well as faculty in health disparities research issues. Students in the Educational Opportunity Program and the Honors College learned of the Center’s research. The Core arranged for two speakers, one on the responsible conduct of research, and another on race and racism in health disparities. Additionally, a conference entitled “Health Disparities in Sexual Minorities along the Life Cycle: A Beginning Community Discussion” took place November 7 and 8, and brought in speakers from across the US.  In addition to over 8 talks, included discussions with students and junior faculty on engaging in and obtaining funding for health disparities research.

Statistical support for researchers is provided by Dr. Yucel who is also on the Research Core.

Using university funds, the Center also funded a developmental grant on the health of youth transitioning from the foster care system. The Community Outreach and Engagement Core continues to partner with health care organizations, community organizations and individuals.

The leadership was improved by the addition of Mr. Greg Owens as co-director.  He is well connected to the Albany minority community and works in the mental health field.

The PI of the Core presented at many national venues concerned with health disparities as an expert on community engagement and medical interpretation. The program, “Moms on a Mission,” addressing adolescent mothers’ health, has developed strongly with much participation from young moms.

C. SIGNIFICANCE

The Center continues to develop and become more established through research projects, community outreach and engagement, and involvement in training students and faculty. Operations to expand activities of cores have a firm foundation.

D. PLANS Each core will continue to execute activities to achieve its specific aims. The Administrative Core will concentrate on 1) fostering communication among cores and communities, and 2) developing processes to foster the center’s sustainability. The Research Core will continue its supportive role and increase participation in regional programs. The Community Outreach and Engagement Core will continue to provide expertise on matters of medical interpretation and community engagement, and will develop the “Moms on a Mission” program. The Research Training Core will continue to increase communication with students, sponsor lectures, and support the development of new health disparity scholars through mentoring, funding and providing venues for research discussions.  

E. PUBLICATIONS Several articles have  been published; several others have been submitted for publication. See reports by individual cores and projects, and the appendix.

F. PROJECT-GENERATED RESOURCES

A website was created for research project

1. Administration Core – Schell L.M. (PI)

A. SPECIFIC AIMS

The specific aims of the Administration Core have not been modified.

B. STUDIES AND RESULTS

In the third year the Administrative Core continued to increase the efficiency of the Center’s administration, improve our communication within the center and with external communities, and expand the Program Advisory Committee (PAC), which is the center’s external advisory committee, to maximize creativity in operations, goals and activities generally.

In August of 2010 the center hired a person to initiate special projects, facilitate grant applications by center members, and increase communication of the Center’s activities. As a result, center members have become better informed of new (non-university) grant opportunities, a workshop on health disparities was held, and planning began on a new workshop on health disparities to be held in the fall of 2011. In mid-summer of 2011, this person resigned for a position in the NYS Department of Health.  Fortunately, we have found a replacement who is more organized, energetic, and knowledgeable with substantial experience working with minority communities. 

The Center held Program Executive Committee (PEC) meetings involving community partners (core co-directors) and university co-directors on a regular basis; To improve communication with our members (associates) and with all members of committees of the center and especially with community partners and individuals, we have revised our newsletter format to make it more accessible and interesting. In addition, we have extensively reviewed and updated our list of recipients to extend the communication reach of the center. 

Finally, we have developed an electronic newsletter for those interested in the center and who use email extensively. Both the paper newsletter and the electronic one are written in both Spanish and English. Links to both newsletters are on the center’s home page (www.albany.edu/cemhd/).

We added one member to our PEC, an at-large member. This member will facilitate interaction between the community outreach and engagement core on the one hand, and the research core and the research training core, on the other.

We seek to increase interaction between the community task forces that are part of the community engagement core, and the research projects that are ongoing, completed or planned. The purpose is to make the research more community-relevant in both aims and methods as well as to return results to community groups. Dr. Janine Jurkowski of the School of Public Health has agreed to serve in this role. She is an expert in community based participatory action research models.  The at-large member arrangement will be tried for a year and evaluated by the PEC.

In Year 3 the PEC had sought to add members to our Program Advisory Committee (PAC).  Previously we added Dr. Chasan-Taber of the School of Public Health, University of Massachusetts at Amherst. This August Dr. Lewis-Fernandez agreed to serve on the PAC.  He is the Director of the NYS Center of Excellence for Cultural Competence and the Hispanic Treatment Program at NYS Psychiatric Institute. Our year three PAC meeting took place on October 7th, 2011.

The university has now created a dedicated space for the Center on the academic podium, which is highly visible and highly accessible, reflecting the University’s appreciation of the role of the Center in university and community life. The Center moved in February of 2012.

The Administrative Core provides monthly reports of expenditures to all core directors, and has made training in budget monitoring available to all core directors.

The Center administers a small program of research support with limited funds provided by the university’s Vice President for Research. The funds support research on health disparities and that also employs a community partnership model. The goal is to facilitate the development of projects begun with funding from the earlier EXPORT Center, or from other sources, to the stage where an application for external funding can be made. The Center has worked to rearrange the timing of funds provision so that they are more available to faculty-community partnerships during the summer.

C. SIGNIFICANCE

The activities of the Administrative Core have maintained the Center with its constituent leadership bodies (PAC and PEC) through a period of change and development. The Administrative Core has maintained its oversight and leadership roles vis-à-vis the center’s activities. Through its efforts the other cores are now working together more closely. The Core also continues to be a local hub for health disparities work that involves communities that is ongoing on other SUNY campuses in the region.

D.  PLANS

1. Manage the Center budget, review allocation of funds, and decide, with the PAC and the PEC, on changes to allocations if needed;
2. Monitor activities of the other cores to ensure goals are being met and reports are filed;
3. Make annual the report to the sponsor;
4. Facilitate interaction and coordination among cores;
5. Be a point of contact with the public media, the sponsor, host and partners;
6. Revise our website and maintain it for information dissemination;
7. Schedule meetings of the Program Executive Committee every other month, and the PAC once in year 4;
8. Maintain official status as a University at Albany research center;
9. Continue to act as a center for leadership and support of similar activities occurring on the smaller SUNY campuses in upstate NY in partnership with local, community groups concerned with health;
10. Move into new, dedicated offices on the main UAlbany campus;
11. Plan for continuation of activities beyond the end date of the current NIH funding.

E. PUBLICATIONS (n/a)

F. PROJECT-GENERATED RESOURCES

None

Research Core (Strogatz, D. - PI)

A. SPECIFIC AIMS (unmodified from original)

1.    To support the implementation of the proposed research projects. 
2.    To support the development of additional applications for funding of studies that will address health disparities in small cities and towns and that are planned and conducted through collaboration between university-based and community-based partners 
3.    To provide expertise on statistical issues in designing and conducting studies, analyzing the data and interpreting and presenting the results 4.    To increase interactions and exchanges across units of the University at Albany and between university-based and community-based groups to discuss the significance of health disparities and to identify new opportunities for multidisciplinary collaboration in research to understand and reduce health disparities.

B. STUDIES AND RESULTS

To support the first Specific Aim, the Research Core has convened meetings of the Principal Investigators for each project with the Core Co-Directors and Core Biostatistician. The standard agenda for the Research Core meeting is a review of accomplishments since the last meeting, a discussion of any problems that arose, a summary of goals to be achieved by the time of the next Research Core meeting, and recommendations for strategies to address problems that are still unresolved or looming on the horizon.

There has been general consensus for a quarterly meeting schedule of the full group of project Principal Investigators with the Research Core Co-Directors and Biostatistician, with the option for scheduling meetings involving individual projects with Research Core staff as needed. For example, Project 3 has established monthly meetings of the project team which the Research Core Director and Biostatistician are able to attend. This additional interaction between faculty from the College of Arts and Sciences and the School of Public Health has led to a broader awareness of relevant scientific literature and methods and to potential opportunities for cross-discipline collaboration.

The Research Core has also supported additional projects addressing health disparities (Specific Aim 2), with a specific emphasis on disparities in small cities and towns and projects linking the university with a variety of community partners. Dr. Strogatz, the Co-Director of the Research Core, has served as a member of the Advisory Board of the Pediatric Asthma Coalition of the Capital Region, which is funded by the New York State Department of Health and led by the Whitney M. Young Jr. Health Center, a federally designated neighborhood health center and a primary partner of the CEMHD.

During 2011 Dr. Strogatz collaborated on the successful application for the next cycle of funding (2012-2016) for the coalition. In this phase the interventions will include adults as well as children with asthma and will again be guided by the Chronic Care Model to work with community resources to reinforce successful self-management skills for asthma. Dr. Strogatz will lead the evaluation of intervention efforts.

The Research Core provided support in 2011 for Dr. Akiko Hosler’s NIH applications for research on the food environment and risk of diabetes in minority communities of the Capital Region. Dr. Hosler submitted an R15 application in spring 2011 to assess longitudinal changes in the food environment and associations with diabetes in predominantly African American neighborhoods of Albany, and she submitted an R21 application in October 2011 to address the role of the food environment and other factors affecting the unexpectedly high prevalence of diabetes in the Indo-Guyanese community of Schenectady. Dr. Hosler’s proposed research in Schenectady will complement an ongoing community survey of diabetes funded by the CDC REACH (Racial and Ethnic Approaches to Community Health) program led by Dr. David Pratt, Commissioner of Schenectady County Public Health Services. Dr. Pratt has agreed to become a member of the Research Core Advisory Committee and has expressed interest in additional opportunities for collaboration.

With respect to the third and fourth Specific Aims, Dr. Recai Yucel’s role as the Core Biostatistician includes supporting statistical and methodological needs of existing projects and projects being proposed. He works with the Center’s Training Core so that students and junior faculty from the College of Arts and Sciences and the School of Social Welfare also have access to his presentations and consultation on projects related to health disparities. In addition to supporting the work of others, Dr. Yucel has developed novel techniques for imputation strategies with incomplete data, and he has used the problem of missing data on race in the Child Development Supplement of the Panel Study of Income Dynamics to illustrate how imputation may lead to more valid inferences pertaining to health disparities; the manuscript describing this work was published this year in Statistics in Medicine (2011; 30:1137-1156).

In support of the fourth Specific Aim, the Research Core sponsored a visit and presentation in December 2010 by Dr. Robert Kaplan of the Albert Einstein School of Medicine, who spoke about initial findings from the Hispanic Community Health Study, a longitudinal study of multiple health outcomes in 16,000 Hispanic adults from New York, Chicago, Miami and San Diego. Dr. Strogatz has also engaged the CEMHD and the School of Public Health’s HRSA-funded Empire State Public Health Training Center as participants in the Rural Minority Health Project of the NYS Health Department’s Office on Minority Health. This project conducted regional forums in summer and fall of 2011 to identify needs and resources; the results will be used in a community participatory process to develop and implement interventions.

The Empire State Public Health Training Center is supporting a graduate research assistant to provide technical assistance to local health departments to prepare for the forums and plan for interventions. These activities, and the design for implementation and evaluation of the interventions, will also draw on the expertise of the Outreach and Training Cores, as well as the Research Core.

C. SIGNIFICANCE

The existing and emerging research projects continue to focus on conditions (e.g. reproductive health, breast and cervical cancer, asthma, diabetes) that are major sources of health disparities and concerns of the communities in which the projects are located. The Center’s projects include quantitative and qualitative research; studies addressing etiology and prevention of disease; the use of primary and secondary data; and disparities affecting a variety of racial and ethnic groups. This diversity is also a strength of the Center.

D. PLANS

During the next year, the Research Core will continue support of the Center’s main research projects and new projects through regular meetings with the project Principal Investigators, through advisement from the Core Advisory Committee, and through collaboration with other Cores of the Center on activities to foster skills and interest for research on health disparities.

E. PUBLICATIONS

Wicks AF, Lumley T, Lemaitre RN, Sotoodehnia N, Rea TD, McKnight B, Strogatz DS, Bovbjerg VE, Siscovick DS. Major life events as potential triggers of sudden cardiac arrest. Epidemiology. 2011; under review. 
Yucel RM, He Y, Zaslavsky AM. Gaussian-based routines to impute categorical variables in health surveys. Statistics in Medicine. 2011; October 4. doi: 10.1002/sim.4355 
Yucel RM. State of the multiple imputation software. Journal of Statistical Software. 2011. 
Yucel RM, Tomaskovic-Devey, D. Multiple imputation in multiple classification and multiple-membership structures. Journal of the Royal Statistical Society, Series C. 2011 
Yucel RM. Logistic mixed-effects models with ambiguous cluster membership. Computational Statistics and Data Analysis. 2011; under review.

F. PROJECT-GENERATED RESOURCES None  

Project 1. Overcoming Barriers to African American Women’s Reproductive Healthcare Seeking (Golden, A. & Pomerantz, A - PIs)

A.    SPECIFIC AIMS (Unmodified from original).

1.    Evaluate the impact of intervention strategies for overcoming barriers to reproductive healthcare seeking for African American women residing in the study’s setting (Hudson, New York). Primary intervention strategies include a series of community health education events and a transportation voucher program.

2.    Increase (by the end of the data collection period of the project, December 2012) by at least 25% the number of African American women in Hudson, New York and environs who are receiving reproductive healthcare as demonstrated by increased clinical attendance at the local publicly funded reproductive healthcare provider, Upper Hudson Planned Parenthood.

B.    STUDIES AND RESULTS

1.    In 2011, through October 20th, the Project conducted 5 Community Health Education

      Events (one every two months) on topics related to women’s reproductive health. Venues

      and formats were varied to assess their effectiveness in engaging underserved women in    

      the community. Assessment tools and measures included attendance numbers, pre- and  

      post-event questionnaires measuring knowledge, attitudes, and behavioral intentions,

      qualitative interviews ascertaining participants’ reactions to events, and the number of

      participants who signed up to receive services.

2.    The Project expanded the range of interventions it designed and conducted to increase underserved women’s access to services related to reproductive health.

3.    In March 2011, the Project initiated monthly HIV/STD testing events out of the Project’s field office in collaboration with the AIDS Council of Northeastern NY.

4.    In May 2011, the Project initiated weekly outreach sessions at the subsidized housing complex in collaboration with Upper Hudson Planned Parenthood, during which UHPP supplied free safer sex kits and emergency contraception kits. Reproductive and sexual health information was offered, and an opportunity to sign up for clinical services at UHPP and taxi vouchers from the Project were available.

5.    In August, 2011 the Project began a peer outreach assistant initiative: 6 women from community were hired to assist with weekly reproductive/sexual health outreach, and to assist with promoting and carrying out monthly community health education events. The group is receiving training on outreach techniques and reproductive/sexual health facts (through UHPP). The group meets weekly for discussion and planning activities.

6.    The Community Advisory Board met January 26 and May 19, and November 3. Meetings provide a forum for discussing past events and planning future events. The Board members are both advisory and represent community partners who participate in the health resource fairs. As local community members, the Board members have been a valuable source of guidance about leveraging event participation around other community events and groups.

7.    The research team continued to collect knowledge, attitude, and behavioral intention data using and pre- and post-event questionnaires, and to collect data on participants’ reactions to events through post-event qualitative interviews, from UHPP clients, and from users of the Taxi Voucher program to collect participants’ perceptions of its impact on their reproductive healthcare seeking behavior. The team continued qualitative data analysis of interview transcripts using NVivo, and quantitative data analysis of pre- and post-interview questionnaires. We added post-testing interviews in connection with AIDS Council testing to collect participants’ perceptions of the importance of availability of on-site testing. We conducted 3 focus group discussions with women in the community on perceptions of women’s health needs, availability of resources, and barriers to healthcare seeking.

8.    Nov. 15 will be Mammography Night at Columbia Memorial Hospital held in partnership with the CMH Medical Imaging Unit and the Columbia County Community Healthcare Consortium.  In December the project will conduct a multiple CBO event including a health education/entertainment presentation.

9.    Gather quantitative outcome data and qualitative process data on experiences of peer outreach assistants.

10.  Continue to collect and analyze qualitative (interview, ethnographic) and quantitative (pre- and post-questionnaire; attendance) data.

C. SIGNIFICANCE

1.    During the project’s third year, the Project has continued to explore new venues and new formats for engaging underserved women in the community. The 14 health education events and resource fairs conducted so far, together with our more recent smaller scale interventions and analysis of the data gathered from them, have helped the research team identify effective strategies for planning and conducting community events. The primary challenges the project faces are eliciting participation in interventions and moving individuals who do participate to take the next step to signing up to receive healthcare services. In the second half of Year 3, and going forward into Year 4, the Project is shifting its strategy to work more intensively and individually with organizations whose missions most closely align with the Project’s central goals; however, the Project will continue to maintain relationships with community organizations and promote women’s reproductive health as part of overall healthy lifestyle through at least 2 multi-organization events in Year 4.

2.    In addition to encouraging underserved women to seek reproductive and sexual health-related services at UHPP and other health service organizations, the Project will continue to emphasize bringing the services to the women, for example in weekly outreach sessions and monthly on-site testing.

D. PLANS

Continue to conduct community health education events every 1 to 2 months.
Continue to work with peer outreach assistants on community activities and to gather qualitative process data on their experiences.
 
Continue to partner with agencies such as UHPP, Healthcare Consortium, and the AIDS Council to bring services related to reproductive and sexual health to underserved women in the focus community.
 
Continue to collect and analyze data for presentations and publication.


E. PUBLICATIONS AND PRESENTATIONS

Golden, A. G., & Pomerantz, A. (2011). Intermediate and behavioral health outcomes of community education events: Evidence from interventions to increase reproductive healthcare seeking among small town, low income African American women. Session presentation at the APHA Annual Meeting, Washington, DC, November.

Golden, A. G., Pomerantz, A., & Scott, M. (2011). Becoming part of the environment of the underserved: An ecologically informed intervention to increase reproductive healthcare seeking among low income African American women. Session presentation at the National Conference on Health Communication, Marketing, and Media of the CDC, Atlanta, August.

Golden, A. G., & Pomerantz, A. (2011). Communicating in time: Temporal dimensions of community health promotion. Competitive poster presented at the D.C. Health Communication Conference, Fairfax, VA, April.

Curry, R., Golden, A. G., & Pluviose, C. (2011). Do you have “C.L.A.S.”? Workshop presentation at the National Lesbian, Gay, Bisexual & Transgender People of Color Health Summit, Albany, NY, October.


F. Project-generated resources

·     Project website www.albany.edu/womenshealthproject (established 2009 and updated before and after each event).


Project 2: Environmental contaminants and reproductive health of Akwesasne Mohawk women.Schell, LM (PI)

A.    SPECIFIC AIMS

The specific aims of the study are unchanged from original application. They are summarizedhere:

1.    Aim 1 is to determine the relationship between the body burden of PCB congeners and specific measures of reproductive function in females, specifically: a) pituitary function as indexed by gonadotropin levels, b) gonadal function as indexed by estradiol (E2) and progesterone (P) levels, and c) other characteristics of the menstrual cycle as reported through diary and questionnaire.

2.    Aim 2 is to determine the relationship between lead levels and measures of reproductive function as described in Aim 1 above.

3.    Aim 3 is to determine whether there are moderating factors (includes susceptibility factors) that influence effects of PCBs and lead on measures of reproductive functioning.

B.    STUDIES AND RESULTS

During the third grant year, continued time and effort was focused on maintaining a high level of effort in recruitment of potential participants, and data collection. In concert with this effort we concentrated on:

1.    The hire of an additional woman to facilitate data collection and conduct interviews. A community member that is invested in the well-being of the people of Akwesasne, she helps the Project staff on all participant visits with anthropometric measurements and blood draws.

2.    Re-training the Project staff in data collection techniques including conducting interviews, phlebotomy (for certification) and anthropometry, research ethics, and other data collection methods.

3.    Development of the database has been completed, and data entry and checking is ongoing.

4.    Our recruitment has expanded to women who seek care from the Canadian Health Service, with permission and approval by the University at Albany IRB, the Canadian Health Services Director, and the SRMHS Director. Our pool of potential participants has increased.

5.    Recruitment to date:

a.    As of 9/30/2011, a total of 641 women have been approached. Of these, 188 were eligible, 453 were ineligible (on birth control, pregnant, nursing, on thyroid medications, or outside age range).

b.    128 women have signed informed consent forms. Of these 128, 27 withdrew before completing project requirements (either became pregnant, decided to go on birth control, or were unable to be reached to schedule appointments), 82 have completed all requirements of the study, 7 have yet to finish their saliva collection, and 12 are waiting for their next menstrual cycle to begin.

c.    As of 9/30/2011, there is one potential participant who is waiting to meet the eligibility criteria (Completed time post-nursing, post-birth control, post-pregnancy).

6.    Results as of 09/30/2011:

a.    Toxicant levels:

                                            i.    Of the 102 whole blood serums delivered to the Exposure Assessment Laboratory, final toxicant levels on 41 have been received (includes redraws).

b.    Clinical chemistries:

                                            i.    Of the 109 bloods delivered to LabCorps Inc. for analysis of the clinical chemistries, results on all 109 individuals have been received.

c.    Salivary estradiol and progesterone levels:

                                            i.    Saliva collected over the course of one menstrual cycle on 86 women has been delivered to the Neurobehavioral Laboratory. Preliminary results on 82 women have been completed.

C.   SIGNIFICANCE

Scientific significance cannot be assessed until more results are obtained, and this cannot occur until data collection is complete for more participants. The immediate and non-scientific significance is that the work to date shows that there is substantial interest in the research by the community, good participation from those women who are eligible, and that the protocol for data collection and laboratory analyses is workable. It also shows that the partnership between the Akwesasne Mohawk Nation and the University at Albany is on solid footing.

D.   PLANS 

Our plans for the near future are as follows:

1.    Continue recruiting participants. We estimate an average of three to four participants a month.

2.    Continue data collection and data entry; start preliminary analyses.

3.    Continue meeting with the SRMHS director to discuss the project and future directions.

4.    Conduct a CKON Radio (local station) interview with the PI (Schell) which will be broadcast in both English and Mohawk (translated) to discuss the project.

5.    Present results to the health providers and the project participants. 

E.    PUBLICATIONS AND PRESENTATIONS

1.    Gallo MV, Schell LM, DeCaprio AP, Jacobs, A. Levels of persistent organic pollutant and their predictors among young adults. Chemosphere. 2011 May; 83(10):1374-82.
2.    Behforooz B, Brooke GC, Fan W, Lee JE, Newman J, Gallo MV, Schell, LM, Akwesasne Task Force on the Environment. The Influence of Breastfeeding on the Cognitive Functioning of Children Raised in an Environment Polluted with PCBs (Poster).  Presented at Society for Research in Child Development, Montreal, Canada in March-April 2011. 
3.    Burnitz KK, Schell LM, Gallo MV.  The impact of early exposure to PCBs and p,p’-DDE on adult BMI in the Akwesasne Mohawk (Poster) Presented at the 2011 Human Biology Association, Minneapolis, Minnesota, April 2011. 
4.    Karsten JK, Schell LM, Gallo MV.  The impact of toxicants and maternal cigarette use on sex steroid levels in pre-menarcheal Mohawk females (Poster). Presented at the 2011 Human Biology Association, Minneapolis, Minnesota, April 2011. 
5.    Nelder KR, Schell LM, Gallo MV. Persistent organic pollutants and testosterone levels in a male adolescent Native American sample (Poster). Presented at the 2011 Human Biology Association, Minneapolis, Minnesota, April 2011. 
6.    Schell LM, Gallo MV, Ravenscroft J, Nelder KR , Burnitz KK. Toxic foods: What shouldn’t be for dinner? (Podium Presentation). Presented at the 2011 Human Biology Association, Minneapolis, Minnesota, April 2011.

F.    PROJECT-GENERATED RESOURCES None to date.


Project 3: Decomposing Racial/Ethnic Disparities in Health (Lahiri, K.; Chatterji, P. - PIs)

A. SPECIFIC AIMS (unmodified from original)

1. Estimate and compare quality of health by racial/ethnic group; by state; by community size; and to examine trends over time in quality of health.
2. Estimate within-group total and income-related health inequalities and their decomposition
3. Decompose between-group health inequalities into their determinants with special emphasis on the role of community size.

B. STUDIES AND RESULTS

The project team continues to meet monthly as a large group, as well as weekly in smaller groups that are convened to discuss particular tasks and papers. We have complete drafts of the following three papers.

(1) Beware of being unaware: racial/ethnic disparities in awareness of chronic disease (Specific Aims 1 and 2) estimates racial/ethnic disparities in individuals’ awareness of chronic disease using biomarker data from the 2006 Health and Retirement Study.  We focus on racial/ethnic differences in disease awareness since these differences may be a critical factor underlying disparities in treatment and adequate control of disease. The findings suggest that African-Americans are more likely than non-Latino whites to have hypertension, but we find no statistically significant differences in awareness of hypertension between African-Americans and non-Latino whites. All minority groups are more likely than non-Latino whites to have diabetes but, among those with diabetes, African-Americans and Latinos are less likely to be aware of their condition compared to non-Latino whites.

(2) Child health inequality and its dynamics through adolescence (Specific Aim 3) applies innovative methods from econometrics to estimate racial/ethnic disparities in child health in U.S., and examine how disparities change as children enter adolescence. Data come from the Panel Study on Income Dynamics – Child Development Supplement.  The results indicate parental education and employment are important factors underlying income-related health inequality among children in the US. Especially for African-American children, effective policies to reduce disparities would include policies that target family structure and mother’s education and employment.  Living in a large metropolitan area (1 million+ population) in the US is associated with higher levels of child health after controlling for other factors.  Urban residence is an important factor in the decomposition of child health inequality both across and within racial/ethnic groups.

(3) Early health conditions and disparities in academic achievement , uses data from the Child Development (CDS) and the Transition into Adulthood (TA) Supplements of the Panel Study of Income Dynamics (PSID) to examine the role of health at birth and in early childhood as a contributor to racial disparities in academic achievement and educational attainment later in life. Our preliminary findings show that poor health at birth and in childhood indeed is more prevalent among African-American children compared to non-Latino white children.  However, the negative effects of poor health on academic outcomes appear to be concentrated among non-Latino white children, and the effects of poor health at birth on academic outcomes are small in magnitude.  As a result, early health is not an important contributor to racial differences in test scores or educational attainment.  Racial differences in educational attainment, in fact, are fully accounted for by racial differences in maternal SES at the time of the child’s birth.

All three papers were presented at the American Society of Health Economists (ASHE) biennial conference in July 2010.  The third paper was part of a session our group organized on this topic.  In addition, the second paper was accepted for and presented at a selective meeting on health and SES research hosted by the Panel Study on Income Dynamics in Ann Arbor, MI in September 2010.

Project staff had training opportunities, including taking on-line courses in STATA and attending a selective Summer Institute on Health and Aging held at RAND in July, 2010.

C. SIGNIFICANCE

The completion of these analyses, particularly the analyses associated with Specific Aim 3, will provide unique data on the magnitude and persistence of health disparities along an urban-rural continuum. These results will identify health disparities that may be especially important to address in the smaller cities and towns comparable to the communities in which the Center is developing its intervention research.

D. PLANS

In the next year, we will work to obtain community level data which can be merged to individual records in these large secondary data sets.  This will allow us to examine effects of community size and community attributes at a more disaggregated level.

E. PRESENTATIONS AND PUBLICATIONS

Chatterji P, Heesoo J, Lahiri K. Beware of Being Unaware: Disparities in the Awareness of Major Chronic Illnesses. American Society of Health Economists, 3rd Biennial Conference, Ithaca, NY, June 2010.
Chatterji P, Lahiri K, Song J. Child health disparity analysis and income gradient: evidence from PSID-CDS Data. American Society of Health Economists, 3rd Biennial Conference, Ithaca, NY, June 2010.
Chatterji P, Lahiri K. Early Health Conditions and Racial Disparities in Academic Achievement. American Society of Health Economists, 3rd Biennial Conference, Ithaca, NY, June 2010.
Chatterji P, Lahiri K, Song J. Child health disparity analysis and income gradient: evidence from PSID-CDS Data. Panel Study on Income Dynamics Conference: Research on Connections between Health and Socioeconomic Status Using PSID Data. Ann Arbor, MI, September 2010.
Chatterji P, Joo H, Lahiri K. Beware of being unaware: Racial/ethnic disparities in awareness of chronic disease, National Bureau of Economic Research (NBER) working paper, 2010.
Lahiri K, Pulungan Z. Health inequality and its determinants in New York. Journal of Human Capital. Submitted for publication, 2010.

F.  PROJECT-GENERATED RESOURCES

None.

Research Training/Education Core (Miller, RM – PI)

SPECIFIC AIMS

The specific aims of the Research Training and Education Core (RTEC) have not been modified.

STUDIES AND RESULTS During the fall 2011 semester the Honors College and the EOP programs were offered research learning opportunities through presentations offered by CEMHD researchers engaged in research efforts, and opportunities for learning to conduct responsible research. The RTEC scheduled statistical consultative support for graduate students and faculty. The statistical support and discussion groups were scheduled in 16 thirty minute blocks.  In the last academic year, 294 different appointments were scheduled and filled. This represents 79 unduplicated users of the consultation services. The consultations are held on the downtown campus of the graduate and professional schools.  This service is available to the entire University community.  We have continued this service during this academic year.  

During the spring 2011 term a research consultant provided research training support for untenured faculty preparing a journal publication. This effort resulted in a publication. The title is listed in section E of this report.  

During the fall 2011 semester the research core co-director (Miller) offered two presentations to the students of the Honors College and the EOP program. Twenty-two students of the Honors College and 45 students of the EOP program attended. During the presentations, I described my role of the Core Director, the intention and goals of the Research Training/Educational Core, the current research programs that may be soliciting student participation, and presented an opportunity for participation in a community event featuring one of the funded R01 research projects. I also provided a basic orientation to ethical and responsible research.  A question and answer period followed the presentation and a contact sheet email contact sheet was developed to maintain communication with the interested students.

A formally approved Certificate of Health Disparities program was marketed through various colloquia and discussion groups. Two students have completed the requirements for the Certificate program in Health Disparities. At this writing we are still recruiting for the program.  Several other students have expressed interest in and plan to make application for admission to the Certificate Program.  

In the spring 2011 semester, “A Seminar on Ethics and Responsible Research” was conducted by Dr. Dan Thompson, M.D., M.A., FACP, and FCCM.  In addition, relationships were established with ethicists concerned with conducting responsible research from Albany College of Pharmacy.  At this writing, we are scheduling a presentation featuring personnel from their Institutional Review Board.   In the spring 2011 semester, “Considering Race and Racism in Health Disparities: Empirical and Theoretical Perspectives” was presented by Dr. Alex Pieterse, a counseling psychologist who is in the School of Education. His research focuses on the intersection of racism and health.  

On November 7th and 8th, 2011 a conference “Health Disparities in Sexual Minorities along the Life Cycle: A Beginning Community Discussion” took place.  Speakers presented empirical data and participate in strategy development for framing potential points of intervention to reverse the common health disparities experienced by this population.  The conference will feature seven paper presentations and breakout sessions for population-specific questions.  There were also two roundtable breakfast meetings.  In one, the speakers, many of whom are principal investigators on R01 NIH grants, discussed with undergraduate and graduate students how they (MDs, PhD nurses, counseling and clinical psychologists) frame their programs of research to include minority health and health disparities. The second round table breakfast meeting is designed to support beginning researchers who are pursuing federal funding. The plan is for the researchers seeking funding to describe their current efforts and to receive feedback from the presenters.  

The RTEC administers a program of small grant support with funds from the university’s Vice President for Research. The goal is to facilitate the development of research projects to the level that investigators and projects are appropriate for external funding.

One award of $6,500 was made in 2011 for a study, “Enablers and Barriers to Obtaining and Maintaining Health Care for Youth who have Transitioned from the Foster Care System.”  

C. SIGNIFICANCE

The activities of the RTEC have provided increased visibility to the CEMHD. The efforts of the Core continue to stimulate interest in health disparities and minority health in both the undergraduate, graduate student and faculty populations. As program planning continues and is implemented, further interest in minority health and health disparities will be cultivated in the university community and among untenured faculty.

D.  PLANS     

Specific activities planned by the RTEC for Year 4 are to do: 
1.    Schedule two seminars that provide training in conducting responsible research that does not replicate existing training. 
2.    Schedule two peer review opportunities to new research associates who are submitting proposals or manuscripts for publication in peer reviewed journals. 
3.    Conduct three information seminars for undergraduate students to cultivate interest in minority health and health disparities. 
4.    Follow up on the application process for the health disparities certificate program and cultivate additional interest among graduate students to pursue the certificate. 
5.    Continue providing statistical consultative support to the research associates and other interested members of the University at Albany community.

E. PUBLICATIONS

Austin, S. & Claiborne, N. (2011). Faith Well Collaborative: A community based approach to addressing Type II Diabetes disparities in an African American Community. Social Work in Health Care. 50(360-375).  

F. PROJECT-GENERATED RESOURCES None  

Community Outreach/Engagement Core   (Alvarado-Little, W.M. – PI) A.

SPECIFIC AIMS

Aim 1: To develop and disseminate general and Center-specific health information. 
Aim 2: To encourage and equip the community for participation and partnership in research studies and interventions 
Aim 3: To empower the communities with responsibility and ownership of addressing health disparities

B.    STUDIES AND RESULTS

As in Year 2, the Outreach Committee continues to partner with health care organizations, community organizations and individuals to maintain a robust network of supporters who provide health-related support services to minority communities.

The Outreach Committee continues to engage the community via presentations and the coordination and hosting of community events to disseminate general and Center-specific health information:

·         Cultural Perspectives of Health, Disability and Wellness. Russell Sage College School of Health Sciences  Health Science Program, Troy, NY., March 2011
·         Minority Health Disparities, Health Access and Outcomes. Capital Area School Development Association (CASDA), Hudson, NY.   March 2011
·         Language Access Resources in the Health Care Community. Russell Sage College School of Health Sciences  Health Science Program, Troy, NY, April 2011
·         Emergency Preparedness and Mental Health and the Impact of Cultural and Linguistic barriers. National Council on Interpreting in Health Care, New Orleans, LA   May 2011  Addressing Health Disparities- Justice Works: A Conference for Progressive New York  Citizens in Action,  Albany,  NY.  June 2011
·         New York State Office of Mental Health Town Hall Meeting:  Addressing  Mental Health  Disparities  Albany, NY July 2011
·         The Legacy of Women’s Lives-Trauma, Abuse and Violence: Health Impact and Strategies for Healing in the  Community.  The Women’s Building Albany, NY  September  2011 
·         Webinar:  Interpreters: Why Language and Culture Matters in Behavioral Health Sciences  New York State Office of Mental Health, Bureau of Cultural Competency Albany, NY September 2011
. ·         Healthy Choices/Healthy Outcomes. 4th Annual Latino Youth Conference Capital District YMCA, Albany, NY October 2011

In Year 2, the Outreach Core resolved organizational issues involving the roles of the Outreach Core co-director and Albany Minority Health Task Force Community Liaison. While Greg Owens, LMSW remains Outreach Core Co-director, Kelvin Sapp was not retained as the Albany Community Liaison. Filling the vacancy of Albany Minority Health Task Force Liaison was easily remedied by including Mr. Owens in this role in addition to his role as co-director. His analytical community building skills, expertise and knowledge have resulted in newly formed partnerships within the African-American community in Albany. The community liaison for Amsterdam, NY, Nilda Giraldi, remains with the Outreach Core as an independent consultant with relationship building skills and sophisticated knowledge of the needs of the Latino community. The Outreach Core task force groups continue to serve as a communication bridge between the community and the University.   The Task Force groups have not changed since Year 1.

C.   SIGNIFICANCE

Upon review and reflection of the work conducted during Year 1 and 2, and with feedback provided by the Albany and Amsterdam communities, the Outreach Core focused on concerns involving youth and adolescents. With newly formed partnerships, the Outreach Core has been able to partner with local K-12 organizations to create an awareness of the issues involving health disparities within the youth of the Capital District area. Albany Education, Awareness and Empowerment

·         Albany High School Mentoring Program Presentation- A presentation on Minority Health Disparities was given to the Albany High School (AHS) Mentoring Program, which is  sponsored by AHS and the Capital Region Chapter of the National Black Child Development Institute. The group that the Core presented to consisted of mentees, their mentors, program support staff, and some parents.  Evaluations indicated that the presentation was well received and follow up sessions were requested.  January  2011

·         Albany High School Health Education Day – The Outreach Co-directors presented to four Health classrooms (grades 10-12) at Albany HS as part of their Black History Month celebration.  February  2011

·         Siena College /Macedonia Baptist Church Urban Scholars Mentoring Program-Outreach Core Co-directors presented to the students and staff of the Siena College/Macedonia Baptist Church Urban Scholars Mentoring Program with an invitation to return to do another presentation.  The program has provided mentoring and tutoring services for youth from local elementary schools in Albany for more than 7 years.   February 2011

·         Take Your Child to School Day – Approximately 13 schools are involved throughout the Capital District to support the role of fathers or father figures.

The Outreach Committee presented on health disparities and assisted in collecting materials on prevention from the NYS Department of Health for distribution to the participants.

September 2011 Amsterdam Minority Health Task Force (AMHTF) Adolescent Health Project The Latino community members of Amsterdam identified an increase in adolescent sexual activity resulting in an increased pregnancy rate for females as young as 12 years old. In response, the AMHTF members developed a series of workshops aimed at females within the Latino community to build a trusting and nonjudgmental environment among them.

The first of the series “Moms on a Mission” was aimed at females and their partners no longer enrolled in school due to pregnancy and who encountered challenges such as a lack of adequate health care for themselves and their infant. The AMHTF identified academic, not- for-profit and state agencies which provided resources on health and education, reproductive health care options, in addition to mental and primary health services and peer and family support. 

To date, participants have enrolled in CNA programs and GED classes in response to information presented during the first workshop. Evaluations have included requests by the participants to address issues such as domestic violence, education, adolescent health, mental health and healthy financial practices.

Feedback for all four workshops has been reviewed by the AMHTF to determine future topics and to identify steps needed to conduct focus groups for research purposes.

D.   PLANS

·         Continue to clarify healthcare concerns within African American and the Latino communities. 
·         Continue to clarify needs for health education information among various age groups.
·         Continue to involve CEMHD researchers in task force meetings with the community.
·         Continue to ensure target community collaboration with Research Core studies by developing a process for community participation in research design, data collection, data analysis and results proliferation strategies; and to partner with the Mentoring, Training and Education Core to encourage faculty to develop research prioritized by minority communities.

E.    PUBLICATIONS None

F.    PROJECT-GENERATED RESOURCES None

 Progress Report Center of Excellence 2010

Administrative  | Research  | Research Training Education Community Outreach/Engagement

2010 Administrative Core - Lawrence M. Schell (PI)

A. SPECIFIC AIMS
The specific aims of the Administative Core have not been modified.

B. STUDIES AND RESULTS 
In the second year the Administrative Core sought to improve on the administrative organization of the center, update the website, replace two losses on our Program Executive Committee (PEC), and expand the Program Advisory Committee (PAC) which is the center’s external advisory committee.

To improve on the administrative organization, in the late winter of 2010 the center hired a person for special projects and a webmaster. Unfortunately, the person filling the combined position resigned for health reasons after a short period.  A replacement was made at the end of the summer and orientation and training has occurred.

The Center held Program Executive Committee meetings involving community partners (core co-directors) and university co-directors on a bi-monthly basis.

During 2010 the university adopted a new system of content management for the web.  We have converted our site into the new content management system and begun training our manager of special projects in the new system. When trained, the center will be able to maintain its own website (http://www.albany.edu/cemhd/ ).    

In the spring a member of the Program Executive Committee, Mr. James Sinkoff, suddenly left his position with one of our community partners, The Whitney M. Young, Jr., Health Center, and left our Executive Board and his co-directorship of the research training core.  We have replaced him with Dr. Kallanna Manjunath, the medical director of the health center that Mr. Sinkoff vacated.  (See the report of the Research Training Core.)  Additionally, Dr. Kevin Jobin-Davis, director the Health Capital District Initiative, a community organization and early partner of the Center, resigned from our PEC.  He had served as co-director of the Community Engagement and Outreach Core. We have replaced Dr. Jobin-Davis with Mr. Greg Owens as the new co-director of the Community Engagement and Outreach Core. (See the report of the Community Engagement and Outreach Core.)

The PEC has considered the composition of our Program Advisory Committee. One member, Michelle Van Ryn has not been able to participate and asked to be relieved of her position. We invited two new persons to join the PAC.  We are pleased to report that Dr. Chasan-Taber of the School of Public Health, University of Massachusetts at Amherst has accepted.  Additionally, Dr. Chapa is considering our invitation while also dealing with permissions from her institution to allow her to serve.  Our year two PAC meeting is scheduled for October 22th, 2010. This meeting will contribute to several aims including the provision of leadership and to the annual review of progress and plans.

The Center’s liaison with the university administration has resulted with a concrete plan for space dedicated to the Center.  The space will be on the academic podium which is highly visible and highly accessible, reflecting the university’s appreciation of the role of the center in university and community life.  Architectural plans for offices have been drafted and work should be completed in the fall of 2011.   

The Vice President for Research has reaffirmed the commitments of the university to the Center.  All funds promised by the university to the Center as per the application now have been transferred to the Center’s accounts.

The Administrative Core now provides monthly reports of expenditures to all core directors, and has made training in budget monitoring available to all core directors. 
On October 1st, the Center’s PI made a presentation to the New York Department of Health’s Council on Minority Health. The presentation described the center’s mission, activities and organization to committee members. 
The Center seeks to expand its reach by collaborating more formally with other SUNY campus’ by taking the model developed by our center and apply it to other campuses in other small towns. The Center can support nascent efforts on smaller campuses, and connect researcher expertise with more local communities where health disparities exist.  In the spring of 2010 the Center hosted a one day meeting of researchers from the Albany campus and other SUNY campuses (Potsdam, Cortland, Cobleskill, and New Paltz) to bring researchers together. Enthusiasm for this network was substantial and the Center conducted a two day workshop in the early October that is described in the Research Training Core report. 
C. SIGNIFICANCE
The activities of the Administrative Core have maintained the Center with its constituent bodies (PAC and PEC) through a period of significant change in personnel, showing that it can adapt to challenges and maintain its focus.  The Core has maintained its oversight and leadership roles vis-à-vis the center’s activities.  The Core also has enlarged the scope of the center by engaging complementary activities on other SUNY campuses in the region.

D. PLANS (Specific activities planned by the Administrative Core for Year 3):
1. Manage the Center budget, review allocation of funds, and decide, with the PAC and the PEC, on changes to allocations if needed;
2. Monitor activities of the other cores to ensure goals are being met and reports are filed; 
3. Make annual the report to the sponsor;
4. Facilitate interaction and coordination among cores;
5. Serve as a point of contact with the public media, media offices of the sponsor, host institutions and organizations;
6. Revise our website and maintain it for information dissemination; 
7. Schedule meetings of the Program Executive Committee every other month, and the PAC once in year 3; 
8. To maintain official status as a University at Albany research center;
9. Expand our Program Advisory Committee by one member; 
10. Develop the center as a hub for similar activities are smaller campuses in the state university system located throughout upstate NY in partnership with local, community groups concerned with health.

E. PUBLICATIONS 
None

F. PROJECT-GENERATED RESOURCES
None to date.

  
2010 Research Core - David Strogatz (PI), Jose Rossy-Millan (Co-Director)

A. SPECIFIC AIMS (unmodified from original)

1. To support the implementation of the proposed research projects
2. To support the development of additional applications for funding of studies that will address health disparities in small cities and towns and that are planned and conducted through collaboration between university-based and community-based partners
3. To provide expertise on statistical issues in designing and conducting studies, analyzing the data and interpreting and presenting the results
4. To increase interactions and exchanges across units of the University at Albany and between university-based and community-based groups to discuss the significance of health disparities and to identify new opportunities for multidisciplinary collaboration in research to understand and reduce health disparities

B. STUDIES AND RESULTS

 To support the first Specific Aim, the Research Core has convened meetings of the Principal Investigators for each project with the Core Co-Directors and the Core Biostatistician. The Research Core meetings have an established framework for the agenda – a review of accomplishments since the last meeting, a discussion of any problems that arose during that time period in accomplishing project goals, a summary of goals to be achieved by the time of the next Research Core meeting, and recommendations for strategies to address problems that are still unresolved or looming on the horizon. For example, the presentation by Project 3 investigators of analyses using data from the Health and Retirement Study and the Child Development Supplement of the Panel Study of Income Dynamics led to suggestions for how the analyses of disparities by race and socioeconomic status might be expanded with additional variables to examine disparities along a more complete urban-rural continuum. There has been general consensus for a quarterly meeting schedule of the full group of project Principal Investigators with the Research Core Co-Directors and Biostatistician, with the option for scheduling meetings involving individual projects with Research Core staff as needed.

 The Research Core Advisory Committee lost one of its three members when Dr. Donald Hernandez left the University at Albany in the 2009-2010 academic year, and a second member of the Advisory Committee, Dr. Edward Hannan, has retired from the University in the fall of 2010. Dr. James Dias is currently the university’s interim Vice President for Research and has agreed to replace Dr. Hernandez; the Co-Directors of the Research Core will consult with the Center’s Executive Committee and the remaining members of the Research Core Advisory Committee (Drs. Dias and Lynn Videka) to identify a new member to replace Dr. Hannan by the end of 2010.

 The Research Core has also been active in support of additional projects addressing health disparities (Specific Aim 2), with a specific emphasis on disparities in small cities and towns and projects linking the university with a variety of community partners. Dr. Strogatz, the Co-Director of the Research Core, has provided technical assistance to two community partners (a network of African American churches and a non-profit organization supporting community gardens and access to healthy foods) developing an R21 application to the National Institutes of Health for the implementation and evaluation of van-based mobile farmers’ markets to serve urban church congregations in Albany and Troy, New York. As a member of the Advisory Board of the Pediatric Asthma Coalition of the Capital Region, Dr. Strogatz contributed to the evaluation design for a community-based intervention involving health care providers, pharmacists and school nurses in a coordinated effort to improve self management skills for pediatric asthma in children from low socioeconomic status households. Dr. Strogatz is also directly involved in collaborative projects with the New York State Department of Health to establish a statewide surveillance system for tracking obesity in children attending public schools and to evaluate the impact of staff training to enhance the impact of WIC services on nutrition and physical activity in children. 

 With respect to the third and fourth Specific Aims, Dr. Recai Yucel’s role as the Core Biostatistician includes providing support for statistical and methodological needs of existing projects and projects being proposed. He has continued to work with the Center’s Research Training/Education Core so that students and junior faculty from the College of Arts and Sciences and the School of Social Welfare also have access to his presentations and consultation on projects related to health disparities. In addition to supporting the work of others, Dr. Yucel has developed novel techniques for imputation strategies with incomplete data, and he has used the problem of missing data on race in the National Survey of Children with Special Health Care Needs to illustrate how imputation may lead to more valid inferences pertaining to health disparities. In support of the fourth Specific Aim, the Research Core also sponsored a visit and presentation by Dr. David Savitz of Mt. Sinai School of Medicine, who spoke about racial and ethnic variation in gestational diabetes and also met with researchers from multiple schools and colleges of the university.

C. SIGNIFICANCE

 The existing and emerging research projects of the Center continue to focus on conditions (e.g. reproductive health, breast and cervical cancer, childhood obesity and subsequent manifestations of obesity) that are major sources of health disparities and major concerns of the communities in which the projects are located. The Center’s projects include quantitative and qualitative research; studies addressing etiology and prevention of disease; the use of primary and secondary data; and disparities affecting a variety of racial and ethnic groups. This diversity is also a strength of the Center. 

D. PLANS

 During the next year of funding, the Research Core will continue its support of the Center’s main research projects and new projects through regular meetings with the project Principal Investigators, through advisement from the newly comprised membership of the Core Advisory Committee, and through collaboration with the other Cores of the Center on activities to foster skills and interest for research on health disparities.  
Research Core Publications

E. PUBLICATIONS

Yucel RM. Imputation of Categorical Variables Using Gaussian-based Routines. Statistics in Medicine, Submitted for publication, 2010.

F. PROJECT-GENERATED RESOURCES

None

Research Project 1:  Overcoming Barriers to African Amerian Women's Reproductive Healthcare Seeking

Research Project 2:  Environmental Contaminants and Reproductive Health of Akwesasne Mohawk Women

Research Project 3:  Decomposing Racial/Ethnic Disparities in Health

 

2010 Research Training/Education Core  - Robert Miller (PI), Dr. Kallanna Manjunath (Co-Director)

A.  SPECIFIC AIMS
The specific aims of the Research Training and Edcuation Core (RTEC) have not been modified.

B.  STUDIES AND RESULTS

During the Spring 2010 semester The Honors College and The EOP program was invited to participate in research learning opportunities. They were specifically invited to presentations offered by CEMHD researchers engaged in research efforts, as well as opportunity for learning to conduct responsible research. 
The RTEC developed a schedule of statistical consultative support for graduate students and untenured faculty.  Currently, the statistical support and discussion groups happen during an eight hour block of time.  The appointments were in 30 minute increments.  In the last academic year, 256 different appointments were scheduled and filled. This represents 98 unduplicated users of the consultation services. The consultations are held on the downtown campus of the graduate and professional schools.  This service is available to the entire University community.  We have continued this service during this academic year.

During the Spring 2010 term a research consultant was hired to help provide research training support for untenured faculty preparing a grant application.  The application is being submitted this Fall.

The RTEC sponsored a Brown Bag presentation entitled: The disproportionality of youth of color in the foster care and juvenile justice systems.  The presentation was offered by Mr. Greg Owens, Director of Special Projects Office of Strategic Planning & Policy Development NYS Office of Children & Family Services.  18 people attended the presentation. 

During the Fall 2010 semester two presentations were offered the students of the Honors College and the EOP program. Twenty-two students of the Honors College attended the presentation and 45 students of the EOP program attended the presentation.  During the presentations, I described my role of the Core Director, the intention goals of the Research Training/Educational Core, the current research programs that may be soliciting student participation, and presented an opportunity for participation in a community event featuring one of the funded R01 research projects.  A question and answer period followed the presentation and a contact sheet email contact sheet was developed to maintain communication with the interested students.

During the Fall 2010 semester both programs were invited to participate in research learning opportunities. They were invited to the Fall Conference on SUNY projects working on health disparities that was sponsored by the CEMHD.  The Plenary speaker for the first day of the conference was Dr. Garth Graham, Deputy Assistant Secretary for Minority Health. He shared a lunch with twenty students who are interested in minority health and health disparities, answering their questions and increasing their interest.  The second day of the conference included a keynote talk by Wilma Waithe, the director of the Office of Minority Health for the NYS Department of Health.

In a previous iteration of the Center, a Certificate of Health Disparities was developed and approved by the University at Albany and the Chancellor of the SUNY system.  Efforts to market the Certificate program are being developed through various colloquia and discussion groups.  Several students have expressed interest in and plan to make application for admission to the Certificate Program.

The Certificate program in Health Disparities has admitted its first student in the Fall 2010 term.  There are two more students in the application process. 

Planning efforts are underway with the Assistant Vice President for Research, who is the director of the Office of Regulatory Research Compliance and the Research Compliance Officer to develop a program offering a series of workshops on conducting responsible research for New Research Associates of the Center as well as other members of the University community.  Because our University requires all researchers who conducted research with human subjects, to go through responsible research training as well as complete CITI training, we are with working the Office of Regulatory Research Compliance to develop a seminar that is not redundant with the existing training opportunities.  
There was a change to the personnel of the Research Training and Education Core leadership. Mr. Jim Sinkoff resigned his position of Co-Chair of the Core.  Dr. Kallanna Manjunath, the Chief Medical Officer of the Whitney M. Young, Jr. Health Center has accepted this position.  Dr. Manjunath, who in addition to his duties as CMO, is also one of Whitney Young's staff pediatricians, completed his medical training at Bangalore Medical College, Bangalore, India, and was trained in pediatrics at Blackburn and Burnley Hospitals in the United Kingdom. He completed his pediatric residency training at Albany Medical College, Albany, NY, where he served as Chief Resident from 1986 to 1988. After completing the residency training program, Dr. Manjunath worked as a staff pediatrician at Albany Medical Center. In 1991, he joined St. Peter's Hospital Ambulatory Care Network as a staff pediatrician and seven years later assumed the role of the Medical Director for the network. In 2002, Dr. Manjunath joined the Whitney Young staff in the positions he currently holds. He is also Fellow of American Academy of Pediatrics and Diplomate of the American Board of Pediatrics.

C. SIGNIFICANCE

The activities of the RTEC have provided increased visibility to the CEMHD. The efforts of the Core continue to stimulate interest in health disparities and minority health in both the undergraduate and graduate student population. As program planning continues and is implemented, further interest in minority health and health disparities will be cultivated in the university community and untenured faculty.

D.  PLANS
Specific activities planned by the RTEC for Year 3 are to:
1. Schedule two seminars that provide training in conducting responsible research that does not replicate existing training.
2. Schedule two peer review opportunities to new research associates who are submitting proposals or manuscripts for publication in peer reviewed journals.
3. Conduct three information seminars for undergraduate students to cultivate interest in minority health and health disparities.
4. Follow up on the application process for the health disparities certificate program and cultivate additional interest among graduate students to pursue the certificate.
5. Continue providing statistical consultative support to the research associates and other interested members of the UNIVERSITY AT ALBANY community.

E. PUBLICATIONS 
None

F. PROJECT-GENERATED RESOURCES
None to date.

2010 Community Outreach/Engagement Core – Wilma Alvarado-Little (PI)

G. A. SPECIFIC AIMS
The specific aims of the study are unchanged and are as follows: 
4. To continue the development and dissemination of general and Center-specific health information.
5. To encourage and equip the community for participation and partnership in research studies and interventions 
6. To empower the communities with responsibility and ownership of addressing health disparities

H. STUDIES AND RESULTS
1. As in Year 1, the Outreach Committee members continue to partner with the three constituencies – health care organizations, community organizations and individuals –to maintain a robust network of individuals who provide direct or indirect health related support services to minority communities.   As a result of these efforts, the Outreach Core was invited to present at the following events: 
Building True Collaborations with Community Partners
American Association of Grant Professionals Mohawk-Hudson Chapter of New York State
November 2009 Latham, NY. 
Culture, Language and Health Disparities: Working with Hispanic/Latino Women and Families: Cultural Competency Part III .The Community Cradle. May 2010 Albany, NY.
Interpreting: The Missing Link in Helping to Decrease Health Care Disparities  
The 19th Annual World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians. May, 2010 Cancun, Mexico
Bridging Cultural Distance: Strategies for Working with Interpreters to Enhance Mental Health Care for Patients with Limited English Proficiency
New York State Psychiatric Institute, State Office of Mental Health Bureau of Cultural Competency 
August, 2010 Albany, NY.
Utilizing Interpreting and Translation Resources: Addressing Language Issues for the Limited English Speaking Population
New York State Department of Labor Bureau of Employment and Workforce Opportunities
September 2010 Albany, NY

A needs assessment previously conducted with the Provider Consortium reflected a need for hospitals to obtain resources on how to provide safe and effective health care services to their non-English speaking populations.  The Outreach Core organized the delivery of the following efforts through the Provider Consortium Speaker Series:

• Language Access: The Rights of Limited English Proficient (LEP) Patients    
Designed for health care providers, policy and research advocates, this presentation provided information such as HHS language access requirements of recipients of federal funding (Medicare, Medicaid) and its impact on the diverse population in smaller cities. Presenter: Mike Mule, Staff Attorney Empire Justice Center.  April 23, 2010.
• Immigrant: Access to Health Care: An Overview of NY and Advocacy Opportunities
This presentation provided good grounding on immigrants’ rights to health care and current eligibility for public insurance and financial assistance.  Presenter: Jenny Rejeski, Health Advocacy Coordinator, NY Immigration Coalition. May 10, 2010.
• Certification and Healthcare Interpreters: What does this mean for your organization? 
Local hospitals are impacted by the diverse cultural and linguistic needs of the area’s changing demographics.  This presentation provided hospital management and state agency administrators with the most update efforts regarding certification and its impact on providing quality language access resources. Presenters: Mara Youdelman, Senior Attorney, National Health Law Program and 
Grace Mose, Director, Immigrant Women’s Health Initiative, Family Planning Advocates of New York State. September 13, 2010.
2. The Outreach Core experienced organizational changes in previously identified community partners.  
a. Healthy Capital District Initiative (HCDI) stepped down during Year 2 of funding due to time management commitments.  Since this left a vacancy for a Outreach co-director and Albany Minority Health Task Force Liaison, an extensive search led by the Outreach Core and Program Executive Committee resulted in securing a co-director for the Outreach Core and Albany community liaison. Greg Owens, MSW, has a keen awareness of the health care disparities issues within the African American population, and possesses a sophisticated knowledge of the needs of the African-American community relevant to issues contributing to health disparities  as does Kelvin Sapp, MPH of the NY State Department of Health Development of Human Services will act in the capacity of Albany Minority Health Task Force community liaison.
b. Hispanic Outreach Services, Catholic Charities was eliminated due to the severe budget constraints for New York State. However, the previously identified community liaison Nilda Giraldi remains with the Outreach Core as an independent consultant who possesses the expertise serving the needs of the Latino population and is experienced in fostering collaborative relationships with the social service agencies and schools in Amsterdam, NY.

3. The Outreach Core task force groups continue to serve as a communication bridge between the community and the University.   The Task Force groups have not changed since Year 1.

I. SIGNIFICANCE 
At this time, all activities have been of benefit to the communities in creating and awareness of their patient rights to receive services that are culturally and linguistically appropriate and therefore decreasing barriers contributing to health disparities. Although quantitative data has not been collected for these projects, results collected from informal surveys have  indicated positive feedback to services, workshops and resources presented to address issues impacting the community in the areas of empowerment and self-advocacy  in order to access health services.

J. PLANS
Our plans include the continuation of the following efforts:

Community Engagement: 
o Update and clarify healthcare concerns within African American communities,
o Update and clarify healthcare concerns within Latino communities,
o Clarify community needs for health education information,

CEMHD Engagement:
o    Continue to ensure target community collaboration with Research Core studies by developing a process for community participation - through Outreach Core groups or more specifically assembled community advisory groups - in the refinement of research design, data collection, data analysis and results proliferation strategies to increase the likelihood of target community acceptance and benefit.
o Continue to partner with the Mentoring, Training and Education Core to encourage faculty to develop research prioritized by minority communities and facilitate career education opportunities for minority students promoting consideration of pursuing health careers.

K. PUBLICATIONS
None

L. PROJECT-GENERATED RESOURCES
None

 

Center of Excellence 2010

Administrative  | Research  | Research Training Education | Community Outreach/Engagement

2010 Administrative Core - Lawrence M. Schell (PI)

A. SPECIFIC AIMS
The specific aims of the Administative Core have not been modified.

B. STUDIES AND RESULTS
In the second year the Administrative Core sought to improve on the administrative organization of the center, update the website, replace two losses on our Program Executive Committee (PEC), and expand the Program Advisory Committee (PAC) which is the center’s external advisory committee.

To improve on the administrative organization, in the late winter of 2010 the center hired a person for special projects and a webmaster. Unfortunately, the person filling the combined position resigned for health reasons after a short period.  A replacement was made at the end of the summer and orientation and training has occurred.

The Center held Program Executive Committee meetings involving community partners (core co-directors) and university co-directors on a bi-monthly basis.

During 2010 the university adopted a new system of content management for the web.  We have converted our site into the new content management system and begun training our manager of special projects in the new system. When trained, the center will be able to maintain its own website (http://www.albany.edu/cemhd/ ).    

In the spring a member of the Program Executive Committee, Mr. James Sinkoff, suddenly left his position with one of our community partners, The Whitney M. Young, Jr., Health Center, and left our Executive Board and his co-directorship of the research training core.  We have replaced him with Dr. Kallanna Manjunath, the medical director of the health center that Mr. Sinkoff vacated.  (See the report of the Research Training Core.)  Additionally, Dr. Kevin Jobin-Davis, director the Health Capital District Initiative, a community organization and early partner of the Center, resigned from our PEC.  He had served as co-director of the Community Engagement and Outreach Core. We have replaced Dr. Jobin-Davis with Mr. Greg Owens as the new co-director of the Community Engagement and Outreach Core. (See the report of the Community Engagement and Outreach Core.)

The PEC has considered the composition of our Program Advisory Committee. One member, Michelle Van Ryn has not been able to participate and asked to be relieved of her position. We invited two new persons to join the PAC.  We are pleased to report that Dr. Chasan-Taber of the School of Public Health, University of Massachusetts at Amherst has accepted.  Additionally, Dr. Chapa is considering our invitation while also dealing with permissions from her institution to allow her to serve.  Our year two PAC meeting is scheduled for October 22th, 2010. This meeting will contribute to several aims including the provision of leadership and to the annual review of progress and plans.

The Center’s liaison with the university administration has resulted with a concrete plan for space dedicated to the Center.  The space will be on the academic podium which is highly visible and highly accessible, reflecting the university’s appreciation of the role of the center in university and community life.  Architectural plans for offices have been drafted and work should be completed in the fall of 2011.   

The Vice President for Research has reaffirmed the commitments of the university to the Center.  All funds promised by the university to the Center as per the application now have been transferred to the Center’s accounts.

The Administrative Core now provides monthly reports of expenditures to all core directors, and has made training in budget monitoring available to all core directors.
On October 1st, the Center’s PI made a presentation to the New York Department of Health’s Council on Minority Health. The presentation described the center’s mission, activities and organization to committee members.
The Center seeks to expand its reach by collaborating more formally with other SUNY campus’ by taking the model developed by our center and apply it to other campuses in other small towns. The Center can support nascent efforts on smaller campuses, and connect researcher expertise with more local communities where health disparities exist.  In the spring of 2010 the Center hosted a one day meeting of researchers from the Albany campus and other SUNY campuses (Potsdam, Cortland, Cobleskill, and New Paltz) to bring researchers together. Enthusiasm for this network was substantial and the Center conducted a two day workshop in the early October that is described in the Research Training Core report.
C. SIGNIFICANCE
The activities of the Administrative Core have maintained the Center with its constituent bodies (PAC and PEC) through a period of significant change in personnel, showing that it can adapt to challenges and maintain its focus.  The Core has maintained its oversight and leadership roles vis-à-vis the center’s activities.  The Core also has enlarged the scope of the center by engaging complementary activities on other SUNY campuses in the region.

D. PLANS (Specific activities planned by the Administrative Core for Year 3):
1. Manage the Center budget, review allocation of funds, and decide, with the PAC and the PEC, on changes to allocations if needed;
2. Monitor activities of the other cores to ensure goals are being met and reports are filed;
3. Make annual the report to the sponsor;
4. Facilitate interaction and coordination among cores;
5. Serve as a point of contact with the public media, media offices of the sponsor, host institutions and organizations;
6. Revise our website and maintain it for information dissemination;
7. Schedule meetings of the Program Executive Committee every other month, and the PAC once in year 3;
8. To maintain official status as a University at Albany research center;
9. Expand our Program Advisory Committee by one member;
10. Develop the center as a hub for similar activities are smaller campuses in the state university system located throughout upstate NY in partnership with local, community groups concerned with health.

E. PUBLICATIONS
None

F. PROJECT-GENERATED RESOURCES
None to date.

  
2010 Research Core - David Strogatz (PI), Jose Rossy-Millan (Co-Director)

A. SPECIFIC AIMS (unmodified from original)

1. To support the implementation of the proposed research projects
2. To support the development of additional applications for funding of studies that will address health disparities in small cities and towns and that are planned and conducted through collaboration between university-based and community-based partners
3. To provide expertise on statistical issues in designing and conducting studies, analyzing the data and interpreting and presenting the results
4. To increase interactions and exchanges across units of the University at Albany and between university-based and community-based groups to discuss the significance of health disparities and to identify new opportunities for multidisciplinary collaboration in research to understand and reduce health disparities

B. STUDIES AND RESULTS

 To support the first Specific Aim, the Research Core has convened meetings of the Principal Investigators for each project with the Core Co-Directors and the Core Biostatistician. The Research Core meetings have an established framework for the agenda – a review of accomplishments since the last meeting, a discussion of any problems that arose during that time period in accomplishing project goals, a summary of goals to be achieved by the time of the next Research Core meeting, and recommendations for strategies to address problems that are still unresolved or looming on the horizon. For example, the presentation by Project 3 investigators of analyses using data from the Health and Retirement Study and the Child Development Supplement of the Panel Study of Income Dynamics led to suggestions for how the analyses of disparities by race and socioeconomic status might be expanded with additional variables to examine disparities along a more complete urban-rural continuum. There has been general consensus for a quarterly meeting schedule of the full group of project Principal Investigators with the Research Core Co-Directors and Biostatistician, with the option for scheduling meetings involving individual projects with Research Core staff as needed.

 The Research Core Advisory Committee lost one of its three members when Dr. Donald Hernandez left the University at Albany in the 2009-2010 academic year, and a second member of the Advisory Committee, Dr. Edward Hannan, has retired from the University in the fall of 2010. Dr. James Dias is currently the university’s interim Vice President for Research and has agreed to replace Dr. Hernandez; the Co-Directors of the Research Core will consult with the Center’s Executive Committee and the remaining members of the Research Core Advisory Committee (Drs. Dias and Lynn Videka) to identify a new member to replace Dr. Hannan by the end of 2010.

 The Research Core has also been active in support of additional projects addressing health disparities (Specific Aim 2), with a specific emphasis on disparities in small cities and towns and projects linking the university with a variety of community partners. Dr. Strogatz, the Co-Director of the Research Core, has provided technical assistance to two community partners (a network of African American churches and a non-profit organization supporting community gardens and access to healthy foods) developing an R21 application to the National Institutes of Health for the implementation and evaluation of van-based mobile farmers’ markets to serve urban church congregations in Albany and Troy, New York. As a member of the Advisory Board of the Pediatric Asthma Coalition of the Capital Region, Dr. Strogatz contributed to the evaluation design for a community-based intervention involving health care providers, pharmacists and school nurses in a coordinated effort to improve self management skills for pediatric asthma in children from low socioeconomic status households. Dr. Strogatz is also directly involved in collaborative projects with the New York State Department of Health to establish a statewide surveillance system for tracking obesity in children attending public schools and to evaluate the impact of staff training to enhance the impact of WIC services on nutrition and physical activity in children. 

 With respect to the third and fourth Specific Aims, Dr. Recai Yucel’s role as the Core Biostatistician includes providing support for statistical and methodological needs of existing projects and projects being proposed. He has continued to work with the Center’s Research Training/Education Core so that students and junior faculty from the College of Arts and Sciences and the School of Social Welfare also have access to his presentations and consultation on projects related to health disparities. In addition to supporting the work of others, Dr. Yucel has developed novel techniques for imputation strategies with incomplete data, and he has used the problem of missing data on race in the National Survey of Children with Special Health Care Needs to illustrate how imputation may lead to more valid inferences pertaining to health disparities. In support of the fourth Specific Aim, the Research Core also sponsored a visit and presentation by Dr. David Savitz of Mt. Sinai School of Medicine, who spoke about racial and ethnic variation in gestational diabetes and also met with researchers from multiple schools and colleges of the university.

C. SIGNIFICANCE

 The existing and emerging research projects of the Center continue to focus on conditions (e.g. reproductive health, breast and cervical cancer, childhood obesity and subsequent manifestations of obesity) that are major sources of health disparities and major concerns of the communities in which the projects are located. The Center’s projects include quantitative and qualitative research; studies addressing etiology and prevention of disease; the use of primary and secondary data; and disparities affecting a variety of racial and ethnic groups. This diversity is also a strength of the Center. 

D. PLANS

 During the next year of funding, the Research Core will continue its support of the Center’s main research projects and new projects through regular meetings with the project Principal Investigators, through advisement from the newly comprised membership of the Core Advisory Committee, and through collaboration with the other Cores of the Center on activities to foster skills and interest for research on health disparities. 
Research Core Publications

E. PUBLICATIONS

Yucel RM. Imputation of Categorical Variables Using Gaussian-based Routines. Statistics in Medicine, Submitted for publication, 2010.

F. PROJECT-GENERATED RESOURCES

None

Research Project 1:  Overcoming Barriers to African Amerian Women's Reproductive Healthcare Seeking

Research Project 2:  Environmental Contaminants and Reproductive Health of Akwesasne Mohawk Women

Research Project 3:  Decomposing Racial/Ethnic Disparities in Health

 

2010 Research Training/Education Core  - Robert Miller (PI), Dr. Kallanna Manjunath (Co-Director)

A.  SPECIFIC AIMS
The specific aims of the Research Training and Edcuation Core (RTEC) have not been modified.

B.  STUDIES AND RESULTS

During the Spring 2010 semester The Honors College and The EOP program was invited to participate in research learning opportunities. They were specifically invited to presentations offered by CEMHD researchers engaged in research efforts, as well as opportunity for learning to conduct responsible research.
The RTEC developed a schedule of statistical consultative support for graduate students and untenured faculty.  Currently, the statistical support and discussion groups happen during an eight hour block of time.  The appointments were in 30 minute increments.  In the last academic year, 256 different appointments were scheduled and filled. This represents 98 unduplicated users of the consultation services. The consultations are held on the downtown campus of the graduate and professional schools.  This service is available to the entire University community.  We have continued this service during this academic year.

During the Spring 2010 term a research consultant was hired to help provide research training support for untenured faculty preparing a grant application.  The application is being submitted this Fall.

The RTEC sponsored a Brown Bag presentation entitled: The disproportionality of youth of color in the foster care and juvenile justice systems.  The presentation was offered by Mr. Greg Owens, Director of Special Projects Office of Strategic Planning & Policy Development NYS Office of Children & Family Services.  18 people attended the presentation. 

During the Fall 2010 semester two presentations were offered the students of the Honors College and the EOP program. Twenty-two students of the Honors College attended the presentation and 45 students of the EOP program attended the presentation.  During the presentations, I described my role of the Core Director, the intention goals of the Research Training/Educational Core, the current research programs that may be soliciting student participation, and presented an opportunity for participation in a community event featuring one of the funded R01 research projects.  A question and answer period followed the presentation and a contact sheet email contact sheet was developed to maintain communication with the interested students.

During the Fall 2010 semester both programs were invited to participate in research learning opportunities. They were invited to the Fall Conference on SUNY projects working on health disparities that was sponsored by the CEMHD.  The Plenary speaker for the first day of the conference was Dr. Garth Graham, Deputy Assistant Secretary for Minority Health. He shared a lunch with twenty students who are interested in minority health and health disparities, answering their questions and increasing their interest.  The second day of the conference included a keynote talk by Wilma Waithe, the director of the Office of Minority Health for the NYS Department of Health.

In a previous iteration of the Center, a Certificate of Health Disparities was developed and approved by the University at Albany and the Chancellor of the SUNY system.  Efforts to market the Certificate program are being developed through various colloquia and discussion groups.  Several students have expressed interest in and plan to make application for admission to the Certificate Program.

The Certificate program in Health Disparities has admitted its first student in the Fall 2010 term.  There are two more students in the application process. 

Planning efforts are underway with the Assistant Vice President for Research, who is the director of the Office of Regulatory Research Compliance and the Research Compliance Officer to develop a program offering a series of workshops on conducting responsible research for New Research Associates of the Center as well as other members of the University community.  Because our University requires all researchers who conducted research with human subjects, to go through responsible research training as well as complete CITI training, we are with working the Office of Regulatory Research Compliance to develop a seminar that is not redundant with the existing training opportunities. 
There was a change to the personnel of the Research Training and Education Core leadership. Mr. Jim Sinkoff resigned his position of Co-Chair of the Core.  Dr. Kallanna Manjunath, the Chief Medical Officer of the Whitney M. Young, Jr. Health Center has accepted this position.  Dr. Manjunath, who in addition to his duties as CMO, is also one of Whitney Young's staff pediatricians, completed his medical training at Bangalore Medical College, Bangalore, India, and was trained in pediatrics at Blackburn and Burnley Hospitals in the United Kingdom. He completed his pediatric residency training at Albany Medical College, Albany, NY, where he served as Chief Resident from 1986 to 1988. After completing the residency training program, Dr. Manjunath worked as a staff pediatrician at Albany Medical Center. In 1991, he joined St. Peter's Hospital Ambulatory Care Network as a staff pediatrician and seven years later assumed the role of the Medical Director for the network. In 2002, Dr. Manjunath joined the Whitney Young staff in the positions he currently holds. He is also Fellow of American Academy of Pediatrics and Diplomate of the American Board of Pediatrics.

C. SIGNIFICANCE

The activities of the RTEC have provided increased visibility to the CEMHD. The efforts of the Core continue to stimulate interest in health disparities and minority health in both the undergraduate and graduate student population. As program planning continues and is implemented, further interest in minority health and health disparities will be cultivated in the university community and untenured faculty.

D.  PLANS
Specific activities planned by the RTEC for Year 3 are to:
1. Schedule two seminars that provide training in conducting responsible research that does not replicate existing training.
2. Schedule two peer review opportunities to new research associates who are submitting proposals or manuscripts for publication in peer reviewed journals.
3. Conduct three information seminars for undergraduate students to cultivate interest in minority health and health disparities.
4. Follow up on the application process for the health disparities certificate program and cultivate additional interest among graduate students to pursue the certificate.
5. Continue providing statistical consultative support to the research associates and other interested members of the UNIVERSITY AT ALBANY community.

E. PUBLICATIONS
None

F. PROJECT-GENERATED RESOURCES
None to date.

 

2010 Community Outreach/Engagement Core – Wilma Alvarado-Little (PI)

G. A. SPECIFIC AIMS
The specific aims of the study are unchanged and are as follows:
4. To continue the development and dissemination of general and Center-specific health information.
5. To encourage and equip the community for participation and partnership in research studies and interventions
6. To empower the communities with responsibility and ownership of addressing health disparities

H. STUDIES AND RESULTS
1. As in Year 1, the Outreach Committee members continue to partner with the three constituencies – health care organizations, community organizations and individuals –to maintain a robust network of individuals who provide direct or indirect health related support services to minority communities.   As a result of these efforts, the Outreach Core was invited to present at the following events:
Building True Collaborations with Community Partners
American Association of Grant Professionals Mohawk-Hudson Chapter of New York State
November 2009 Latham, NY.
Culture, Language and Health Disparities: Working with Hispanic/Latino Women and Families: Cultural Competency Part III .The Community Cradle. May 2010 Albany, NY.
Interpreting: The Missing Link in Helping to Decrease Health Care Disparities 
The 19th Annual World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians. May, 2010 Cancun, Mexico
Bridging Cultural Distance: Strategies for Working with Interpreters to Enhance Mental Health Care for Patients with Limited English Proficiency
New York State Psychiatric Institute, State Office of Mental Health Bureau of Cultural Competency
August, 2010 Albany, NY.
Utilizing Interpreting and Translation Resources: Addressing Language Issues for the Limited English Speaking Population
New York State Department of Labor Bureau of Employment and Workforce Opportunities
September 2010 Albany, NY

A needs assessment previously conducted with the Provider Consortium reflected a need for hospitals to obtain resources on how to provide safe and effective health care services to their non-English speaking populations.  The Outreach Core organized the delivery of the following efforts through the Provider Consortium Speaker Series:

• Language Access: The Rights of Limited English Proficient (LEP) Patients   
Designed for health care providers, policy and research advocates, this presentation provided information such as HHS language access requirements of recipients of federal funding (Medicare, Medicaid) and its impact on the diverse population in smaller cities. Presenter: Mike Mule, Staff Attorney Empire Justice Center.  April 23, 2010.
• Immigrant: Access to Health Care: An Overview of NY and Advocacy Opportunities
This presentation provided good grounding on immigrants’ rights to health care and current eligibility for public insurance and financial assistance.  Presenter: Jenny Rejeski, Health Advocacy Coordinator, NY Immigration Coalition. May 10, 2010.
• Certification and Healthcare Interpreters: What does this mean for your organization?
Local hospitals are impacted by the diverse cultural and linguistic needs of the area’s changing demographics.  This presentation provided hospital management and state agency administrators with the most update efforts regarding certification and its impact on providing quality language access resources. Presenters: Mara Youdelman, Senior Attorney, National Health Law Program and
Grace Mose, Director, Immigrant Women’s Health Initiative, Family Planning Advocates of New York State. September 13, 2010.
2. The Outreach Core experienced organizational changes in previously identified community partners. 
a. Healthy Capital District Initiative (HCDI) stepped down during Year 2 of funding due to time management commitments.  Since this left a vacancy for a Outreach co-director and Albany Minority Health Task Force Liaison, an extensive search led by the Outreach Core and Program Executive Committee resulted in securing a co-director for the Outreach Core and Albany community liaison. Greg Owens, MSW, has a keen awareness of the health care disparities issues within the African American population, and possesses a sophisticated knowledge of the needs of the African-American community relevant to issues contributing to health disparities  as does Kelvin Sapp, MPH of the NY State Department of Health Development of Human Services will act in the capacity of Albany Minority Health Task Force community liaison.
b. Hispanic Outreach Services, Catholic Charities was eliminated due to the severe budget constraints for New York State. However, the previously identified community liaison Nilda Giraldi remains with the Outreach Core as an independent consultant who possesses the expertise serving the needs of the Latino population and is experienced in fostering collaborative relationships with the social service agencies and schools in Amsterdam, NY.

3. The Outreach Core task force groups continue to serve as a communication bridge between the community and the University.   The Task Force groups have not changed since Year 1.

I. SIGNIFICANCE
At this time, all activities have been of benefit to the communities in creating and awareness of their patient rights to receive services that are culturally and linguistically appropriate and therefore decreasing barriers contributing to health disparities. Although quantitative data has not been collected for these projects, results collected from informal surveys have  indicated positive feedback to services, workshops and resources presented to address issues impacting the community in the areas of empowerment and self-advocacy  in order to access health services.

J. PLANS
Our plans include the continuation of the following efforts:

Community Engagement:
o Update and clarify healthcare concerns within African American communities,
o Update and clarify healthcare concerns within Latino communities,
o Clarify community needs for health education information,

CEMHD Engagement:
o    Continue to ensure target community collaboration with Research Core studies by developing a process for community participation - through Outreach Core groups or more specifically assembled community advisory groups - in the refinement of research design, data collection, data analysis and results proliferation strategies to increase the likelihood of target community acceptance and benefit.
o Continue to partner with the Mentoring, Training and Education Core to encourage faculty to develop research prioritized by minority communities and facilitate career education opportunities for minority students promoting consideration of pursuing health careers.

K. PUBLICATIONS
None

L. PROJECT-GENERATED RESOURCES
None