Faculty Bibliography

We have reported results from the formative stage of a community health worker intervention designed to improve diabetes management among Bangladeshi patients in New York City. Trained community health workers conducted focus groups (n = 47) and surveys (n = 169) with Bangladeshi individuals recruited from community locations. Results indicated that participants faced numerous barriers to care, had high rates of limited English proficiency, and had low levels of knowledge about diabetes. Most participants expressed interest in participating in a community health worker intervention.

PROBLEM: Considerable progress in Asian American health research has occurred over the last two decades. However, greater and sustained federal support is needed for reducing health disparities in Asian American communities. PURPOSE OF THE ARTICLE: This paper reviews federal policies that support infrastructure to conduct minority health research and highlights one model for strengthening research capacity and infrastructure in Asian American communities. KEY POINTS: Research center infrastructures can play a significant role in addressing pipeline/workforce challenges, fostering campus-community research collaborations, engaging communities in health, disseminating evidence-based strategies and health information, and policy development. CONCLUSION: Research centers provide the capacity needed for academic institutions and communities to work together synergistically in achieving the goal to reduce health disparities in the Asian American community. Policies that support the development of concentrated and targeted research for Asian Americans must continue so that these centers will reach their full potential.

CONTEXT: Data regarding effects of lower-dose GH on cardiopulmonary function in GH-deficient (GHD) adults are limited. OBJECTIVES: The objective was to assess effects of lower-dose GH on exercise capacity and echocardiographic parameters in GHD adults. DESIGN: The study was a 6-month double-blind, placebo-controlled randomized trial. SETTING: The study was conducted at the General Clinical Research Center. PARTICIPANTS: Thirty hypopituitary adults with GHD were studied. INTERVENTION: Subjects were randomized to recombinant human GH or placebo for 6 months, followed by open-label recombinant human GH for 12 months. MAIN OUTCOME MEASURES: Primary endpoints were exercise duration, maximal oxygen consumption, and left ventricular ejection fraction. Secondary endpoints were echocardiographic indices of systolic and diastolic function, left ventricular mass, lipids, and body composition. RESULTS: In the 6-month double-blind phase, mean GH dose was 0.64 mg/d. Mean IGF-I sd score increased from -4.5 to -1.0. Exercise duration, maximal oxygen consumption, left ventricular ejection fraction, and other echocardiographic parameters were normal at baseline and did not change. GH decreased total and low-density lipoprotein cholesterol by 7.5% (P = 0.016) and 14.7% (P = 0.002) (P = 0.04 vs. placebo). Mean lean body mass increased by 2.2 kg (P = 0.004), fat mass decreased by 1.7 kg (P = 0.21), and percent body fat decreased by 2.5% (P = 0.018), although between-group changes were not significant. CONCLUSIONS: Human GH did not improve exercise performance or echocardiographic parameters or decrease fat mass but significantly decreased total and low-density lipoprotein cholesterol, increased IGF-I, and increased lean body mass. These results indicate that responses to human GH are variable and should be assessed at baseline and during treatment

Background: Community coalitions are increasingly recognized as important strategies for addressing health disparities. By providing the opportunity to pool resources, they provide a means to develop and sustain innovative approaches to affect community health. Objectives: This article describes the challenges and lessons learned in building the Asian American Hepatitis B Program (AAHBP) coalition to conduct a community-based participatory research (CBPR) initiative to address hepatitis B (HBV) among New York City Asian-American communities. Methods: Using the stages of coalition development as a framework, a comprehensive assessment of the process of developing and implementing the AAHBP coalition is presented. Lessons Learned: Findings highlight the importance of developing a sound infrastructure and set of processes to foster a greater sense of ownership, shared vision, and investment in the program. Conclusion: Grassroots community organizing and campus-community partnerships can be successfully leveraged to address and prevent a significant health disparity in an underserved and diverse community

Disparities in the quality of health and healthcare delivery across racial, ethnic, gender, and socioeconomic groups have been documented, specifically when evaluating cardiovascular diseases. As the US population has diversified, the elimination of these disparities has become the focus of a national initiative. In this regard, the promotion of patient-centered care and cultural competency in healthcare delivery has been proposed using approaches such as: the development and integration of culturally appropriate educational curricula for training future care providers, the promotion of underrepresented racial and ethnic minorities among healthcare professionals, the recruitment of community healthcare workers to promote health within their cultural communities, the establishment of culturally tailored interventions for delivering quality care to racial and ethnic minorities, the improvement of patient and provider communication by eliminating language barriers, and the education of minorities about access to healthcare and participation in clinical decision making. This article discusses initiatives aimed at achieving equitable access and delivery of cardiac health in minorities.