Projects
Current Projects
Lung Cancer Surgery: The Anatomy of Decisions Against Life Saving Care – Lung cancer is the leading cause of cancer death in the United States. Non-small cell histology represents about 80% of all cases; surgical resection during stage I or II disease remains the only reliable treatment for cure. Despite the mortality associated with rejecting surgery, 24% of white patients and 36% of black patients diagnosed with stage I or II disease do not proceed to operation. This prospective cohort study in four sites in NC (two university and two community settings, including chest surgery, pulmonary medicine, and thoracic oncology) includes 380 newly diagnosed, early stage lung cancer patients (approximately 60% white, 40% black). It allows patient factors (age, race, comorbidity, pulmonary physiology, spirituality, trust in physicians, functional status) and physician factors (specialty, experience, beliefs regarding operative morbidity, decision-making style) affecting the decision-making process to be identified.
Principal Investigator: Samuel Cykert, M.D.
Funding Source: American Cancer Society
Total Project Period: 07/05 –12/09
Project GRACE: A Participatory Approach to Address Health Disparities – This planning grant builds on the infrastructure of the NCMHD funded Carolina-Shaw Partnership for the Elimination of Health Disparities (Project EXPORT) and existing academic-community partnerships that share the common goal of eliminating health disparities in the African American communities and uses a community-based participatory research (CBPR) framework for partnership development and intervention design. The long-term goal is the development of feasible and sustainable interventions that reduce the spread of HIV in Edgecombe and Nash counties. To that end this project aims to: 1) expand, strengthen and evaluate The Project GRACE Consortium; 2) identify community needs and assets to support the development of multilevel interventions to address individual and environmental/contextual factors that influence the spread of HIV; 3) define culturally appropriate multilevel interventions that draw on community insights and available resources to address individual and environmental/contextual determinants of the spread of HIV; and 4) test the feasibility of proposed methods for recruiting and training lay health advisors to address both individual and environmental/contextual determinants of the spread of HIV.
Principal Investigator: Giselle Corbie-Smith, M.D.
Funding Source: National Center for Minority Health and Health Disparities (NCMHD), NIH
Total Project Period: 09/30/05 – 02/28/10
HIV/AIDS Research Among African American Women in Rocky Mount, NC – This is a cross-sectional study of 500 African American women in two North Carolina counties with high rates of sexually transmitted diseases and HIV to examine risk factors for these infections. Specifically, the prevalence of Neisseriae gonorrhoeae (GC), Chlamydia trachomatis (CT), and HIV and estimate HIV incidence is being determined. In particular, the project aims to increase understanding of socio-cultural factors (for example, religiosity and spirituality) and proximate determinants (e.g., epidemiologic factors and high-risk sexual behaviors and practices, such as concurrent partnerships) that influence HIV/STI transmission and determine the strength of their association with GC, CT, and HIV infection. Qualitative research is also being conducted using focus groups among 70-80 African American women to obtain a more in-depth understanding of socio-cultural, structural, socioeconomic, and other contextual factors that influence HIV transmission among African American women in the study population; and behavioral and other proximate determinants identified as important in the cross-sectional study. Understanding these factors is a critical first step in designing effective HIV interventions for this population.
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Principal Investigator: Adaora A. Adimora, M.D.
Funding Source: Centers for Disease Control and Prevention
Total Project Period: 09/30/05 – 09/29/09
Shaw University M-RISP Minority Elderly Research Center (SUMMER CENTER) – Faculty members at UNC-CH are providing the following to Shaw University and its investigators: 1) a program of training and skills-building; 2) research support including assistance with grant and budget preparation, data management, analysis, and report writing; 3) mechanisms for the development and evaluation of new study proposals that ensures their relevance to eliminating racial and ethnic disparities in health; 4) workshops for minority, health services research, and service communities to promote and disseminate Shaw findings; 5) assistance in recruiting more senior research-oriented faculty; 6) promotion of more scholarly research publications; and 7) expansion into other substantive areas and study population as Shaw expertise evolves.
Principal Investigators: Timothy S. Carey, M.D., M.P.H.
Funding Source: Agency for Healthcare Research and Quality (subcontract with Shaw University)
Total Project Period: 12/05 – 11/10
Increasing Access to HIV Trials for Rural Minorities – Despite an epidemic of new HIV infections in racial and ethnic minorities and continued emphasis on minority inclusion in research, minority participation in HIV/AIDS trials has not kept pace. In rural minority communities many barriers limit access to clinical trials, at the community and individual levels. This project is fully characterizing individual and community influences on research participation of rural African Americans and Latinos and develop innovative, theory-based, culturally responsive interventions. In Phase 1 focus groups with community leaders and health care/service providers were held and semi-structured interviews with individuals with HIV will characterize influences on willingness to participate in research. Phase 1 participants will give feedback on a culturally responsive outreach strategy for the community and providers, individual enrollment sessions, and a mobile trials unit. In Phase 2 these data will be used to modify the conceptual model and the model will be used to develop and refine the outreach strategy. Cognitive interviews with community leaders, providers and individuals with HIV will determine the acceptability of each component. In Phase 3 a 12-month assessment of the individual enrollment session and mobile unit, alone and in combination, will be conducted in a single site.
Principal Investigator: Giselle Corbie-Smith, M.D.
Funding Source: National Institute for Nursing Research (NINR), NIH
Total Project Period: 06/06 – 05/10
Primary Care-Practice Based Research Network (PBRN) – This is a master task order contract that brings together five North Carolina-based PBRNs, three based at UNC-CH, one based at Duke University, and one based at Carolinas HealthCare System. Although no core funds are allocated, it places UNC on a “short list” for contract work from AHRQ over the next 3-5 years, and multiple research projects will result.
Principal Investigator: Philip D. Sloane, M.D., M.P.H.
Funding Source: Agency for HealthCare Policy and Research (AHRQ)
Total Project Period: 01/29/07 – 9/1/10
The UNC-Chapel Hill/Shaw University Comprehensive NCMHD Research Center – With the Goal of eliminating health disparities, the UNC-Shaw NCMHD Research Center aims to be a research incubator that will conduct innovative minority health research among adult African –American populations in North Carolina. This project builds on the previously funded Carolina-Shaw University Partnership for Health Disparity Research. The NCMHD Center will be organized into three cores. The Administrative Core enhances the comprehensive research center structure developed during the initial Project EXPORT grant period through which the partnership between UNC and Shaw University implements research activities, pilot projects, and community engagement efforts. The Research Core leverages the recently enhanced research infrastructure at Shaw University and the existing research resources by managing three-component research projects and seven pilot projects in an effort to foster research leading to measurable improvements in health disparities. The Community Engagement Core supports and conducts innovative research activities involving the DC2 church network established in the initial grant. This core seeks to know and understand better the components of black churches organizational readiness to engage in research, in particular the kinds of research that are effective for 1) engaging clergy, laity, and faculty in disseminating evidence based interventions and 2) engaging African- American communities and individuals as active participants in the research process.
Principal Investigator: Paul A. Godley, M.D., Ph.D.
Funding Source: National Center for Minority Health and Health Disparities (NCMHD), NIH
Total Project Period: 09/30/07 – 05/31/12
A Family-Focused Lay Health Advisor Program to Reduce the Rate of Cardiovascular Disease among African Americans - Provide consultation and guidance for the development of the Train-the-Trainers curriculum and the revision of the Power 2 Prevent (P2P) curriculum; Participate in monthly conference calls with all partners; Assist with the evaluation of the proposed program: Provide expertise at the Diabetes Overview session of each P2P round (8 times per year) Provide 10% of Research Assistant's time to assist with curriculum development and collection of evaluation data.
Principal Investigator: Crystal Wiley, PhD
Primary Funding Source: Together Transforming Lives via NC Health and Wellness Trust Commission
Total Project Period: 7/1/09-6/30/12
North Carolina Cancer Clinical Trial Community Advisory Board- Mistrust of medical research remains as a significant obstacle to minority participation in clinical research. Strategies seeking to increase community knowledge underestimate the gravity of distrust. In order to address disparities in cancer, engaging community representatives/patient advocates (CR/PA) as research partners can enhance research participation of people of color and increase the value of cancer research. This perspective recognizes that public representatives have a role in cancer clinical research beyond research participation to ensure a meaningful role of community representatives/patient advocates to provide the fundamental perspective from the public and advance implementation of research. Three comprehensive cancer centers in North Carolina design and conduct clinical trials for our local strengthen academic accountability to the medically underserved. Despite this, NCI clinical trial participation in the surrounding counties is low. We propose to 1) develop and train a Community Advisory Board to provide guidance to local research sites and 2) partner with local research sites to enhance the role of CR/PAs local cancer clinical trials. Trained in the ethical protocols of research principles and clinical protocols, minority cancer survivors and caregivers are ideal community representatives to review clinical trial protocols for community relevance and feasibility.
Principal Investigator: Giselle Corbie-Smith, PhD
Primary Funding Source: Education Network to Advance Cancer Clinical Trials (ENACCT)
Total Project Period: 1/1/09-12/31/09
Recently Completed Projects
Initiative to Identify and Eliminate Racial Ethnic Disparities within UNC Health Care – Disparities in the health and health care of racial and ethnic minorities in the U.S. are well recognized and their causes are known to be many, but there are few tested models for reducing disparities, particularly for patients within a particular practice organization. This project aims to 1) use analyses of a wide variety of available health care system data to identify differences in access to care, use of health care services and care experiences for African American, Hispanic and non-Hispanic white patients of UNC Health Care; 2) use analysis of health system data and the methods of continuous quality improvement (CQI) to help clinical departments identify the causes for identified racial-ethnic disparities in care and design, implement and monitor interventions to reduce the disparities; and 3) to formally evaluate the usefulness of these approaches in identifying and reducing racial-ethnic disparities in care within UNC Health Care and to broadly disseminate the findings.
Co-Principal Investigators: Donald E. Pathman, M.D., M.P.H.
Funding Source: UNC School of Medicine, Investments in the Future
Total Project Period: 07/07 – 06/10
Disparities in the Diffusion of State-of-the-Art Prostate Cancer Treatments – The project will explore the hypothesis that racial disparities in prostate cancer mortality are associated with disparities in the diffusion of new prostate cancer treatments to African American patients. SEER Medicare data will be used to identify prostate cancer patients and longitudinally follow the adoption of new treatments among Caucasian and African Americans. Seer site, age, disease stage, and socio-economic status will be controlled for. The results of the study could lead to increased understanding of how delayed access to state-of-the-art treatments can affect racial disparities in cancer outcomes.
Principal Investigator: Paul A. Godley, M.D., Ph.D.
Funding Source: U.S. Department of Defense
Total Project Period: 02/07 – 03-09
High-Risk Heterosexual Partnering in the Age of AIDS: A Multilevel Analysis – Mathematical modeling demonstrates that concurrent partnerships speed transmission of HIV through sexual networks much more effectively than does serial monogamy with the same total number of sexual partners. The social and economic environment in which many African Americans live discourages long-term monogamy and promotes concurrent partnerships. Extensive involvement in concurrency may be a critical factor in the epidemic of HIV and other sexually transmitted infections (STIs) among African Americans. This study will test the following hypotheses through multilevel analyses of a nationally representative data set, Cycle 6 of the 2002 National Survey of Family Growth: 1) African American men and women are more likely than white men and women to have had heterosexual concurrent partnerships during the preceding 12 months and 2) involvement in concurrent partnerships is related to lower community sex ratio, education, and marriage rates, and to higher unemployment, poverty and crime rates.
Principal Investigator: Adaora A. Adimora, M.D.
Funding Source: National Institute of Child Health and Human Development (NICHD), NIH
Total Project Period: 04/20/07 – 03/31/09
Lay Health Pilot Study: On Our Own Terms – This pilot study designs and tests the feasibility of a Lay Health Advisor intervention with the overall objective of improving treatment for pain and suffering for African American patients with cancer. To achieve this objective, a successful research partnership between the UNC-CH School of Medicine and Shaw University, a historically black university is being used. An interdisciplinary group of faculty with expertise in palliative care and in community-based research are recruiting 30 Palliative Care Lay Health Advisors (PCLHA) from 6 African American churches. The specific aims of this project are to: 1) explore the acceptability and comprehensiveness of an existing measure of quality of life at the end of life (QUAL-E) in focus groups of African-American cancer patients and family caregivers; 2) test the feasibility of proposed methods for recruiting and training PCLHAs from African-American churches; 3) test the feasibility of proposed methods for pairing PCLHAs with African-American patients with advanced cancer and their family caregivers; and 4) describe the impact of PCLHAs on these cancer patients’ knowledge of local providers of pain and symptom treatment, communication about life-sustaining treatment choices, quality of life, and perceived unmet need for treatment of pain and suffering.
Principal Investigator: Laura C. Hanson, M.D., M.P.H.
Funding Source: National Institute of Nursing Research, NIH
Total Project Period: 09/12/05 – 08/31/08
Project GRACE: A Participatory Approach to Address Health Disparities – This planning grant builds on the infrastructure of the NCMHD funded Carolina-Shaw Partnership for the Elimination of Health Disparities (Project EXPORT) and existing academic-community partnerships that share the common goal of eliminating health disparities in the African American communities and uses a community-based participatory research (CBPR) framework for partnership development and intervention design. The long-term goal is the development of feasible and sustainable interventions that reduce the spread of HIV in Edgecombe and Nash counties. To that end this project aims to: 1) expand, strengthen and evaluate The Project GRACE Consortium; 2) identify community needs and assets to support the development of multilevel interventions to address individual and environmental/contextual factors that influence the spread of HIV; 3) define culturally appropriate multilevel interventions that draw on community insights and available resources to address individual and environmental/contextual determinants of the spread of HIV; and 4) test the feasibility of proposed methods for recruiting and training lay health advisors to address both individual and environmental/contextual determinants of the spread of HIV. more info...
Principal Investigator: Giselle Corbie-Smith, M.D.
Funding Source: National Center for Minority Health and Health Disparities (NCMHD), NIH
Total Project Period: 09/30/05 – 06/30/08
Shaw UNC-CH Center for Prostate Cancer Research (SUCPCR) – As a subcontractor, UNC-CH is providing a structured program of training and skill-building for Shaw University investigators that will include monthly seminar/colloquia series, skills building workshops, one-on-one meetings, and weekly telephone conferences.
Principal Investigator: Paul A. Godley, M.D., Ph.D.
Funding Source: U.S. Department of Defense
Total Project Period: 7/05 – 7/08
