Overcoming Barriers to Effective Care for Minorities

描述（由申请人提供）：少数群体的健康状况可能比大多数人差，因为他们接受有效的医疗保健服务的频率较低。改善患者自我管理很可能是改善有效护理的关键杠杆点。增加提供有效医疗保健服务的干预措施，如果经过精心设计，以解决他们寻求补救的使用不足问题的具体原因，可能是最有效的。我们现在正在进行许多多机构研究和社区外展项目，以改善对纽约市东部和中部哈莱姆少数民族社区的有效护理。我们建议通过提高哈莱姆东部和中部患者的自我管理技能，围绕改善健康和减少差距的主题发展我们的中心。我们中心的研究核心将加强2个已经资助的干预试验，以检查同行领导的患者支持小组干预的有效性（一个在不受控制的高血压患者中，另一个在中风患者中）;我们将在第三个已经资助的试验中增加一个干预措施，该干预措施将匹配早期乳腺癌妇女和现有社区服务的特定需求。一个强有力的社区外展核心，旨在将成功的方案嵌入社区，以最大限度地提高研究结束后继续存在的可能性，将补充这些研究战略。我们将加强现有的联系，并与社区领导人和组织建立新的联系，以保持社区，研究人员和教育工作者之间的相互信息交流。我们的中心将在其培训活动中追求互补的目标。我们建议加深与北方总医院的伙伴关系，这是除西奈山以外唯一一家位于东部或中部哈莱姆的私立医院。我们将让北总公司参与我们的研究，就像我们已经资助的研究一样。我们将开创一个多方面的临床研究培训计划，将广泛介绍临床研究的概念和方法，并更深入地参与选定的北总教师，以加强我们社区的少数民族卫生服务研究基础设施，并促进少数民族教师进入研究生涯。

DESCRIPTION (provided by applicant): Minority populations may experience poorer health status than the majority because they receive proven effective health care services less often. Improving patient self-management is most likely a critical leverage point in improving the delivery of effective care. Interventions to increase the delivery of effective health care services are likely to be most effective if they are carefully tailored to address the specific causes of the under use problems they seek to remedy. We have many multi-institutional research and community outreach projects underway now to improve the delivery of effective care to the minority communities of East and Central Harlem in New York City. We propose to develop our Center around the theme of improving health and reducing disparities by enhancing self-management skills among patients in East and Central Harlem. Our Center's research core will enhance 2 already-funded intervention trials to examine the effectiveness of a peer-led patient support group intervention (one in patients with uncontrolled hypertension and a second in those with stroke); we will add to a third already-funded trial an intervention that will match women with early-stage breast cancer and specific needs for support to existing community services. A vigorous community outreach core that will aim to embed successful programs in the community to maximize the likelihood that they will remain after the research studies are concluded will supplement these research strategies. We will strengthen existing linkages and build new ones with community leaders and organizations to maintain a mutual exchange of information between the community, researchers, and educators. Our Center will pursue complementary objectives in its training activities. We propose to deepen our partnership with North General Hospital, the only private hospital other than Mount Sinai in East or Central Harlem. We will involve North General in the enhancements to our research studies, as we have with the already-funded research. We will inaugurate a multi-faceted clinical research training program that will introduce clinical research concepts and methods broadly and engage selected North General faculty more intensively to enhance the minority health services research infrastructure in our community and to facilitate the entry of minority faculty into research careers.