SAN DIEGO LATINO RESEARCH CENTER OF EXCELLENCE PARTNERSHIP TO REDUCE CVD DISPARIT

点击翻译按钮获取中文摘要

SAN DIEGO LATINO RESEARCH CENTER OF EXCELLENCE: PARTNERSHIP TO REDUCE CVD DISPARITIES IN LATINOS The San Diego Latino Research Center of Excellence is a tri-lateral collaboration that seeks to promote and expedite research that improves diabetes and cardiovascular disease outcomes in low-income Latinos living in the border region of San Diego. San Diego State University (SDSU) and the University of California, San Diego (UCSD) represent two large research intensive universities, one with a school of public health and the other with a school of medicine but both with experience and interest in community based research and training. The San Ysidro Health Center (SYHC) is a large, predominantly Latino-serving community health center that provides services to disadvantaged patients and also has a research center. SYHC is mandated by the Health Resources and Service Administration (HRSA) to engage in the Federal Initiative called the Health Disparities Collaborative (HOC). The HOC uses the methodology of the Planned Care Model and the Model for Improvement in the context of Community Oriented Primary Care to make a positive difference in the lives of hundreds of thousands of Americans (BPCHC, 2006). The San Diego Latino Research Center of Excellence proposes to focus on the disparities in diabetes and cardiovascular disease (CVD) and its associated bio-behavioral risk factors experienced by low-income Latinos living in the San Diego border region. The main research plan proposes a randomized clinical trial evaluating the efficacy of 2 culturally appropriate methods for applying the National Cholesterol Education Program (NCEP, 2001) and the American Diabetes Association (ADA, 2001) guidelines. The focus of the intervention methods includes strategies that patient self management, delivery system design, clinical information systems and decision support, all key elements of the HDC Planned Care Model. Innovations include the use of bilingual Community Health Workers, environmental assessments for barriers to adherence, culturallyappropriate behavioral strategies based on a theoretical model and the use of carotid intimal medial thickness (CIMT) as the primary outcome in a predominantly Latino cohort. Integrated into the intervention research design is the capacity for CVD cross-sectional studies, for example, identification of genetic risk factors and gene-environment interactions specific to the Latino population, nested case-control studies and banked serum to attract new investigators and expand the scientific capacity of the proposal. The training core plan proposes a training program that focuses on the existing training programs and the strengths of each partner. SDSU and UCSD will supply the training and mentoring in research methods for minority investigators interested in CVD disparities research and non-minority investigators interested in health disparities. The SYHC will provide the population of focus and the setting for disparities research and the clinicians with intimate knowledge of the Latino community.