Institute for Health, Social, and Community Research at Shaw University

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Institute for Health, Social, and
Community Research at Shaw University

• Building Successful Research Infrastructures
  Lessons Learned in Achieving and Measuring
  Success
• Daniel L. Howard, Ph.D.
• Professor of Health Policy and Director

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Institute for Health, Social, and Community
Research at Shaw University

• Outline of Presentation
• Brief update on the M-RISP funded SUMMER Center
• Discuss how success is defined
• Discuss sustaining infrastructure development
• Brief update on the IHSCR
• Challenges/Lessons learned
• Short term effect of the M-RISP
• Long term effect of the M-RISP
• Future plans

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Institute for Health, Social, and
Community Research at Shaw University

• Shaw University M-RISP Minority Elderly Research
  (SUMMER) Center. (R24 HS013353). Shaw University.
  DHHS AHRQ M-RISP. PI DL Howard. 9/30/02-9/29/05.
  1,201,567.00.
• Shaw University M-RISP Minority Elderly Research
  (SUMMER) Center Renewal (2 R24 HS013353). Shaw
  University. DHHS AHRQ M-RISP. PI DL Howard.
  12/1/05-11/30/09. 1,094,055.00.

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Institute for Health, Social, and Community
Research at Shaw University

• Why Minority Elderly Research?
• PI was familiar with topic
• Some Shaw faculty had expertise in topic
• PI was familiar with available dataset
• PI strength was in secondary data analysis
• PI, with the assistance of mentor, could put
  together several reasonable studies
• In other words, assess your strengths and go with
  that!

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Institute for Health, Social, and Community
Research at Shaw University

Specifically, the two components of the SUMMER
Center are (1) to establish institutional
infrastructure support for research development
to strengthen and enhance the capability of Shaw
faculty members to undertake health services
research and (2) to support individual
investigator research projects focused on the
elimination of health disparities which will, in
turn, lead to increases in health knowledge and
will form the basis for Shaw faculty to become
more competitive in extramural research.
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Institute for Health, Social, and Community
Research at Shaw University
SUMMER Center Structure

• Administrative Core
• Methods Core focusing on Statistics and
  Measurement Issues
• Ongoing Seminar Series
• Training Component for Shaw faculty
• Seven (7) Research Projects

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Institute for Health, Social, and Community
Research at Shaw University

• Where did my doctor go? The impact of
  physician workforce transitions on the disruption
  of longitudinal physician-patient relationships
  in a racially diverse sample of elders.
• Publications
• Konrad, Thomas R., Daniel L. Howard, Lloyd J.
  Edwards, Anastasia Ivanova, and Timothy Carey.
  Physician-Patient Racial Concordance, Continuity,
  and Patterns of Care for Hypertension. American
  Journal of Public Health 2005 Dec.
  25(12)2186-90.
• Howard, Daniel L., Carol D. Bunch, Wilberforce O.
  Mundia, Thomas R. Konrad, Lloyd J. Edwards, M.
  Ahinee Amamoo, and Yhenneko Jallah. Comparing
  United States Vs. International Medical School
  Graduate Physicians Who Serve African American
  and White Elderly. HSR Health Services Research
  416 (December 2006).

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Institute for Health, Social, and Community
Research at Shaw University
(2) Physician Patient Racial Concordance and
Continuity of Care Among Elders and its Effect on
Medical Interventions for Symptomatic Prostate
Health Problems. Publications Howard, DL,
Edwards, BG, Whitehead, K, Amamoo, MA and Godley,
PA. Quality and Severity of Lower Urinary Tract
Symptoms Among African American Elders. Journal
of Health Disparities Research and Practice
Vol.1, No. 2, Winter 2007, pp.73-91. Howard, DL,
Edwards, BG, Whitehead, K, Amamoo, MA and Godley,
PA. Racial Differences in the Healthcare Seeking
for Lower Urinary Tract Symptoms. Journal of the
National Medical Association Vol.99, No.4,
pp.404-411, April 2007. Howard, DL, Taylor, YJ,
and Ross, LE. Differences in Lower Urinary Tract
Symptoms (LUTS) Treatment and Mortality among
African American and White Elderly Men. Journal
of the National Medical Association (in press)
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Institute for Health, Social, and Community
Research at Shaw University
(3) Regional Study of Incontinence and Stage
I-IV Pressure Ulcers Among African American
Nursing Home Residents. Publications
Boyington JE, Howard DL, Carter-Edwards L,
Jallah, Y,Gooden KM, Busby-Whitehead J. Racial
differences in resident characteristics and UI
prevalence in nursing homes in the southeastern
United States (MDS Atlanta Region). Nursing
Research Vol.56, No.2, March/April 2007. Erdem N,
Howard, DL, Carter-Edwards L, Gooden KM, Amamoo,
MA. and Busby-Whitehead J. Racial disparities in
the nursing home management of urinary
incontinence in the southeastern United States.
Journal of Aging and Gerontological Sciences (in
press) Howard, DL, Taylor YJ. Racial and Gender
Differences in Pressure Ulcer Development among
Nursing Home Residents in the Southeastern United
States. Journal on Women and Aging (in review)
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Institute for Health, Social, and Community
Research at Shaw University
(4) The Effect of Racial Congruity, Continuity
of Care, Health Care Utilization on Physical
Function Among African Americans and Caucasians
with Stroke and Diabetes. Publications Boyingto
n JEA, Howard, DL, Holmes. DN. Self-rated health
(SRH), ADL and Mobility Limitations among black
and white stroke survivors of the NC EPESE
population. Journal of Aging and Health (in
press) Kim, MM, Howard, DL, Kaufman, JS, and
Holmes, D. Predicting medication use in an
elderly hypertensive sample Revisiting the
Established Populations for Epidemiologic Studies
of the Elderly study. Journal of the National
Medical Association (in press)
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Institute for Health, Social, and Community
Research at Shaw University
(5) Social Constructions of Cultural Meaning and
Reasons for Caregiving in African American
Families (6) Examination of the relationship
of Diabetes and Hypertension to the Onset of Eye
Disease, Specifically Cataracts and Glaucoma,
among African Americans (7) Depression Among
African-American Elderly in Long-Term Care
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Institute for Health, Social, and Community
Research at Shaw University How is success
defined?

• The HBCU administration defines it as Hey we
  got the money!
• (There is no concern regarding the research now
  the light bill can be paid.)
• The PI defines it as Now I finally made it!
• (Writing a successful grant application is seen
  as the crowning achievement rather than realizing
  that the real work has just begun.)
• AHRQ defines it as meeting the mission of the
  agency and showing a worthwhile investment of
  federal funding.
• EVERYONE HAS TO BE ON THE SAME PAGE

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Institute for Health, Social, and Community
Research at Shaw University Is there congruency
between how you define success and how AHRQ
defines success?

• Did you complete the research project(s)?
• Did you disseminate the results in conferences?
• Did you publish the results?
• Did you do enough to justify a renewal? / Are you
  going to apply for a renewal?
• Were you renewed?
• How many involved faculty can now submit their
  own grants?
• How many involved students are now interested in
  graduate school?
• Has the research development been sustained?

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Institute for Health, Social, and Community
Research at Shaw University How do you sustain
research infrastructure development?

• Conduct a research needs assessment
• Collaboration, collaboration, collaboration
• Seek more funding
• Seek out strong co-investigators
• Let everyone know what you are doing
• You have to think beyond the completion of
  individual research projects toward putting in
  place infrastructure that will help replicate
  productivity.
• THINK BIG!!!

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Institute for Health, Social, and Community
Research at Shaw University

• Mission Statement
• to become a national leader in the
  multidisciplinary empirical investigation of
  diverse issues that affect the health and
  well-being of minorities, particularly African
  Americans, their families, and the communities in
  which they live.

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Institute for Health, Social, and Community
Research at Shaw University

• The Institute will
• develop a collective of proficient researchers
  involved in health-related areas of research
• conduct scientifically sound and relevant
  minority health and health disparity research
• enhance collaborations with Research I level
  universities and other institutions
• provide leadership to Shaw in developing a
  university focus toward public health.

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Institute for Health, Social, and
Community Research at Shaw University

• About the IHSCR
• Organized in 2003
• In 2006, officially recognized as a Department of
  Shaw University
• Constitutes the largest Department of the
  University
• Composed of 35 individuals including PhD-level
  investigators, Masters level public health
  professionals, and administrative staff
• Established research collaborations with academic
  institutions including UNC-CH, Johns Hopkins
  University, Duke University, University of
  Michigan, Wake Forest University, and Morehouse
  Medical School
• Has secured funding for research totaling more
  than 20 million dollars

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Institute for Health, Social, and
Community Research at Shaw University

• Other Current Funding Sources
• 1. National Institutes of Health, National
  Center on Minority Health and Health Disparities
• 2. National Institutes of Health, National
  Center for Research Resources
• 3. U.S. Department of Health and Human Services,
  Centers for Medicare and Medicaid Services
• 4. U.S. Department of Defense,
  Congressionally-Directed Medical Research
  Programs

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Institute for Health, Social, and Community
Research at Shaw University

• Sentinel Events
• In 2002, Shaw University was the only university
  in the nation to hold two NIH NCMHD-funded
  Project EXPORT grants (P60 and R24)
• Carolina-Shaw EXPORT Center identified as
  showcase model by external Scientific Program
  Advisory Committee of national research experts
• Renewal of the Project EXPORT Center of
  Excellence for 5 more years
• Renewal of the SUMMER Center grant for 4 more
  years
• Eleven IHSCR investigators and staff have secured
  external research funding beyond the initial
  funding provided by AHRQ M-RISP
• Daniel L. Howard, Ph.D., was recipient of the
  2006 Minority Access National Researcher Role
  Model Award
• IHSCR hosts second major research conference,
  September 26, 2008
• New 32,500 sq. ft., 5.3 million IHSCR Building
  completed September 2008

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Institute for Health, Social, and Community
Research at Shaw University

• IHSCR researchers have published twenty-two (22)
  manuscripts in leading peer-reviewed scientific
  journals.
• Additionally, IHSCR researchers have nine (9)
  manuscripts accepted and in press in leading
  peer-reviewed scientific journals.
• Moreover, IHSCR researchers have nine (9)
  manuscripts in review in leading peer-reviewed
  scientific journals. (Twenty-eight (28) are in
  various stages of process.)
• IHSCR investigators have made fifty-one (51)
  conference presentations at professional,
  national, and state meetings.

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Institute for Health, Social, and Community
Research at Shaw University

• Challenges
• Heavy teaching loads of Shaw faculty / Ensuring
  release time for research for Shaw faculty
• Authorship Issues
• Manuscript review, submission and tracking issues
• Renewing partnership leadership and faculty
• Continuing to enhance the infrastructure of the
  university to support research activities
• Moving from Infrastructure Enhancement to
  Research
• Adjusting to the ebb and flow of funding to
  support research priorities

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Institute for Health, Social, and Community
Research at Shaw University

• Lessons Learned
• Leadership starts with the PI.
• Quality preparation is essential for junior
  faculty seeking to become researchers / Recruit
  researchers with a commitment and ability to
  complete studies and produce publications.
• Hold technical assistance research meetings with
  junior faculty.
• Proper delegation to highly trained, experienced,
  eager individuals is key to sustained quality
  program (Support and Administrative staff).
• Establish priorities and use them as a guide as
  you expand your operations.
• Proper communication is essential and ongoing.
  Always put your thoughts, ideas, and plans in
  writing.
• Careful planning and organization will yield the
  most success / Implement a documented system for
  assessing, measuring, and evaluating progress and
  providing feedback.
• Sustaining support for a new research venture
  requires tangible results.

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Institute for Health, Social, and Community
Research at Shaw University

• How has M-RISP Impacted Research in the Short
  Term
• Initiated a firm foundation for research at Shaw
• Elevated research activities on Shaws campus
• Increased the volume and level of scholarly
  research conducted
• Created an environment for attracting top level
  researchers
• Facilitated the creation of the Center for Survey
  Research and the Center for Biostatistics and
  Data Management within the IHSCR
• Established collaborative seminar series, skill
  building and mentoring sessions with UNC-CH
• Assisted the pursuit of additional grant funding
• Increased publications in peered reviewed
  journals
• Increased presentations at scientific conferences

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Institute for Health, Social, and Community
Research at Shaw University

• How has M-RISP Impacted Research in the Long Term
• Has helped the IHSCR become a national leader in
  health services research
• Has enhanced Shaws and the IHSCRs
  infrastructure to support research
• Has increased collaborations with more Research 1
  Level Institutions
• Has facilitated the expansion of research to
  other health related areas
• Has increased research visibility

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Institute for Health, Social, and Community
Research at Shaw University

• Future Plans
• To become a national leader in minority health,
  health services, and health disparity research by
  expanding our research endeavor into various
  substantive health areas.

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Institute for Health, Social, and Community
Research at Shaw University

• Research Infrastructure Development Articles
• Carey, TS, Howard, DL, Goldmon, M, Roberson, JT,
  Godley, PA, and Ammerman, A. Developing
  Effective Inter-University and Community
  Partnerships to Address Health Disparities.
  Academic Medicine 2005 Nov. 80(11)1039-45.
• Carey, TS, and Howard, DL. The development of the
  field of health disparities research the role of
  cross-disciplinary and institutional
  collaboration. Harvard Health Policy Review
  Vol.8,No.1,pp.136-144, Spring 2007.
• Walker, TA, Howard, DL, Washington, CR, and
  Godley, PA. Development of a Health Sciences
  Library at an HBCU Laying the Foundation for
  Increased Minority Health and Health Disparities
  Research. Journal of the Medical Library
  Association 95(4) October 2007.
• Howard, DL, Boyd, C, Walker, TA, Kalsbeek, WD and
  Godley, PA. Investigating health disparities
  Survey research infrastructure at a historically
  Black college/ university. Journal for
  Healthcare of the Poor and Underserved (revise
  and resubmit)
• Howard, DL, Walker, TA, Boyd, C, Nelson, D,
  Washington, C and Godley, PA. Getting from A to
  IRB Developing an Institutional Review Board at
  a Historically Black College and University
  (HBCU). Journal of Empirical Research on Human
  Research Ethics (in review)