- Specific Aim 1: Provide research leadership for the Center.
- Specific Aim 2: Develop locally operated secondary data bases pertinent to disparities research.
- Specific Aim 3: Reinforce the personnel infrastructure needed to enable Meharry’s predominantly clinical faculty to pose challenging research questions using these data bases.
- Specific Aim 4: Establish a Health Services and Translational Research Studio to provide an opportunity for faculty and graduate students to have their health services and translational research proposals critiqued by senior faculty
- Specific Aim 5: Publish at least four scientific, peer reviewed papers, per year, on health disparities
The Role of Federal Legislation on Breast Cancer Disparities (Levine, RS, PI)
The goal of this research project is to test the hypothesis that the Medicare law (which defines medical assistance/health insurance) as a cash benefit regardless of the extent to which cash is a barrier to service acquisition) and administrative policies of the food and Drug Administration (basing drug marketing decisions on biological safety/efficacy without considering possible adverse social effects, contribute to disparities in black/white mortality, helping to ensure that the benefits of life-saving innovations are more likely to accrue to persons of higher socioeconomic status. This is not deny the beneficial effects of these programs, but rather to suggest that any health-related intervention may have unintended, adverse effects. The present study focuses on breast cancer in order to address the overarching hypotheses as they pertain to Medicare law. We will purchase Medicare claims data from the Center for Medicare and Medicaid Services (CMS) and SEER-Medicare data. We shall also use data from the Area Resource File and the National Cancer Institute’s Cancer Information System (CIS) to locate medical resources and programs that support utilization of screening mammography.
- Specific Aim 1: To determine the importance of regional level characteristics on the utilization of mammography by elderly women in the years 1992 to 1995 and 2002 to 2005. We will use the Medicare data to identify patient level information (e.g., age, race, co-morbidity, regular source of care), and both ARF and CIS to identify regional level data. We will use multilevel logistic regression to model women clustered within regions and states.
- Specific Aim 2: To examine the association between screening mammography utilization and breast cancer survival of women age 67 and older. For the years 1992 through 2005, we will use Statistical Epidemiology and End Results (SEER)-Medicare data to take potential confounding (e.g., age at diagnosis) and effect modification (e.g., race/ethnicity) of this association into account
Culturally-Appropriate Childhood Obesity Prevention Program for Hispanic Families (Zoorob, R, PI)
The long-term goal of this research study is to contribute to the reduction of racial/ethnic disparities in obesity and obesity-related outcomes among Hispanics by testing a childhood obesity prevention program that has been culturally tailored for the Hispanic population through a participatory process. The study uses a community-based participatory research (CBPR) approach through a collaborative community-academic partnership between Meharry’s National Health Disparities Research Center (NHDRC), Tennessee State University-Center for Health Research (TSU-CHR), Vanderbilt University, a grassroots Hispanic community organization called Progreso Community Center (PCC), and the Nashville Latino Health Coalition (NLHC). The short-term goal of this study is to test the efficacy of a culturally-tailored intervention for childhood obesity prevention through a randomized controlled trial. The specific aims of the project are to:
- Specific Aim 1: Refine a culturally-appropriate childhood obesity intervention program (adapted from We Can!)based on previous pilot study findings and additional qualitative data (key informant interview and focus groups). (Phase 1)
- Specific Aim 2: Conduct a randomized controlled trial to assess the efficacy of the culturally-appropriate childhood obesity intervention with Hispanic families. (Phase 2)
Research Disparities Supplement to: Culturally-Appropriate Childhood Obesity Prevention Program for Hispanic Families (Sylvie Akohoue, PhD)
The overarching goal of this research supplement is to provide Dr. Akohoue with technical and methodological expertise that can enhance her research skills and establish the foundation for her career path toward becoming an independent investigator on the relationship of childhood nutrition, obesity, and associated health disparities. To acquire these skills, which are critical for today’s emerging research in nutrition and health disparities, Dr. Akohoue will focus her research effort on the proposed Specific Aim II of the NCMHD Health Disparities Research Center of Excellence (funded parent grant) to examine nutrition-related health disparities by utilizing a combination of quantitative and qualitative approaches. Specifically, Dr. Akohoue will examine how diets of children pre- and post-intervention conform to the newly released dietary guidelines and recommendations. During the remaining years of the funded parent grant, Dr. Akohoue will devote the equivalent of 80% effort in each 12-month period to this research project.
We plan to achieve four specific goals for the proposed research and career development experience of Dr. Akohoue. The goals, strategies, and experiences the of the two-year research and career development plan proposed for the candidate are summarized in Table 1 below. The specific goals of this supplemental research project are described in Section I-II (see details below).
Research Goal 1: To provide Dr. Akohoue technical and methodological expertise related to the application of the Healthy Eating Index and the Youth Healthy Eating Index.
Research Goal 2: To provide Dr. Akohoue training in statistical computing of dietary data, including appropriate use and interpretation of statistical methods: We anticipate that to capture dietary behaviors.
Research Goal 3: To provide Dr. Akohoue research collaboration with community based participatory research investigators.
Research Goal 4: To increase publications and improve funding opportunities for the candidate.