SPECIAL EDITION - PART I                                                                                                                                                                                                                                                                                   SUMMER 2017  
IN THIS ISSUE 
 
  1. UAB Health Disparities Research Symposium 2017 
  2. Social Determinants of Health
  3. Biostatistics
  4. Academic/Community Engagement
  5. Research and Pilot Projects
  6. Scientific Publications
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  UAB HEALTH DISPARITIES RESEARCH SYMPOSIUM 2017:  THE ROLE OF SOCIAL DETERMINANTS OF POPULATION HEALTH   
   
 The 12th UAB Health Disparities Research Symposium, hosted by the UAB Minority Health & Health Disparities Research Center (MHRC) was h eld in Birmingham, Alabama on May 3, 2017.   The event highlighted health disparities research in the biological, clinical, social, and behavioral sciences and convened 210 physicians, scientists, academic investigators, community partners, and students  to share the latest research in this field. 
 

"Eliminating health disparities makes the entire population healthier," said Mona Fouad, MD, MPH, Director of the UAB Minority Health & Health Disparities Research Center (MHRC). "The MHRC connects different academic disciplines to investigate differences in health outcomes while developing partnerships with communities to put research into action to improve population health," she added.

This year's symposium focused on the role of social determinants in population health with featured speakers Catarina Kiefe, PhD, MD, Chair of the Department of Quantitative Health Sciences, University of Massachusetts Medical School,   and Jeroan Allison, MD, MS, Professor and Vice Chair of the Department of Quantitative Health Sciences at the University of Massachusetts Medical School. In the lecture, "Social Determinants of Health: From Understanding to Action?", Dr. Kiefe analyzed the recognized pathway from poverty to Type 2 diabetes; while Dr. Allison discussed "Fixing the Social Determinants of Health: Emerging Lessons from Education, Practice and Policy".   
The event included a poster session, a panel discussion on Health Care Reform and Disparities, and five breakout sessions: Advancing Health Policy Research Through Academic and Community Partnerships; Basic and Clinical Science of Disparities;  Social Influences on Disparities; Racial/Ethnic Disparities; and Place-Based Disparities.   

Clayton Yates, PhD, and Henry Wang, PhD, received Excellence in Mentoring Awards for Graduate, and Post-Doctoral or Junior Faculty, respectively.  
 
       
Click to watch brief updates from Mid-South TCC investigators during the symposium

             
   
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SOCIAL DETERMINANTS OF HEALTH (SDH) MEASUREMENT CORE
 
Addressing health disparities in terms of social determinants requires a complex, multidimensional effort that assumes a transdisciplinary approach involving multilevel research designs and complex analyses with a diverse range of measures across several research disciplines. In such a framework, research focused on a single level is mispecified because it underestimates the effects of contexts at other levels. Only by integrating the various contexts in which an individual is embedded we can begin to develop valid models of risk.

The objective of the Social Determinants of Health Measurement (SDH) Core is to support Mid-South TCC's life-course transdisciplinary research exploring the etiology of chronic diseases and health inequalities across the Mid-South region.  The following specific aims have been successfully met:

1. Provide theoretical and methodological expertise to the collaborative research sub-projects, pilot research projects, and other research activities conducted by the Mid-South TCC; 
2. Provide research tools, such as data products and measurement tools, to collaborative research sub-projects, pilot research projects, and other research generated by the Mid-South TCC; 
3. Generate and maintain a database with important region-specific data related to social determinants of health.

Additionally, the SDH core assisted investigators with:

* Theoretical models
* Selecting appropriate measurements
* Properly using measurements/tools
*S urvey assessment/development
* I nstrument translation
* Access to secondary data sources
   
 
SIGNATURE PROJECT:   SOCIAL DETERMINANTS OF HEALTH RESEARCH TOOLKIT  
Isolation Index of Mid-South States by County 
Scribner et al. 
Walkability Index of Albertville, AL 
Cherrington et al. 
* Validated scales
* Indices
* Measurement instruments
* Secondary data sources
* Region specific data and GIS mapping
 

William Cockerham, PhD     Robert Collins, PhD           Richard Scribner, MD, MPH       Mario Sims, PhD

              UAB, AL                                Dillard, LA                              LSUHSC, LA                         UMMC, MS 

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BIOSTATISTICS AND STUDY DESIGN CORE

The Biostatistics and Study Design (BSD) Core addresses the critical statistical and bioinformatics needs of the Mid-South TCC research projects. The BSD Core facilitates close statistical and bioinformatics interactions and collaborations among the institutions to enhance SDH in health disparities research capabilities and competitiveness.

The BSD Core provides scientific and statistical input into the study design, data management, and statistical analyses for the Mid-South TCC collaborative research sub-projects, pilot projects, and other emerging research.  The Core Co-leaders in each academic institution work with early-stage investigators to provide individually tailored biostatistical and study design training and support to facilitate their research and career development.

The following specific aims have been successfully met:
  1. Provide statistical consultation for sub-, pilot, and other research projects regarding study design, data management, bioinformatics, and statistical analysis, with emphases on applications of statistical principles in exploring the social factors influencing disparate health outcomes;
  2. Provide biostatistical mentorship to early-stage investigators
  3. Develop a data sharing plan, safeguard the privacy of participants, and protect confidential data
  4. Establish regional biostatistical and bioinformatics capabilities to provide resources to scientists interested in conducting research in the thematic area of the TCC.
Additionally, the BSD Core assisted investigators and community partners with writing statistical section for grant proposals, power analysis, data for community project, and manuscript writing (7).

SIGNATURE INITIATIVE: REGIONAL CANCER COHORT


Link SDH measures in existing study cohorts (CARDIA, REGARDS, JHS)
with State Cancer Registries across the
region to establish Regional Cancer Cohort



 
  Sejong Bae, PhD         Claudia Leonardi, PhD             Nancy Min, PhD            Dongquan Chen, PhD
          UAB, AL                          LSUHSC, LA                            UMMC, MS                             UAB, AL  
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ACADEMIC-COMMUNITY ENGAGEMENT CORE

The Mid-South TCC recognizes that our region becomes stronger and healthier when communities and universities work together to build mutually beneficial partnerships. In all of our work, we emphasize academic-community partnerships that are collaborative, participatory, and empowering. Through these partnerships academic investigators benefit from enhanced community participation in related research studies, greater community buy-in to the research agenda of the Mid-South TCC, and clearer routes of dissemination and intervention sustainability. The communities benefit by participating in dialogue with the Mid-South TCC about the research agenda, through the dissemination of evidence-based obesity and chronic disease interventions and enhanced access to state-of-the-art research.

The specific aims of the academic-community engagement core have been met:

1. Promote capacity building in the targeted Mid-South communities by educating and empowering the community constituents, such as community-based organizations and church representatives, and by building upon existing networks of well-trained community volunteers
  2. Assist investigators with culturally appropriate strategies for recruitment & retention of minorities in obesity and chronic diseases research studies
3. Facilitate the training of pilot and full-project investigators and staff on best practices for conducting research in minority communities
4. Assist investigators pilot-test SDH measurement tools and complete needs assessments and formative assessments in the communities through community forums, interviews, and surveys
5. Assist investigators and community partners to disseminate results of their studies (in progress)


Donna
Antoine-Levine, PhD       Yu-Mei Schoenberger, PhD   Richard Scribner, MD            Joanice Thompson
             JSU, MS
                             UAB, AL                                     LSUHSC, LA                             UAB, AL 
   
   
     
SIGNATURE INITIATIVE: MULTI-STATE MAYORS MENTORING MAYORS 
 
 




 
 
  Mayors who have seen the benefits of policy, program, and environmental changes first-hand have become champions for Arkansas Coalition for Obesity Prevention ( ArCOP)'s program to encourage cities to grow a healthy economy. Through Mayors Mentoring Mayors (3M), mayors share their successes, lessons learned and best practices with fellow mayors . Champion mayors mentor other mayors to hep them make their communities healthier places
to live, work, play and pray.   
    
With support from the Mid-South TCC, ArCOP expanded Mayors Mentoring Mayors to 9 cities in 5 Mid-South states. Participating mayors now have a feasibility assessment, at least one Growing Healthy Community in their state, a recognition designation as either as "emerging", "blossoming", or "thriving" communities, mentor mayors, a core team or taskforce, a sustainability plan, branded 3M material, a 3M toolkit, evaluation of their first 3M session, and ArCOP as a partner.

To encourage "buy-in" of mentee mayors, 3M provided seed funds to continue their health initiatives .  
 
 
On May 12, 2017, a Multi-State 3M Summit was held in Little Rock, Arkansas.  Mayors, City Elected Officials and their community's team members shared exciting work of each of the Mid-South state's successes, lessons learned, barriers and best practices.
 







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RESEARCH AND PILOT PROJECTS CORE 

The Research Core aims to advance the understanding of how Social Determinants of Health (SDH) generate and sustain health disparities, with a specific focus on pathways to obesity and chronic illness and mechanisms connecting these pathways throughout the life-course.  This is being pursued in two ways, by:  
  1. Developing and testing interventions in "critical periods" in the life course, such as pregnancy, early childhood, and old age; and
  2. Conducting retrospective studies to identify the contemporaneous, delayed, or cumulative effect of specific social determinants on biological and behavioral mechanisms that produce health disparities.

The life-course approach pinpoints critical periods when social context is especially important to health in a person's life course. The focus is on the relationship between social factors and health during these critical periods, using a variety of cross-sectional analyses; at the same time, promote longitudinal studies that can reveal lagged, cumulative, and contemporaneous effects of SDH over a person's life span. To conduct longitudinal epidemiological studies with biomarkers, existing cohorts established by the participating institutions are utilized, with appropriate measures of both socioeconomic status and physiological data, such as:  
  1. The Jackson Heart Study - a large, community-based observational study with 5,301 participants were recruited from among the non-institutionalized African American adults in the Jackson, MS, metropolitan statistical area to investigate the causes of cardiovascular disease in African Americans
  2. The REasons for Geographic and Racial Differences in Stroke (REGARDS) Study - an ongoing national observational study of risk factors for stroke in adults 45 years or older, with 30,239 participants; the study PI, as well as the statistical and data coordinating center, the survey research unit, and the outcomes unit are housed at UAB; Dr. George Howard, co-PI of REGARDS, is a Mid-South TCC consultant.
  3. The UAB Study of Aging - a prospective study at UAB of an ethnically and geographically (urban/rural) diverse population-based cohort of 1,000 community-dwelling Medicare beneficiaries, age 65 years and older.

All of the above cohort studies have been or are being conducted in our Mid-South TCC consortium institutions. The datasets from these cohorts include baseline and follow-up health and risk data, dietary data, health status, and biospecimen samples from our Mid-South TCC population.  
 
Consistent with the life-course approach, the work of the Mid-South TCC address obesity, a risk factor for chronic diseases, during three critical time points across the lifespan: pregnancy, early childhood, and old age. At each of these time points, the prevalence of obesity is higher in African Americans than in Caucasians and poses a greater threat to health and well-being. Obesity as a risk factor for chronic disease during pregnancy and in childhood is addressed with the two collaborative sub-projects.

The specific aims of the Research and Pilot Project Core  are being successfully met:

1. Oversee the implementation of two regional collaborative research sub-projects:
2. Provide research support for Mid-South TCC investigators working in the thematic area of the Consortium and for junior faculty participating in the Pilot Projects Program;
* Sub-aim A . Provide support in the form of 2-year pilot awards for promising health disparities research especially for those that have the potential to have a transdisciplinary focus.
* Sub-aim B. Increase the critical mass of scientists in health disparities research by providing support and resources for junior faculty and senior faculty interested in moving their research toward a transdisciplinary focus.
* Sub-aim C . Mentor junior faculty and develop methodologies for mentoring that can be adapted across the Mid-South Transdisciplinary Collaborative Center on Health Disparities.
3. Facilitate the submission for extramural funding (e.g., R01s, R21s, or R03s) of new SDH-related research projects developed at UAB, JSU, MMC, LSU, partnering HBCUs, and academic institutions throughout the Mid-South region.
4. Integrate multiple sources of expertise in SDH and life-course research, minority health, and health disparities research throughout the region and nationally, to allow for intellectual cross-fertilization and leveraging of resources.



Wendy Demark, PhD                 Lucio Mieli, MD, PhD             Anita Norwood, PhD, MPH        Isabel Scarinci, PhD, MPH
             UAB, AL                                    LSUHSC, LA                               UMC, MS                                       UAB, AL 
 

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SCIENTIFIC PUBLICATIONS FROM THE MID-SOUTH TCC 
 
PRELIMINARY LIST

Ethn Health. 2017 Apr;22(2):196-208. doi: 10.1080/13557858.2016.1232805. Epub 2016 Sep 29.
 

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COMING UP IN NEXT Mid-South TCC eNEWS:  
  • Pilot projects: progress and preliminary findings
  • Secondary data analyses
  • Scientific publications from the Mid-South TCC
  • Community-Led Projects
  • Dissemination Innovation

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 MID-SOUTH TRANSDISCIPLINARY COLLABORATIVE CENTER FOR HEALTH DISPARITIES RESEARCH
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