The goal of this application is to establish the Contextual Health Disparities-Core (COHD) in the Northern Manhattan Center of Excellence in Minority Health and Health Disparities at Columbia University (NOCEMHD) in response to RFA-MD-11-008, """"""""Limited Competition: NIMHD Revision Applications to Support Environmental Health Disparities Research (P60)."""""""" The COHD will be established through a partnership with the Center for Study of Social Inequalities and Health (CSSIH) at the Mailman School of Public Health (MSPH), (director, Bruce Link, PhD). The leader of the COHD will be Dr. Link. The co-leader of this core will be Dr. Dana March. Research in NOCEMHD has focused on cohort studies and clinical trials examining determinants of minority health at the individual level, particularly in our focus areas of cardiovascular conditions (diabetes, hypertension), mental health (cognition, depression), and their coexistence. However, environmental factors interact with individual level factors to determine health outcomes in cardiovascular conditions and mental health. We refer to these factors as Health Disparity Environmental Factors (HDEF). We will collect a battery of validated measures of these HDEF used by the CSSIH in 4 ongoing NOCEMHD studies: The Northern Manhattan Study of Metabolism and Mental Health (NOMEM), The Northern Manhattan Community Outreach Project (NOCHOP), The Northern Manhattan Caregiver Intervention Project (NOCIP), and The Counseling Adults to Control Hypertension Study . (COACH). NOMEM is a cohort study. COACH, NOCHOP, and NOCIP are clinical trials.
Our specific aims (SA) are: SA 1: To examine in NOMEM cross-sectional analyses the respective contributions of HDEF at the national, state, city, neighborhood, and individual levels to proximal behavioral and biological risk and protective factors for diabetes and depression in a midlife Hispanic population;SA2: To examine how HDEF at the national, state, city, neighborhood, and individual levels modify the response to the community-based interventions in COACH, NOCHOP, and NOCIP. The rich data collected with support from this application will be part of our data and biospecimen repository (DBR) managed by the NOCEMHD Research Core.
Funding of this application will support collection of data on health disparities environmental factors in Northern Manhattan. These data will allow us to understand environmental determinants of cardiovascular conditions in mental health in Northern Manhattan. Furthermore, these data will allow us to understand how environmental factors modify the effect of community based interventions.
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