Showing 9 ideas for tag "inequities"

Goal 2: Reduce Human Disease

Obesity and health inequities

What are the most effective weight loss/weight gain prevention strategies for high risk groups?

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

Details on the impact of addressing this CQ or CC

Effective obesity interventions for high risk groups would help reduce health disparities.

Feasibility and challenges of addressing this CQ or CC

This CQ is feasible because there are significant data that shows that health disparities exist and should be addressed.
Currently two thirds of Americans are either overweight or obese and obesity disproportionately affects individuals from disadvantaged backgrounds. To date there have been few, well designed trials that target high risk groups and it is still unclear what are the most effective strategies to prevent obesity and promote weight loss among ethnic minorities and low-income populations. For instance, the prevalence of obesity is highest among Mexican American boys (compared to white and African American boys; Ogden 2014), yet there are few (if any) trials targeting this high risk group.

Name of idea submitter and other team members who worked on this idea NHLBI Staff

Voting

73 net votes
113 up votes
40 down votes
Active

Goal 2: Reduce Human Disease

Can Psychological Science Improve Weight Loss?

Will sensitivity to the psychological aspects of obesity, including lifestyle priorities and motivations, improve the efficacy of long-term effectiveness of weight loss and obesity prevention interventions?

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

Details on the impact of addressing this CQ or CC

A primary focus on principles of psychology may result in significantly improved control of the obesity epidemic. Effective interventions could reduce the risk of diabetes, sleep apnea, and hypertension. This research could also affect clinical practice guidelines for weight loss and obesity treatment.

Feasibility and challenges of addressing this CQ or CC

Psychological science has been successful in developing effective treatments for a number of conditions, including sleep disorders, depressive symptoms, anxiety and phobias. Many of the behavioral principles employed in such interventions (e.g., cognitive restructuring, motivational methods) could be translated for the prevention and treatment of obesity within a reasonable time frame. Additional attention should be directed to the needs of population subgroups in which obesity is most prevalent.
In their Viewpoint article on weight loss intervention research, Pagoto and Appelhans (JAMA, 2013, see attachment) question whether a continued focus on dietary factors in research on weight loss and obesity is warranted. Their commentary raises the importance of attention to the individual psychological characteristics that influence adherence to weight loss interventions rather than dietary composition.

Name of idea submitter and other team members who worked on this idea NHLBI Staff

Voting

51 net votes
104 up votes
53 down votes
Active

Goal 3: Advance Translational Research

Interventions to Eliminate Health Inequities

There is a need to identify effective interventions for heart, lung, blood, and sleep diseases that could have a transformative population level impact on health inequities if expanded at the national level.

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Critical Challenge (CC)

Details on the impact of addressing this CQ or CC

• Provide new knowledge for implementing strategies that will tackle inequities
• Provides opportunity to create multidiscipline research communities focused on health inequities
• Will gain momentum from federal and national implementation institutions to promote effective interventions to address health inequities

Feasibility and challenges of addressing this CQ or CC

• Capitalizing on new methods, metrics and tapping big data could provide a promising platform to use systems science to better understand the barriers to eliminating health inequities in a short timeframe
• Identifying barriers will allow investigators to devise innovative implementation strategies that can reduce health inequities
• NHLBI could encourage communities of researchers to use team science to both identify barriers and link with other teams to implement strategies to reduce and eliminate barriers
• Established NHLBI health inequities Think Tank and space for developing innovative strategies to address health inequities.

Name of idea submitter and other team members who worked on this idea NHLBI Staff

Voting

32 net votes
47 up votes
15 down votes
Active

Goal 3: Advance Translational Research

Improving heart, lung, blood, sleep Health Outcomes for Minority and Underserved Men

What are the best strategies to improve implementation of evidence-based practices (EBP) to enhance effective health risk communication strategies among racial and ethnic minority males and underserved men?
Examples of several issues that need to be addressed are:
• Need for better definition of the role of families/communities in EBP (as co-therapists).
• Requires less system fragmentation
• Need for improved measurement,... more »

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

Details on the impact of addressing this CQ or CC

Our improved ability to develop, implement and disseminate EBPs tailored specifically for men in health disparity populations may help us move beyond current obstacles in addressing health inequities and improve health outcomes.
Some current challenges:
• High blood pressure affects more than 40 percent of African Americans.
• The odds for stroke, the third leading cause of death in the United States, are especially high for African American men at 70%.
• African Americans are about 50% more likely to experience stroke than Caucasians.
• Sleep apnea is seen more frequent among men than among women, particularly among African-American and Hispanic men.
• Life expectancy for African American men is 4.7 years less than for white men (2010).
• Native American men have an average life expectancy of 71 years old compared to white men who have an average life expectancy of 76.5 year.

Feasibility and challenges of addressing this CQ or CC

• Shifting demographics of race as well as ageing of the population in this country will have a major impact on the utilization, organization and delivery of health care.
• Country acknowledges significant economic burden of health inequities in the U.S. in the near future.
• Hospitals and health systems are working hard to align quality improvement goals with disparities solutions. Opportunity to leverage these efforts for the development and implementation of targeted health disparities initiatives is timely.
• HL has a number of large population-based studies (such as JHS, Strong Heart, Hispanic Community Health) that could be leveraged to specifically identify EBP for wider implementation and dissemination to underserved areas.

Name of idea submitter and other team members who worked on this idea NHLBI Staff

Voting

14 net votes
32 up votes
18 down votes
Active

Goal 4: Develop Workforce and Resources

Implementation Research Workforce Addressing Health Inequities

What are the best strategies to develop a highly competent diverse Implementation Science research workforce to address health inequities?

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

Details on the impact of addressing this CQ or CC

• Enhance fundamental knowledge about new and trans-disciplinary D&I field.
• Improve understanding on ways to scale-up and deliver proven interventions to address health inequities.
• New knowledge generation regarding important adaptations of interventions implemented in the local context.
• Improve health outcomes, particularly in underserved populations in both the U.S. and abroad.
• Successful D&I research training programs will help ensure a competent diverse D&I research workforce.
• Identification of the most effective career timing and combination (balance) of discipline-specific and trans-disciplinary courses essential to develop a cadre of trans-disciplinary implementation science researchers.

Feasibility and challenges of addressing this CQ or CC

Feasibility:
• Dedicated NHLBI Center to promote, develop, implement, and disseminate research findings to address heart, lung, blood, sleep-related conditions and diseases.
• Identified new approaches to creating partnerships with trans-disciplinary research teams that expand beyond academia and increased understanding of the unique nature of mentorship needed for this discipline.
• Experience from several other ICs can be leveraged to improve or ability to be successful and decrease our launch time.
• Field is gaining momentum because of the realization of the unsustainable economic burden of health inequities (expected to increase in the future) in the U.S.

Challenges:

 

• Dedicated training mechanisms are needed to develop and meet our current/future T4 research workforce needs to address health inequities.

• Resources needed that provide unique training approaches (e.g., a trans-disciplinary scientific training environment, knowledge and experience with health disparity populations, unique training faculty (mentor) composition and opportunities to train mentees as future D&I mentors, innovative research tools and research experiences, and broad and diverse partnerships.

• Unique linkages with practice settings across disciplines needed.

Name of idea submitter and other team members who worked on this idea NHLBI Staff

Voting

11 net votes
20 up votes
9 down votes
Active

Goal 3: Advance Translational Research

Implementation of T4 Translation Research Platforms and Networks

How can cost-effective implementation of late stage translation (T4) research protocols be facilitated for heart, lung, blood, sleep diseases and health inequities?

Can research platforms and networks be created and utilized to facilitate execution of multi-level interventions and approaches for the end user in collaboration with key stake holders?

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

Details on the impact of addressing this CQ or CC

Answering this question would lead to timely implementation and dissemination of new knowledge that will be available to address the current heart, lung, blood, sleep health burden.
One of NHLBI’s current strategic plan’s goals is to translate research knowledge for use in populations so that it has significant positive health impacts and provides a return on investment from discovery and early translation research. Currently, only a fraction of new knowledge yielded from proven effective early stage translation research is being used in the real world – resulting in an avoidable disease burden. Late stage translation (T4) research studies the implementation of proven-effective interventions at a multi-level to include populations, communities, healthcare systems, providers, families and patients. Conducting T4 research requires development of comprehensive research teams across communities, public health and health care delivery systems, families, and patients along with unique translation T4 research methods and metrics. Because resource intensive infrastructure is needed to conduct high quality T4 research and this infrastructure is not widely or readily available, a platforms and network for conducting protocols will prove efficient and provide high quality standard outputs.

Feasibility and challenges of addressing this CQ or CC

The NHLBI Health Inequities Think Tank highly recommended that creating T4 translation research platforms and networks would meet the needs of the scientific community enabling them to respond to the heart, lung, blood, sleep health burden.

Name of idea submitter and other team members who worked on this idea NHLBI Staff

Voting

4 net votes
13 up votes
9 down votes
Active

Goal 3: Advance Translational Research

Addressing Health Inequities through Nontraditional Partnerships

What non-traditional partnerships can be leveraged to address health inequities?

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

Details on the impact of addressing this CQ or CC

- Broaden reach to underserved populations
- Increase ability to generate evidence based solutions to address health inequities
- Bring expertise and resources to core partner (NIH)
- Enhance ability to identify unanticipated problems and strengthen efforts across all phases of the implementation research agenda

Feasibility and challenges of addressing this CQ or CC

Feasibility:
- Increased emphasis on health and health inequities by non-profit and particularly, for-profit organizations
- Affordable Care Act (ACA) includes both general and explicit provisions that could narrow the health disparities gaps through implementation research.
- Can leverage and build upon current research partnerships that exist between government agencies and health care delivery systems to address questions of major public health importance
- Opportune time to employ implementation research addressing health inequities through non-traditional research partnership with sectors such as education, state and local government, transportation (built environment), penal and re-entry systems (health risks and disparities), ministries of health, and for-profits, foundations, and non-profits with health care focus.

 

Challenges:

 

- Risk of disagreements and friction among partners and management with different priorities

- Synchronization of timing for decision making

- Achieving partners’ concurrence on decisions that provide the most cost effective solutions

- Time needed to establish trust among partners that do not routinely partner to address health inequities

- There are limited resources dedicated to fostering Public Private Partnerships

Name of idea submitter and other team members who worked on this idea NHLBI Staff

Voting

6 net votes
19 up votes
13 down votes
Active

Goal 3: Advance Translational Research

Culturally competent T4 research interventions to reduce heart, lung, blood, sleep

Using previous federal and partner infrastructure, what are the best methods to promote culturally competent T4 interventions that will reduce cardiopulmonary risk factors in global populations with a disproportionate burden of heart, lung, blood, sleep diseases?

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

Details on the impact of addressing this CQ or CC

Reduction of cardiopulmonary risk factors
Reduction of health inequities

Feasibility and challenges of addressing this CQ or CC

Proven, evidence-based interventions exist for common diseases that can be adapted to reduce burden in low resource settings.
However,determining the best way to adapt existing interventions that are culturally competent and effective is a sensitive issue.

Name of idea submitter and other team members who worked on this idea NHLBI Staff

Voting

-7 net votes
9 up votes
16 down votes
Active

Goal 3: Advance Translational Research

Leveraging Networks of Federally Qualified Healthcare Centers

How best do we leverage the existing Federally Qualified Healthcare Center’s (FQHC) infrastructure to study T4 Implementation Research for heart, lung, blood, sleep diseases and conditions among high risk and vulnerable populations?

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

Details on the impact of addressing this CQ or CC

• Develop strategies to reduced Health Inequities
• Potentially be scaled up across an entire health system with huge population impact
• Studies would be done in the environment and context where the findings with be implemented leading to better uptake and sustainability.

Feasibility and challenges of addressing this CQ or CC

• Formative FQHC groups are already being organized but do not have strong leadership and support
• FQHCs have ready access to the high risk and vulnerable populations that would benefit most from the research

Name of idea submitter and other team members who worked on this idea NHLBI Staff

Voting

-14 net votes
7 up votes
21 down votes
Active