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Pilot Grants Click on the name of the Pilot Study to view the related abstract: Racial Disparities in Substance use and Services Dr. Ty Borders, Principal Investigator The overall objective of this study is to examine
racial (especially African American vs. white) differences in need for
treatment for substance use (both illicit drug and alcohol use) and access to
formal substance abuse services. A secondary objective is to describe
rural/urban differences in need for treatment services, including whether
African American vs. white disparities are exacerbated in rural areas. To
address these issues, we plan to conduct in-depth statistical analyses of the
2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions
(NESARC), a nationally representative in-person interview conducted by the
National Institute on Alcohol Abuse and Alcoholism (NIAAA). The NESARC, which
is publicly available for use by researchers, is a very unique data source as
it contains information on both alcohol use and illicit drug use among approximately 40,000 persons. A better understanding of racial and rural/urban
differences in access to substance abuse services would enable health policy
makers, treatment program managers, and providers to make more informed
decisions about the targeting and tailoring of programs aimed at improving
entry into the substance abuse treatment system. The WORD (Wholeness, Oneness, Righteousness, Deliverance): Feasibility test of a healthy weight program for rural, Southern churches Dr. Karen H. Kim Yeary, Principal Investigator
Practice-based Methods to Improve Quality of Care and Reduce Health Disparities in Diabetes and Cardiovascular Disease Dr. Creshelle R. Nash, Principal Investigator Approximately 6% of Americans (19 million people) have diabetes, with
substantially higher rates among ethnic and racial minority populations. This
translates into a significant economic and personal burden. Arkansas ranks in
the top 5 states in the country for diagnosed diabetes. Timely access to
preventive care and routine disease management services and enhanced adherence
to current standards of treatment could prevent many diabetes-related
complications. Unfortunately, many people do not receive these services, and
there are wide disparities across racial and gender groups. Ethnic and racial
minority groups also have substantially higher rates of CVD morbidity and
mortality and have significantly lower rates of being offered and receiving
appropriate care. Physician practice-based methods to enhance adherence to
practice guidelines and improve overall quality of care have been examined in
a variety of prevention and treatment arenas, however there is little research
in using these methods to reduce health disparities by improving overall
quality of care. Therefore, formative research is critical to understand how
best to approach practices to engage them in promoting appropriate care for
diabetes and CVD among minority patients and how best to facilitate enhanced
adherence to established practice guidelines so that health disparities are
reduced. The specific aims of the proposed pilot are to conduct qualitative
research to explore these important themes at a practice level, to inform the
design of an intervention approach tailored to the needs of the practices and
to evaluate the feasibility of conducting this intervention in
practice-settings on a larger scale. Understanding the Underutilization of Tobacco Cessation Programs in the Mississippi Delta Dr. Christine Sheffer, Principal Investigator Tobacco use is the leading cause of preventable death,
contributing greatly to the incidence and progression of coronary heart
disease (CHD). Cessation provides immediate and major health benefits,
lowering the CHD death risk almost immediately. Lower socio−economic (SES)
groups have more difficulty with cessation and suffer disproportionately from
CHD and other tobacco−related disease. This disparity is linked with access to
evidence−based treatments for tobacco dependence. Several Understanding sexual and reproductive health and the impact of migration in an emerging Latino community in Arkansas Drs. Katharine Stewart & Eduardo Ochoa, co-Principal Investigators The relationship between migrant status and sexual/reproductive health (SRH)
outcomes in the Mexican migrant and immigrant population is poorly understood,
yet appears to be quite complex. On one hand, migration appears to have a
positive impact on infant health, both for the children of women who migrated to
the US and for women who remain in Mexico but whose partners are temporary
migrants to the US. However, migrant workers and their spouses or sexual
partners who remain in Mexico also appear to be at higher risk for negative
outcomes as well, including STD/HIV risk, decreased access to SRH care,
decreased access to prenatal and well-baby care, disruption of social support
networks and coping structures, and depression/anxiety. The objectives of the
proposed project are (1) to identify immigrants' perceptions of the facilitators
and barriers of SRH-promoting behaviors, including condom use, STD/HIV testing
and screenings for cancers of the reproductive system, use of informal health
care systems, prenatal care, and well-baby care, and (2) to describe immigrants'
expectations and utilization of informal, public health, and individual health
systems in Mexico and Arkansas. We will conduct four focus groups, two groups
with men and two groups with women, enrolling a maximum of thirty-two
participants, all of whom will be adults aged 18 to 45 years of age who have
migrated to Arkansas from Mexico at least three months but no more than three
years prior to the date of their enrollment in the study. All participants must
have had contact with a health care provider in the past twelve months for
sexual or reproductive health care, including testing or treatment for sexually
transmitted infections, prenatal or well-baby care, or another sexual or
reproductive health concern. Participants will be reimbursed for their time and
travel. Confidentiality concerns and the risk of potential discomfort with
personal questions will be managed with well-defined and established procedures.
Results of the study will be used to identify the principal concerns regarding
sexual and reproductive health care among recent immigrants from Mexico,
approaches used in this community to reduce sexual and reproductive
health-related risks, and perceived barriers to and facilitators of accessing
sexual and reproductive health care. Engaging at-risk youth in physical activity and health improvement: Feasibility analysis of the iPod Sports Kit and digital feedback Dr. Alan VanBiervliet, Principal Investigator
UAMS Arkansas Center for Health Disparities
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Despite multidisciplinary efforts to control the nation's
obesity epidemic, obesity has persisted as one of the U.S.'s top public health
problems, particularly among African Americans and rural residents. To
combat current disparities in health, innovative approaches to address obesity
that are sensitive to the unique issues of rural African Americans are needed.
Current approaches have emphasized the importance of culturally appropriate
materials and the potential impact of a faith-based intervention in
underserved rural communities. The purpose of this pilot is to conduct
a feasibility test of a faith-based weight loss intervention culturally
adapted for rural African American adults. The materials will incorporate
weight loss methods and materials from evidence-based behavioral weight loss
interventions and will adapt these materials to integrate deep structure
cultural components, and spiritual and faith related themes. The pilot will test a
culturally adapted, faith-based behavioral weight loss intervention
implemented among African American churches. The pilot will build
upon preexisting relationships with the Faith Task Force, which consists of
over 30 churches and community organizations in rural, low income Arkansas
counties, and with which the Pilot PI has been involved for over 3 years. 
Statewide in-school BMI measurements have documented very high rates of
overweight children in Arkansas, particularly among children in rural areas
and in African-American and Hispanic children. Overweight children are at
increased risk of having lipid, cardiac and vascular abnormalities. Research
clearly shows that increasing physical activity is one of the cornerstones of
pediatric obesity treatment along with dietary and behavioral change. Many
programs for decreasing childhood obesity have been implemented in schools and
clinics, but few have succeeded in long term weight management. The long term
goal of the proposed research is to develop and evaluate a strategy that can
engage at risk youth in healthy physical activity that can be maintained
throughout their lives. This strategy could be incorporated into a wide range
of intervention programs involving physical activity, nutrition, and
behavioral change. This pilot study will conduct a systematic feasibility
analysis of an iPod Sports Kit physical activity program designed for at risk
youth from minority and lower socioeconomic households in rural and urban
communities. The project will be accomplished through a partnership with public
schools in the Little Rock area. Using community-based participatory
methodologies groups of representative youth and professionals will
participate in a structured process to identify design guidelines, create
prototype graphical user interfaces, design music playlists, create graphical
components, design a performance tracking and feedback system, and participate
in the evaluation of the system. An iterative user-centered development
process following the Usability.gov guidelines will result in design
specifications for the complete development of the system in the second phase
of the research project. The prototype system will undergo systematic
formative analysis and initial testing during this pilot phase.