Export Center 2004 - 2009

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

Administrative

A. SPECIFIC AIMS
The specific aims of the Administration Core have not changed from the original application

B. PROGRESS AND ACCOMPLISHMENTS
In the second year the Administrative Core had to deal with the mid-year resignation of Dr. Nancy Denton who had served as the director of the Mentoring and Training Core. The Center was fortunate to find Dr. Edwina Dorch for the position of Core Director. She agreed to execute the plan described in the original proposal. Dr. Dorch is described in more detail in the Mentoring and Training Core progress report. Dr. Dorch has a PhD in Psychology, is currently a Research Scientist in the Professional Development Program at the Rockefeller College, and has considerable experience in leadership training programs. She is an ideal fit for the position. In addition, as an African American woman, she provides a perspective that had been missing from the Program Executive Committee.

We have provided budgetary oversight of the cores. This includes mentoring and training of core directors and researchers who were unfamiliar with the procedures used by NIH, and with the financial review procedures in place at the University at Albany.

The Program Advisory Committee meeting was held on March 2nd, 2006. This was the first time in grant YR 2 that all members of the PAC could meet. At the all day meeting, cores described their progress and plans; all Health Disparities Research Development awardees were invited and many participated. The PAC provided feedback and very positively endorsed the Center’s activities and plans.

The Program Executive Committee (nine voting members consisting of the directors of all five cores of the center and four representatives from partnering community groups) met 10 times since the start of the current grant year. These meetings helped substantially with the coordination of core activities.

The director met with University’s Vice President for Research to obtain financial support from the university that would provide more administrative support to the cores, particularly the mentoring and training core. The mentoring and training core generates a large number of expenditure and personnel actions because it manages the five Health Disparities Research Development projects. Rather than re-budget NIH EXPORT grant funds towards more administration, the center sought to obtain additional resources from the university for this purpose. The director also met with the University’s Vice President for Governmental Affairs and Public Relations to pursue other revenue streams.

The Center director and appropriate core directors met with officials of a) the NYSDOH Office of Minority Health, b) the Medical Society of the State of New York Task Force on Eliminating Minority Health Disparities, and c) Area Health Education Committee, to determine areas of collaboration, and areas of possible overlap/duplication that should be avoided.

The Center participated in the following conferences by invitation: 1) National Leadership Summit: Eliminating Racial and Ethnic Disparities in Health, sponsored by the U.S. Department of Health and Human Services (HHS), Office of Minority Health (OMH); 2) Office of Minority Health /American Institutes for Research HG-LSIG Expert Panel; 3) The Refugee Health Information Network (RHIN) Colloquium, Co-sponsored by the Robert Wood Johnson Foundation, NLM, the Department of Health and Human Services (DHHS) Office of Minority Health, and Health-Equity.Org. IN addition, the program manager gave presentations on behalf of the Center to: the Massachusetts Medical Interpreter Association, the National Association of Family Practice Physicians, and Albany Medical Center .

Co-sponsored the meeting of New York State ’s six EXPORT centers entitled, “Overcoming Health Disparities: The Changing Landscape.” The meeting was held in May 12-13, 2006 at the New York Academy of Medicine, New York, and involved speakers from EXPORT centers and others of national prominence, as well as workshops of topics relevant to the elimination of minority health disparities.

The external evaluation consortium has provided formative and summative evaluation. Their report is separate.

The web site has been maintained and substantially enlarged (https://www.albany.edu/cemhd/ ). It is active and updated on a biweekly basis. The Core has assessed the prospects for a P-20 application and has sought guidance from the NCMHD as to the exact form and content of the application of the P-20 application

C. SIGNIFICANCE
The activities of the Administrative Core have placed the center as an essential and valued part of the University landscape, and maintained relations with community based organizations.

D. PLANS
Specific activities planned by the Administrative Core for Year 2 are to:

Oversee and coordinate the scheduling of symposia, workshops and discussion groups and other scheduled events by the different cores/components.
Serve as a point of contact with the public media, media offices of the sponsor, host institutions and organizations, and maintain a website for information dissemination.
Create a paper newsletter to be distributed to the partnering community based organization, and individuals in the community to describe the activities of the Center.
Schedule meetings of the Program Executive Committee every other month, and the PAC at least once in year 3 and twice if possible.
Continue web site development and monitor use.
To maintain official status as a University at Albany research center.
Manage the Center budget, review allocation of funds, and decide, with the PAC and the PEC, on changes to allocations if needed.
Monitor activities of the other cores to ensure goals are being met and reports are filed.
Make annual the report to the sponsor.

E. PUBLICATIONS
L. M. Schell, J. Ravenscroft, M. Cole, A. Jacobs, J. Newman. 2005. Health Disparities and Toxicant Exposure of Akwesasne Mohawk Young Adults: A Partnership Approach to Research. Environmental Health Perspectives. 113(12):1826-32.

F. PROJECT-GENERATED RESOURCES
None to date.

Community Engagement / Outreach

A. SPECIFIC AIMS
The specific aims of the Community Outreach and Dissemination Core have not changed from the original application. The specific aims include inventory and dissemination activities in three distinct parts, including (1) the development and dissemination of general and Center-specific health information, (2) encouraging and equipping the community for participation and partnership in research studies and interventions, and (3) sponsoring science education outreach activities. The target audiences include community-based organizations (CBO) serving minority populations, healthcare community (current practitioners and professional schools preparing new practitioners), and K-12 schools serving high percentages of minority populations.

B. PROGRESS AND ACCOMPLISHMENTS
To date, we have:

completed an inventory of the existing information and training resources among the local (Amsterdam and Albany) CBO’s, the healthcare community, and K-12 schools
conducted focus groups about healthcare, information, and research interests, needs, and concerns of members of the minority communities in Amsterdam and Albany
worked with other cores to identify local community needs and opportunities for collaboration, and
based on the information gained from the above activities, developed teams and plans for how to get information to the local community. Specifically, we have developed three groups to assist in the development and dissemination of needed information, and in providing a bridge between the university and community:

MINORITY HEALTH TASK FORCE (MHTF) -- designed to provide consultation and direction for health information, and to serve as a bridge between university and the local community for research information and participation. (This includes two groups—one for Albany , one for Amsterdam —and includes any CBO/organization and K-12 representatives that would like to participate). The Albany MHTF is underway with regular meetings; the Amsterdam MHTF is currently forming and will convene summer/fall 2006

MINORITY HEALTH CARE PROVIDER CONSORTIUM ( Consortium) -- designed to provide local health care providers with opportunities to learn about, inform, and/or participate in research, and to assist in the development of cultural competencies. The Consortium will include all interested providers in region. This group will convene in summer/fall 2006

K-12 MINORITY HEALTH TASK FORCE (K-12 TF) -- designed to learn about resources for the local K-12 curriculum, make recommendations for needed resources about K-12 curriculum, and design professional development opportunities for the Amsterdam and Albany schools. The K-12 TF includes representatives from the Amsterdam and Albany school districts and the Cap Region BOCES, drawing on health teachers, school nurses, school student services personnel, STEP personnel, and other providers of professional development. The K-12 TF is underway with regular meetings.

We are also currently in the process of:

Identifying and developing needed informational materials and best dissemination strategies for the three local audiences (CBO, Healthcare, K-12) via newly the created community partnership groups
Planning culturally sensitive materials on health literacy for local educators, including workshops for educators and incorporating health information in appropriate educational venues, with the K-12 TF.
Identifying and promoting opportunities for local community research participation; increasing local community awareness of ongoing research projects via the MHTF.
Working with the Mentoring/Training Core and the Education Core to facilitate common projects
Getting information back to the university research community (via the Mentor/Training core small grant selection process) about what has been learned about local community interests and perspectives on needed health disparities research

C. SIGNIFICANCE
Our work to date has enabled the Center to obtain visibility and rising acceptance in the local minority communities of Albany and Amsterdam, and has served to establish partnerships that will facilitate all of the core activities.

D. PLANS
For Year 3, our plan is to focus on the further development of the three community partnership groups, and on the projects within these groups that will help to develop and disseminate needed information, and to provide a bridge between the university and the local community:

MINORITY HEALTH TASK FORCE: Plans include developing materials for local CBO use and distribution, seeking MHTF feedback and direction. We will also be working to develop a clearinghouse of desired information for CBO’s to access, use, and modify to suit the particular needs of constituents. We plan to develop the MHTFs into a bridge between university and the local community for research information and participation (for instance—to enable the CEMHD to present information about the current/planned research activities at the CEMHD in relevant format/language, seek input about needed/desired research interests, as well as barriers to participate, and, where appropriate, generate ideas for new research ventures and partnerships).

MINORITY HEALTH CARE PROVIDER CONSORTIUM: Plans include providing a forum for local health care providers to learn about/inform/participate in research, enhance awareness of cultural competency development, share resources about programs to develop competencies, and develop capacity in provider institutions to engage in their own competence training.

K-12 MINORITY HEALTH TASK FORCE: Plans include evaluating resources for local K-12 curriculum, making recommendations for needed resources about K-12 curriculum, and designing professional development opportunities for local educators.

E. PUBLICATIONS
None to date.

F. PROJECT-GENERATED RESOURCES
None to date.

Education

A. SPECIFIC AIMS
The specific aims of the education core have not changed. The aims are (1) to encourage the development of a health related workforce from within the targeted communities and (2) to strengthen the cultural competence of existing health service providers.

B. STUDIES AND RESULTS
During the past year, the collaborative work group has continued meeting regularly to collectively design and implement the core activities. Its composition has remained basically the same with the addition of two representatives from the Family Planning Advocates of New York State. The group focused on the following activities:

Gathered syllabi and other educational material on health disparities curricula to design an interdisciplinary certificate. A data base containing this information has been created. Sought information regarding administrative requirements for the certificate, and began discussing logistic issues.
Conducted exploratory cultural immersion activities to inform the future development of large scale programs in Amsterdam, New York and in Peru. Graduate students (N=3) lived for a short time with Latino families, visited healthcare organizations, and participated in community activities. Participants reported personal and professional satisfaction with the experience and an increased awareness of healthcare disparities;
Conducted a 3-day community immersion program in Albany, New York, to help stimulate African American high school students to pursue careers in the health fields. Students (N=26) received first hand information on the range of these careers and their educational requirements as well as on health advocacy from local African American professional and community leaders. This activity was featured in the UAlbany newspaper, website, and spring 2006 magazine;
Explored and planned a cultural immersion program for US health care educators and professionals to be held in Puerto Rico;
Planned and began data collection to identify strategies for improving minority student recruitment and retention in the health fields. Seven out of nine focus groups have been conducted with African American and Latino middle and high school students (N=56). Discussions were audio taped and are being transcribed. Participants completed a sociodemographic questionnaire;
Planned focus groups with college students to identify strategies for improving minority student recruitment and retention in the health fields; prepared and submitted IRB material.

C. SIGNIFICANCE
The activities carried out this past year will ultimately contribute to the development of a more racially and ethnically representative workforce and to the strengthening of the cultural competency of current and future healthcare providers. They offer the foundation to finalize the development of curricula and evaluative tools for the cultural and immersion programs with Latino and African American communities. The results from the focus groups study will provide baseline data for future research and program development in the areas of recruitment and retention of minority students in the health fields. A significant accomplishment of the education core is its success in facilitating the sustainability of the collaborative partnerships, as indicated by a continued participation and enthusiasm of work group members, for a second consecutive year. This group is providing an optimal vehicle for African American and Latino community leaders, government and community healthcare agencies, and educators from UAlbany and community and four year colleges to work together toward the elimination of health disparities in smaller cities in NY. The sustainability of this work group is vital to the achievement of the aims of the education core.

D. PLANS
During the upcoming year, the core director will continue collaborating with the work group to:

Prepare curricula for an interdisciplinary certificate based on educational material and gathered this past year;
Develop well defined programs for the cultural and community immersion institutes based on the information collected this past year;
Complete analysis of data on youth focus groups and disseminate.

E. PUBLICATIONS
None to date

F. PROJECT-GENERATED RESOURCES
None to date

Mentoring and Training

A. SPECIFIC AIMS
The specific aims of the Mentoring and Training Core have not changed from the original application.

They are:

1) To establish a mentoring program to facilitate the research careers of junior faculty members in the departments participating in this proposal. The mentoring component will consist of four parts:

a. establishment of mentor-mentee relationships between junior and senior faculty

b. a grant preparation program to enable new investigators to complete grant applications

c. a competitive small grants program open only to junior faculty

d. junior faculty travel grants for attendance at conferences focusing on community action research

2) To establish training mechanisms that will raise knowledge of and interest in health disparities research among our researchers as well as our community partners. The training component will consist of four parts:

a. network building colloquia and discussion groups

b. an intramural workshop on participatory action research methodology

c. a methodology colloquia series to expand the participants knowledge of techniques relevant to the study of health disparities and community action research more generally

d. a research colloquia series aimed at sharing results from various components of the project and similar projects.

B. PROGRESS AND ACCOMPLISHMENTS

1a. Two Core Directors, David Strogatz and Blanca Ramos served as mentors for five small grant recipients. Two other non-CEMHD, UAlbany faculty members served as mentors for the other two small grant recipients. Additionally, three small grant recipients mentored two graduate students who assisted with their small grant project.

1b. Two half-day-elementary-grant writing workshops were presented in the fall: Getting Started (10/20); and Preparing Proposals (11/16); and a day-long, advanced grant writing workshop was offered (4/6/06). Eight small grant recipients (along with two CEMHD Core Directors, three Office of Sponsored Funds personnel and the IRB Director) attended a grant writing workshop that included the following topics: (a) Grant Types: RO1, RO3, R21 (b) ‘Modular’ vs. ‘Non-Modular’ Budgets (c) Direct vs. Indirect Cost (d) Budget Justification (e) Salary vs. Fringe Benefit Calculation (f) Key Personnel vs. Significant Contributors (g) Consultants vs. Subcontractors vs. Consortium Agreements (h) Programmatic, Fiscal and Administrative Agreements.

1c. Two small grant research projects continued from year two. Additionally there was a campus-wide competition for small grants of $6,500 in the Fall of 2005. Three grants of $6,500 were awarded (click links below for the details of all small grant research projects).

2a. & b. Three UAlbany senior faculty researchers gave presentations that demonstrated the utilizations of large demographic and health services data bases: Kajal Lahiri, Distinguished Professor of Economics, and Health Policy, Management and Behavior; Richard Alba, Director of The Center for Social and Demographic Analysis (CSDA); and David Strogatz, Chair of the Department of Epidemiology and Biostatistics at the School of Public Health.

2c. Three prominent researchers presented in Fall 2005: Gary W. Evans, Professor of Design and Environmental Analysis and of Human Development at Cornell University on The Environment of Childhood Poverty; and Amy Schulz and Carmen Stokes, on “Social and Physical Environmental Factors and Cardiovascular Risk: The Healthy Environments Partnership.” Professor Stokes is the Associate Director, Center for Research on Ethnicity, Culture and Health. Ms. Stokes is a family nurse practitioner by training and is an instructional assistant at Wayne State University, Detroit Michigan.

C. SIGNIFICANCE
The Mentoring & Training Core assists junior faculty in developing their community participatory action research skills and provides them with the opportunity to interface with the Albany and Amsterdam community agency staff and residents. This core also provides Albany and Amsterdam community agencies and residents with statistics, white papers, and reports generated by junior faculty that involve health disparities and specific illnesses.

D. PLANS
In the coming year, the Mentoring and Training Core Director will:

Obtain time commitments from the Office of Sponsored Funds in developing electronic submissions of actual grants;
Assist the staff of the Albany Institute for Research in Education in producing a grant writing workshop for personnel of community based organizations of Albany and Amsterdam;
Assist small grant recipients in leveraging their small grants into larger ones;
Assist mentors in editing and producing publishable small grant work products;
Encourage small grant recipients to submit abstracts on their work to both national and local conferences;
Schedule small grant recipients for Brown Bag Sessions in preparation for conference presentations;
Schedule one senior faculty member and one junior faculty member to present in Brown Bags to facilitate network building;
Organize a colloquia series with prominent, national and local researchers in the field of health disparities and community action research in order to expand the knowledge and resources available to participants;
Organize a diversity conference for health care providers in the Albany and Amsterdam communities in collaboration with the Education & Outreach Core Directors.

E. PUBLICATIONS
None to date.

F. PROJECT- GENERATED RESOURCES
None to date.

Research

A. SPECIFIC AIMS
Little is known about health disparities among racial/ethnic groups in smaller cities, such as those that predominate in upstate New York. The state of knowledge is quite different from that for larger metropolitan regions, which have been the main focus of research to date.

The Research Core of the Center for the Elimination of Minority Health Disparities therefore has two main goals:

to develop a public data infrastructure about minority-majority health disparities in upstate New York communities;
to conduct studies into the causes of existing disparities and strategies for ameliorating, if not ending, them.

B. STUDIES AND RESULTS
As described in the following pages, two projects have made substantial progress in meeting the first goal. The group led by Alba and Strogatz has attempted to estimate the Prevention Quality Indicators (PQI) developed by the Agency for Healthcare Research and Quality (AHRQ), by racial/ethnic group and city ("The Establishment of a Minority Health Disparities Database for the Communities of Upstate New York"). Disparities for any of these indicators are likely to signal inequalities in the access to and use of medical services. It is in the process of completing a report on the diabetes-related indicators (of which there are four), which will be made available through the CEMHD website and publicized through the media.

The project led by Kajal Lahiri ("Monitoring the Trends in Health Disparity in Upstate New York") has drawn on the CDC-mandated annual survey, the Behavioral Risk Factor Surveillance Survey (BRFSS). Using sophisticated econometric techniques, Lahiri and Pulungan have estimated a continuous measure of individual health and aggregate health inequality from responses on a four-point subjective scale to the standard self-assessed health question. They point to evidence that the untransformed responses to the self-assessed health question cannot be used validly in comparisons of different population groups. They have used the new measure to assess inequalities among major population groups and to investigate the principal determinants of inequalities.

Three other projects have focused on the second goal. The project led by Mary Gallant and Glenna Spitze ("Social Networks, Culture, and Chronic Illness Management") is studying chronic illness management among Latino and African American elderly. The researchers are nearing completion of a major review of the literature, which has positioned them to apply for an R01 grant to undertake a larger empirical study (click here for more details on this study).

A related project led by Anne Fortune and Blanca Ramos ("Overcoming Cultural Barriers to Hispanic Use of Health Education Services") is investigating the structural and cultural factors that may contribute to a health education program’s success in reaching and benefiting Hispanic older adults in smaller cities and attempting to develop a model of a successful program. Data have been collected through six focus groups (N=62), and analysis is underway on the transcribed materials. In addition, the literature on health education programs with Hispanics and/or non-Hispanics necessary to inform the development of a culturally tailored health education program has been gathered.

The final project, led by Kirsten Davison, Catherine Lawson, and Jeff Olson ("Physical Activity: Environmental, Social, and Familial Influences"), is looking at racial differences in children’s physical activities and how they are shaped by personal, familial, and community characteristics. In addition, this group is making progress in the analysis of the interaction between the physical environment and children’s level of activity and has presented this work at professional meetings. It has submitted an R21 proposal to study parental influences on the physical activities of African-American children.

C. SIGNIFICANCE
The two projects analyzing existing data bases on health events and conditions are documenting the health disparities that exist in the smaller cities of upstate New York and finding both similarities and differences with respect to what is known about disparities in the much denser downstate region and, in particular, in New York City. The other projects are focusing on the dynamics that help to produce disparities, for example, the factors leading to less physical activity and greater obesity among African-American youth, or on approaches to remedy health disparities, for example, with culturally sensitive health education programs.

D. PLANS
The plans of the various projects are spelled out in the following progress reports.

E. PUBLICATIONS
Some of the projects already have presentations and publications, and others are approaching this point.

F. PROJECT-GENERATED RESOURCES
The data bases being created by Alba and Strogatz will be made available, as specified in their progress report.