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$45 million over 5 years earmarked for research on ways to eliminate racial and ethnic health disparities

The Agency for Healthcare Research and Quality recently awarded nine grants that will help us understand and address the factors that contribute to ethnic and racial inequities in health care. Known as the EXCEED (Excellence Centers to Eliminate Ethnic/Racial Disparities) initiative, these studies also will help identify practical tools and strategies to eliminate the disparities.

The new research projects will be funded by AHRQ in partnership with the Office of Research on Minority Health and the National Cancer Institute. Each project will consist of a group of four to seven studies organized around a central theme. Funding for these new projects is anticipated to total $45.0 million over a 5-year period. The newly funded projects are:

Racial and Ethnic Variations in Medical Interactions. Principal investigator: Carol M. Ashton, M.D., M.P.H., Baylor College of Medicine, Houston, TX. Total projected funding: $7,813,750. Project period: 9/27/00 - 8/31/05.

The researchers will assess the extent to which problems in doctor-patient communication contribute to racial and ethnic disparities in health care use. Six projects and three core themes will be used to achieve four major objectives: improve understanding of the etiologies of disparities; identify interventions that can reduce disparities; disseminate information to patients; communities, and health care providers; and build capacity for future minority health services research.

Overcoming Racial Health Disparities. Principal investigator: Timothy S. Carey, M.D., M.P.H., University of North Carolina, Chapel Hill. Total projected funding: $1,273,224. Project period: 9/15/00 - 8/31/05.

These researchers will establish a center of excellence on overcoming racial health disparities in African-American adults, particularly in rural settings. They will collaborate with two Historically Black Colleges and Universities during the project.

Improving the Delivery of Effective Care to Minorities. Principal investigator: Mark R. Chassin, M.D., M.P.P., M.P.H., Mount Sinai School of Medicine, New York, NY. Total projected funding: $7,333,543. Project period: 9/13/00 - 8/31/05.

The goal of this project is to measure the underuse in Harlem of selected medical and surgical interventions that are known to be effective. The researchers will assess the reasons for the underuse and develop, implement, and evaluate ways to eliminate the underuse when appropriate.

Understanding and Reducing Native Elder Health Disparities. Principal investigator: Spero M. Manson, Ph.D., University of Colorado Health Sciences Center, Denver. Total projected funding: $6,210,077. Project period: 9/30/00 - 9/29/05.

Four health issues of particular importance to elderly American Indians and Alaska Natives will be addressed: the quality of care for diabetes, delivery of clinical preventive services, cancer screening, and smoking cessation.

Access and Quality of Care for Vulnerable Black Populations. Principal investigator: Robert M. Mayberry, M.S., M.P.H., Ph.D., Morehouse School of Medicine, Atlanta, GA. Total projected funding: $2,128,225. Project period: 9/15/00 - 8/31/05.

The researchers will explore ways to improve health care access and quality for vulnerable African Americans, particularly adults who are chronically ill and low-income children.

Health Disparities in Minority Adult Americans. Principal investigator: Edmund M. Ricci, Ph.D., University of Pittsburgh, Pittsburgh, PA. Total projected funding: $1,273,224. Project period: 9/25/00 - 8/31/05.

The researchers will combine community linkages with academic resources to address differences between white and minority elderly populations in health status and the use of health services, with special emphasis on improving health care for blacks through effective communication and culturally sensitive approaches.

UCLA/DREW/RAND Program to Address Disparities in Health. Principal investigator: Martin F. Shapiro, M.D., Ph.D., University of California, Los Angeles. Total projected funding: $1,273,225. Project period: 9/01/00 - 8/31/05.

In this collaborative project, researchers from the University of California, Los Angeles, Drew University, and RAND, will establish a multidisciplinary program to address racial and ethnic disparities in health. A major goal is to increase the capacity for health services research on health disparities.

Understanding and Eliminating Health Disparities in Blacks. Principal investigator: Barbara Tilley, M.S., Ph.D., Medical University of South Carolina, Charleston. Total projected funding: $10,125,420. Project period: 9/21/00 - 8/31/05.

The goal is to identify solutions to known disparities in health status between blacks and whites living in South Carolina, including those in rural areas. The researchers will focus on interventions related to providers and provider/patient interactions.

Promoting Effective Communication and Decisionmaking for Diverse Populations. Principal investigator: Eugene A. Washington, M.D., M.Sc., University of California, San Francisco. Total projected funding: $7,672,925. Project period: 9/27/00 - 8/31/05.

The researchers will assess ways to promote effective communication and decisionmaking in diverse populations. They hypothesize that racial and ethnic disparities in health care and outcomes may be related to less effective communication and decisionmaking skills in minorities compared with whites.

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