Family Health Histories: Creating a culturally tailored tool to reduce health disparities in the African American Community

非裔美国人（AA）在大多数健康差异（HD）中遭受不成比例的影响。回避行为 包括筛查可以告知积极的措施，以解决许多HD，其中包括：糖尿病，心脏病， 高血压、中风、艾滋病毒、性病/性传播疾病、癌症和心血管疾病，其中大多数可以是 1 -3证据表明，缺乏一般健康素养（HL）和种族适当的健康 沟通策略可能会导致AA社区的健康差异率一直很高。 家庭健康史（FHH）描述了遗传和其他家庭对健康的贡献， 被确定为预防、早期发现和筛查的有效工具。FHH的利用不足， AA社区对筛查和预防措施产生负面影响，这些措施可以防止 4尽管已经创建了许多家庭保健工具包，以帮助家庭 收集FHH信息，这些工具通常主要针对普通人群， 非裔美国人的文化和种族差异、交流偏好和健康素养水平 4未能有效地让AA参与到与文化相关的FHH工具的创建和概念中 而迄今为止的活动可能是造成这一群体利用不足的原因。 本K 01的目标是开发文化上适当的FHH工具，旨在广泛了解 和AA社区的吸收。该提案的核心假设是，使用基于社区的 参与式研究（CBPR）方法，共同开发文化上适当的FHH工具包将增加 AA家庭在FHH活动中的效用和参与;增加家庭内有效的健康沟通 提高参与者的卫生知识水平，以多方面的努力减少并最终消除 种族和民族健康差距。弗林特是进行这种参与性研究的理想社区 因为最近弗林特水危机事件引起了人们对AA中遗传学和FHH的兴趣 由于社区关注细菌和铅暴露对后代的影响， 健康因此，我们将在弗林特的AA社区内拥有合作伙伴，他们将有动力与我们合作 为弗林特和其他少数民族社区开发这些工具。 这个职业发展奖是由肯特基博士提交的，他是一位经验丰富的候选人 在CBPR和质量和健康差异研究的坚实基础。为了实现他的长期目标， 成为CBPR的R 01资助的研究人员，通过提高健康素养来减少健康差距， 使用有效的健康传播战略，减少并最终消除种族健康差距， 对于非洲裔美国人，K 01将在以下领域提供额外培训：（1）干预 随机试验的开发、设计和实施，（2）健康传播模式，（3）健康素养 推广，（4）CBPR方法基因组学和遗传学，（5）生物统计学，（6）赠款写作。

African Americans (AA) suffer disproportionately across most health disparities (HD). Preventative behaviors including screenings can inform proactive measures to address many HD which include: diabetes, heart disease, high blood pressure, stroke, HIV, STDs/STIs, cancer, and cardiovascular disease, most of which can be prevented.1-3 Evidence suggests that a lack of general health literacy (HL) and racially appropriate health communication strategies may contribute to the consistent high rates of health disparities in the AA community. Family Health Histories (FHH), which describe genetic and other familial contributions to health, have been identified as an effective tool for prevention and early detection and screenings. The underutilization of FHHs in AA communities negatively impacts screening and preventative measures that could prevent the onset of disease, illness and ultimately death.4 Although many FHH toolkits have been created to assist families in gathering FHH information, these tools typically are mostly focused for the general population and do not account for the cultural and ethnic nuances, communication preference and health literacy levels of the African American community.4 The failure to effectively engage AA in the creation and conception of culturally relevant FHH tools and activities to date likely contributes to their underutilization in this population. The objective of this K01 is to develop culturally appropriate FHH tools designed for broad understanding and uptake in AA communities. The central hypothesis of this proposal is that, using a community based participatory research (CBPR) approach, co-development of a culturally appropriate FHH toolkit will increase the utility and engagement of AA families in FHH activities; increase effective health communication within the family structure; and increase the health literacy of participants in a multifaceted effort to reduce and ultimately eliminate racial and ethnic health disparities. Flint is an ideal community in which to conduct this participatory research because the recent events of the Flint Water Crisis have created interest in genetics and FHH in the AA community as a result of community concern around the generational impacts of bacteria and lead exposure on health. Therefore, we will have partners within AA communities in Flint who will be motivated to partner with us to develop these tools for Flint and for other minority communities. This career development award is being submitted by Dr. Kent Key, a candidate with extensive experience in CBPR and a solid foundation in qualitative and health disparities research. To reach his long term goal of becoming an R01-funded researcher in CBPR to reduce health disparities by increasing health literacy and using effective health communication strategies to reduce and ultimately eliminate racial health disparities for African-American populations, this K01 will provide additional training in the following areas: (1) intervention development and design and conduct of randomized trials, (2) health communication models, (3) health literacy promotion, (4) CBPR approaches to Genomics and Genetics, (5) biostatistics, (6) grant-writing.