Hawai‘i Health Equity Research and Outreach Network (HAWAI‘I HERON)

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Project Summary It is striking and disheartening that Asian Americans, Native Hawaiians, and other Pacific Islanders (AA-NHPI) experience health disparities that are substantial, growing, and poorly understood. Our project entitled “Hawai‘i Health Equity Research and Outreach Network (HAWAI‘I HERON)” will create an Administrative Core to allow us to quickly respond and participate in multi-institutional studies that support three health equity pillars: equity of voices, equitable data efforts, and equity in clinical trials. First, we will enhance equity of voices by 1) amplifying the voices of our AA-NHPI stakeholder communities; 2) understanding diverse patient perspectives, preferences, and unmet needs; and 3) supporting expansion of culturally and linguistically tailored health education. Second, we will support equitable data efforts by expanding capacity to evaluate outcomes by 1) race/ethnicity; 2) geography; and 3) other social determinants of health. Third, we will promote equity in clinical trials by 1) identifying barriers; 2) employing innovative strategies to increase clinical trial enrollment for AA-NHPI; 3) understanding the impact of the evolving multicultural landscape on trial participation; and 4) increasing training for diverse students and investigators. The HAWAI‘I HERON Administrative Core will foster collaboration with the Food and Drug Administration Office of Minority Health and Health Equity and other institutions that are part of the Racial & Ethnic Minority Acceleration Consortium for Health Equity (REACH) network. In addition, we will leverage the Administrative Core to conduct a pilot study involving a discrete choice experiment examining AA- NHPI perceptions and preferences for diabetes medications. We will gain an understanding of AA-NHPI preferences regarding attributes of diabetes medications through administering patient preference surveys to 50 AA and 50 NHPI with type 2 diabetes. Random utility theory will serve as the basis for analysis. This assumes that individuals make choices to maximize their utility (or wellbeing), which they derive from different choices. Mixed logit regression, which allows for heterogeneity in preferences across individuals, will be used to estimate the random utility models. Results will enable us to better understand the importance of different attributes and levels, as well as willingness to trade-off between attributes. We will compare findings for AA to those of NHPI and describe similarities and differences. Sensitivity analysis will be used to test the robustness of the results to different assumptions and model specifications. We will hire and train a Health Equity Fellow to support the discrete choice experiment in diabetes medications and build expertise and scholarship for future work and engagement. Achievement of these aims will enable HAWAI‘I HERON to be an active partner to the FDA Office of Minority Health and Health Equity in collaborative research efforts to advance minority health and health equity focused research, to improve outreach and communications, and to support training and mentoring of diverse students and junior researchers.