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ARRA Investments in Promoting Health and Preventing Illness

Public Health Burden
The development of preventive interventions based on well-defined underlying biological and behavioral mechanisms is critical to advancing health promotion. In other words, the best way to treat disease and illness is to prevent it from occurring in the first place. As our understanding of the role that lifestyle plays in disease increases, so does the need for predictors and strategies that target long-term behavior change. Environmental and genetic factors, as well as emerging diseases, interact with behavior to create new challenges for individuals, families and communities.

Reducing Health Disparities
Despite decades of research, significant disparities in health exist among people of different racial, ethnic, geographic, and sociodemographic background. For example, African Americans are 30% more likely to die from heart disease as compared to white Americans; and, Asian Americans and Pacific Islanders are more than twice as likely as white Americans to have acute hepatitis B.1 ARRA-supported research is examining the underlying biological and behavioral causes of health disparities, and is developing new ways to reduce such disparities by:
  • Examining behavioral strategies used by Latino diabetes patients to compensate for low literacy and health literacy to guide researchers in developing culturally relevant interventions to reduce disparities in diabetes outcomes among Latinos.2
  • Systematically developing a targeted patient navigation training curriculum to reduce cancer screening disparities in lesbian, gay, bisexual, and transgender persons.3
  • Targeting strategies to improve low-income women's dietary strategies in the first trimester of pregnancy with the goal of reducing the number of low birth weight infants and improving obstetrical outcomes.4
  • Measuring differences in physical activity by race and ethnic group, and the factors contributing to these differences, using a large nationally-derived dataset, the American Time Use Survey.5
  • Developing strategies to enhance self-management practices in underserved, vulnerable populations, focusing on topics such as diabetes and HIV/AIDS, as well as elders at risk for injury by falls.6
  • Identifying interventions for improving nursing practice that can be implemented in hospitals to reduce racial and ethnic disparities in acute care outcomes, through an interdisciplinary collaboration with experts in human geography and information systems.7
Co-Morbid Conditions
An increasing number of people are faced with having to cope with multiple chronic illnesses at the same time, known as co-morbid conditions. Often, when diseases occur concurrently, as is the case with type 2 diabetes (T2D), obesity, and heart disease, intervening to prevent one disease may synergistically work to prevent related conditions. Improving our understanding of the biobehavioral relationships between co-morbid conditions could lead to the development of more effective means for preventing disease and promoting health across the disease and illness spectrum. For example, ARRA-supported grants seek to:
  • Improve current knowledge of the biological factors that lead to the development of postpartum thyroiditis, a common autoimmune disease of the postpartum period. This information could provide a better overall understanding of the development of autoimmunity and associated chronic illnesses.8
  • Develop and evaluate the comparative effectiveness of innovative and interactive web-based high school educational programs aimed at reducing obesity and risk for T2D in a population of high risk teens.9
Promoting Community Health
Broad-based community health promotion interfaces in several spheres of people’s lives: home, work, school, and various sub-communities. Research in community health seeks to plan, design, and evaluate health promotion interventions and strategies in practical ways and in realistic settings. Community health is being promoted through ARRA-funded projects that:
  • Implement an effective worksite wellness program and identify and rank the factors that affect each phase of worksite health promotion. The main objectives in this are to: move science to service in worksites; improve employee health; and reduce costs due to illness, injury, and employee turnover.10
  • Determine the feasibility and effect size of a peer-mentored intervention to improve disaster preparedness of a vulnerable population: adults with a developmental disability who are living independently in the community.11

  1. United States Department of Health and Human Services, Centers for Disease Control and Prevention, Office of Minority Health, 2001
  2. 1R21NR011309-01 -- Literacy- Compensatory Strategies and Resources of Older Latinos with Diabetes- Cordasco, Kristina Marie (CA)
  3. 1R21NR010754-01A1 - Development of a culturally targeted patient navigation curriculum for LGBT adults- Mathews, Alecia (IL)
  4. 1R21NR010592-01A1 - Predictors of Dietary Quality in Low-Income Pregnant Women- Fowles, Eileen R- (TX)
  5. 1R21NR011285-01 -- Racial and Ethnic Differences in Physical Activity- Saffer, (MA)
  6. 3P30NR010677-03S1 - Center for Evidence-based Practice in the Underserved (CEBP)- Bakken, Suzanne (NY)
  7. 3P30NR005043-10S1 - Nursing Interventions to Reduce Disparities in Hospital Outcomes-Aiken, Linda (PA)
  8. 3R01NR005000-06S1 - Influence of Lactation on Postpartum Stress and Immunity- Groer, Maureen Edith- (FL)
  9. 1RC1NR011594-01 -Reducing Obesity & Diabetes in High Risk Youth- Grey, Margaret (CT)
  10. 1RC1NR011793-01 -- IGNITE Investigation to Guide New Insights for Translational Effectiveness-Elliot, Diane L (OR)
  11. 1R21NR11332-01 -- PPM-PREP: Peer-Mentored Preparedness for Adults with Developmental Disabilities-Eisenman, David- (CA)

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