Comprhensive Center of Excellence in Health Disparities

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This Center of Excellence (COE) is being submitted to address significant gaps in our knowledge about disparities prostate cancer (PCa) outcomes, and to develop interventions that can be applied to reduce these disparities between African (AA) and European (EA) Americans in Philadelphia. The mission of the proposed center is to (1) undertake research that will identify biological, behavioral, social, environmental, geospatial, physical environmental, and health care factors that influence PCa outcomes, and (2) integrate, evaluate, and disseminate this information to at-risk populations in Philadelphia communities. These factors include both individual and area-level contextual (e.g., neighborhood) variables. We anticipate that the principles of this approach will ultimately be implementable in other communities to reduce PCa disparities. This COE builds on our existing multidisciplinary research to specifically understand role of biomarkers, patterns of care, geospatial environment, and obesity after the diagnosis of PCa. This research requires transdisciplinary collaboration across multiple disciplines represented by the investigators participating in this COE. The proposed COE intends to catalyze needed improvements in the identification of men at greatest risk of unfavorable PCa outcomes to improve access to appropriate PCa treatment with the following Specific Aims: Aim 1: To conduct three highly interrelated transdisciplinary, translational research projects aimed at addressing prostate cancer disparities: a) Project 1: Evaluate the role of obesity in determining unfavorable prostate cancer outcomes (C. Zeigler-Johnson, PI); Project 2: Develop predictive models for understanding biomarkers, area-level contextual factors, and individual risk factors in predicting prostate cancer outcomes (T. Rebbeck, PI); Project 3: Determine whether variation in experienced and potential health care access and quality contributes to racial differences in treatment among men with localized prostate cancer (K. Armstrong, PI). Aim 2. To create specialized shared resource cores to serve the needs of these projects and the Center, including an Administrative Core (T. Rebbeck, Director); a research core (J. Holmes and C. Branas, co-Directors); and a community core (K. Glanz, Director). Aim 3: To develop transdisciplinary training at a variety of levels to train the next generation of health disparities researchers. Through this research, community outreach, and training, we will develop a program that can identify those groups at greatest risk for an unfavorable prostate cancer outcome, and develop approaches that can be used to minimize poor outcomes and the resulting disparities that unduly burden AA men.