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

项目摘要 令人震惊和沮丧的是，亚裔美国人、夏威夷土著人和其他太平洋岛民(AA-NHPI) 体验巨大的、不断扩大的、且知之甚少的健康差距。我们名为“夏威夷”的项目 卫生公平研究和外展网络(夏威夷苍鹭)“将创建一个行政核心，以允许 美国将迅速做出反应并参与支持三大健康公平支柱的多机构研究：公平 声音、公平的数据努力和临床试验的公平性。首先，我们将通过1)放大来增强声音的公平性 我们AA-NHPI利益相关者社区的声音；2)了解不同的患者观点、偏好、 和未得到满足的需求；以及3)支持在文化和语言上量身定制的健康教育的扩展。第二, 我们将通过扩大按种族/族裔评估结果的能力来支持公平的数据努力；2) 地理位置；以及3)健康的其他社会决定因素。第三，促进临床试验公平1) 确定障碍；2)采用创新策略，增加AA-NHPI的临床试验登记人数；3) 了解不断发展的多元文化格局对试验参与的影响；以及4)增加培训 面向不同的学生和调查人员。夏威夷苍鹭管理核心将促进与 食品和药物管理局少数民族健康和健康公平办公室和其他机构是 种族和少数民族促进健康公平联盟(REACH)网络的成员。此外，我们还将 利用管理核心进行一项试点研究，其中包括一项检验AA- NHPI对糖尿病药物的认知和偏好。我们将对AA-NHPI有一个了解 通过对50名患者进行患者偏好调查，了解糖尿病药物属性的偏好 AA和50NHPI合并2型糖尿病。随机效用理论将作为分析的基础。这假设 个人做出选择是为了最大化他们的效用(或福祉)，这是他们从不同的选择中获得的。 混合Logit回归允许不同个体的偏好异质性，将被用于估计 随机效用模型。结果将使我们更好地理解不同属性和 级别，以及在属性之间权衡的意愿。我们将比较AA和NHPI的结果 并描述相似和不同之处。将使用敏感性分析来测试结果的稳健性 不同的假设和模型规格。我们将聘请和培训一名健康公平研究员，以支持 糖尿病药物的离散选择实验，并为未来的工作和 订婚。这些目标的实现将使Hawai‘i Heron成为FDA办公室的积极合作伙伴 促进少数群体健康和健康公平的合作研究工作中的少数群体健康和健康公平 有重点的研究，以改善外联和沟通，并支持培训和指导不同的 学生和初级研究人员。

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.