Transcript Slide 1

New Tools New Visions
W.K. Kellogg Foundation Grant
Community Partners
HBCU Partners
Health Disparities, Ethics, and
Participation: New Tools/New
Visions
A Program to eliminate health disparities
using Community-Based Participatory
Research
Initiated:
August 2005
Funding: W.K. Kellogg Foundation
Amount: $4 million over 5 years
The Vision
Unite together African American
communities with Historically Black
Colleges and University faculty and
students to create solutions for
reducing the economic, racist,
cultural and health care problems
that cause health disparities.
NTNV Concept of Community
The Approach
1.
2.
3.
4.
Use Community-Based Participatory
Research (CBPR)
Connect Research to Action
Create new leaders in health
Network with communities and
institutions to change local, state
and national policy.
Why Community-Based
Participatory Research
(CBPR)?
 Respect
for Community
Competencies
 Willingness
to share Power/decisionmaking, and
 Accept
all perspectives…
We create powerful investigations, more effective
programs, and enhance the trust within our
communities.
NTNV Seeks to Create
A process for developing current and future
leaders from the African American community
committed to, and capable of, closing the health
divide.
Ongoing community collaborative research
projects in health and health practices that
reflect the unique cultural and historical life of
the community.
A sustainable network of HBCUs/practitioner
organizations/community organizations that will
take an activist approach to eliminating health
disparities.
A communications network with local
communities and HBCU institutions in other
southeastern states.
Background
Traditional Measure of
Health Disparity

Mortality Rate Ratio (RR): Mortality rate
of African American Population / Mortality
Rate of Anglo Population

Note: If the RR = 1, then there is not
disparity. If RR is greater than 1, then
mortality in African Americans is higher.
Age Adjusted Death Rate Ratios for
African Americans
1950 1960 1970 1980 1990 2000 2002
Heart Ds
1.0
1.0
1.1
1.1
1.2
1.3
1.3
Stroke
1.3
1.4
1.4
1.4
1.5
1.4
1.4
Cancer
0.9
1.0
1.1
1.3
1.3
2.6
Diabetes
1.0
1.2
1.2
2.0
2.2
2.2
2.1
HIV
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3.2
8.3
8.6
Homicide 10.9 9.6
9.4
5.8
6.6
5.7
5.6
The Persistence of the Problem

Why have we not solved the problems
of Health Disparities?

Will doing the same things over and
over again achieve a different outcome?
AIDS by Ethnicity:
United States, 1990-2000
120
Rate Ratios as Compared to Whites
Case Rates/100,000
160
80
40
10
8
6
4
2
0
1990
0
1990
1992
1994
1996
1998
Year
White, non-Hispanic
Hispanic*
American Indian/Alaska Native
Black, non-Hispanic
Asian/Pacific Islander
2000
1992
Black, non-Hispanic
Asian/Pacific Islander
1994
1996
Year
1998
2000
Hispanic*
American Indian/Alaska Native
How can we solve the problems
of Health Disparities?

Our experience with HIV has shown us that
providing the same interventions to
ethnically different communities results in
increased health disparities

One Approach: Community-Based
Participatory Research
50
60
40
50
30
Rate Ratio
Case Rates per 100,000
Primary and Secondary Syphilis: United
States, 1995-1999
20
10
40
30
20
10
0
1995
1996
1997
1998
1999
0
1995
Year
White
African American
Hispanic
Asian/Pacific Islander
American Indian/ Alaska Native
1996
1997
1998
Year
African American
Hispanic
Asian/Pacific Islander
American Indian/ Alaskan Native
1999
NTNV--Details
Moving on from Where We
Stand Now.
Project Elements
Element
One
Develop HBCU faculty capacity to
address health disparities
Element
Two
Increase African American leadership in
health administration, management and
policy
Element
Three
Build capacity and readiness of
communities of color for
participatory research and
interventions on health disparities
Element
Four
Clarify minority perspectives on the
ethics of health research and practices.
Project Objectives

Year One –Create partnerships between
communities and HBCUs

Year Two – Conduct pilot project

Year Three – Complete a fundable proposal or
conduct an implementation project

Year Four – Policy translation

Year Five - Final reporting, publications, model
sharing…and building
…….Sustainability after the funding ends
Building Participation into
Decision-Making Process

Grant w/Kellogg set forth objectives for the life of the
project and on an annual basis.

Statewide Coordinating Committee will review overall
project objectives bi-annually (approximately every 6
months)

Evaluation of previous year and plan for subsequent year
outlined in Statewide Coordinating Committee for August
Report by RCHD/SCRC.
Decision-Making Cont…
Site pilots, priorities, tasks,
approaches, and resource
allocation.
Statewide activities, projectwide collaborative activities,
policy initiatives
Site Steering Committee
Local steering committees
establish democratic /
participatory process.
Membership to be > 51% nonresearcher community
members.
Statewide Coordinating
Committee
Representatives from each
site (Community and HBCU
reps) and from RCHD and
SCRC constitute.
Questions
& Discussion