IMPROVING OUTCOMES IN US LATINO CHILDREN

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I am applying for this 5-year K08 Mentored Clinical Scientist Development Award to support and facilitate my development as a health services researcher and speed my transition to an independent investigator. This award will allow me to complete my training in health services methods and provide me with the protected time to assure my publication and grant-making productivity during a pivotal period. I have begun to establish myself as a minority researcher concerned with disparities in health care delivery and outcomes in children through work in 3 areas: 1) analyzing access and quality of care barriers associated with higher asthma morbidity in poor and minority children with asthma; (2) improving survey methods for evaluating morbidity and risk factors associated with asthma, paying particular attention to challenges posed by English/Spanish bilingualism and by the need to incorporate perspectives of both parents and child, and (3) reviewing the existing literature regarding differences in asthma morbidity among Latino children with asthma. Founded on this work and with the guidance of my mentors, Dr. Robert Brook and Dr. Harold Morgenstern, I will continue to develop a research career whose long-term goal is to improve health outcomes and quality of life in Latino children with asthma through evidence-based health care and community- based interventions. The short-term objectives of this 5-year career development award are to: 1) obtain additional formal training in quality of care, statistical, study design, and epidemiological methods, 2) complete a period of supervised experience in analyses of existing datasets to enhance my analytic skills and increase my publication record, 3) submit at least 2 R01 applications to carry out the next phase of my investigations, and 4) continue to develop the community-based and research infrastructure necessary for my research. The specific aims of my intended R01 funded research include to: 1) develop and evaluate a combined health care and school community-based intervention to ensure access to high-quality primary care for Latino and other children with asthma, and 2) identify the factors, such as differences in primary care health care use and socio-demographic risks, that are associated with variations in asthma prevalence and morbidity among US children of Puerto Rican, Mexican, Cuban, and other Latino heritage.