ARRA IMPACT REPORT:
Comparative Effectiveness Research for Minority Health


Public Health Burden
There remains a gap between identification of successful medical treatments and interventions and their use and effectiveness in ‘real world’ settings. Comparative effectiveness research (CER) is the conduct and synthesis of research comparing the benefits and harms of different interventions and strategies to prevent, diagnose, treat, and monitor health conditions in these real world settings. The purpose of this research is to improve health outcomes by developing and disseminating evidence-based information about which interventions are most effective to patients, clinicians, and other decision-makers.

Progress of CER Projects Addressing Health Disparities
ARRA funding provided researchers with opportunities to conduct CER related to a variety of populations, health conditions, and treatment settings.

  • Health Literacy Levels regarding Upper Respiratory Infections (URIs): Investigators from Columbia University conducted a randomized controlled trial to assess the effectiveness of a tailored educational intervention, the Appropriate Care of URI (ACURI) Project, to improve health literacy levels regarding upper respiratory infections (URIs) and to decrease pediatric emergency department (PED) visits among Latino households in Early Head Start/Head Start (EHS/HS). Preliminary analysis of the sample at baseline indicates that among Latino parents enrolled in EHS/HS programs, adequate health literacy was associated with having a college education, and having been born in the U.S or having lived for more than 5 years in the U.S .Inadequate health literacy was associated with lower levels of knowledge about antibiotics. For example, 57% of those with limited health literacy reported that cough syrup was an antibiotic compared with 16% of those with adequate health literacy. Findings highlight the role of health literacy in the appropriate care of child URIs in this population. This tailored health literacy intervention has the potential not only to improve the care of participating minority families, but also may allow for dissemination of this and other health literacy interventions to the nearly 1 million children who attend EHS/HS sites nationally.1
  • Ethnic and Racial Minority Youth Health Disparities: Researchers from the Cambridge Health Alliance used data from the National Comorbidity Survey Adolescent Supplement (NCS-A) to examine a broad range of possible causes for the under recognition of illness and the lack of treatment of ethnic and racial minority youth. Findings indicate that there are few racial/ethnic differences in rates of identification of mental health problems or in encouragement of adolescents to use mental health services when needed. However, Black youth with lower severity internalizing disorders (e.g., depression, anxiety) were less likely than their white counterparts to be identified or encouraged to use services. In the absence of encouragement from teachers or other adults, Black youth with internalizing disorders were subsequently less likely than white youth to use specialty mental health services.2
  • Community-Based Interventions Enhance Hypertension Treatment: Investigators from the University of New Mexico conducted CER in clinical settings along the U.S.-Mexico border. The research examined whether patients diagnosed with hypertension who received standard clinical care plus community-based interventions (promotoras, health education, patient navigation) showed improvements in clinical, patient reported, and economic outcomes compared to a group receiving only standard clinical care. Findings indicate that hypertension treatment enhanced by community-based interventions was more effective than hypertension treatment alone. This pattern was most pronounced in patients with the most severe hypertension.3

Contributing NIH Institutes & Centers

  • National Institute on Minority Health and Health Disparities (NIMHD)

  1. 1RC1MD004109-01, http://www.ncbi.nlm.nih.gov/pubmed/22707307 - STOCKWELL, MELISSA S - COLUMBIA UNIVERSITY HEALTH SCIENCES - NEW YORK - NY
  2. 1RC1MD004588-01, http://www.ncbi.nlm.nih.gov/pubmed/22721593 - ALEGRIA, MARGARITA - CAMBRIDGE HEALTH ALLIANCE - CAMBRIDGE - MA
  3. Presentation: Cacari Stone L, Moffett M, Sanchez V, Nicolae L, et al. Comparative Effectiveness Research: A Primary Care Intervention for Reducing Risks of Cardiovascular Disease among Latinos Living in the U.S.-Mexico Border Region. Paper presented at the American Journal of Public Health. Academy Health Annual Research Meeting, June 2012, Orlando FL.
    3P20MD004996-01S1 - VALDEZ, ROBERT OTTO - UNIVERSITY OF NEW MEXICO - ALBUQUERQUE - NM