The purpose of this project is to develop, apply, and evaluate the culture-centered approach (CCA) to tailoring Comparative Effectiveness Research Summary Guides (CERSGs) published by the Agency for Healthcare Research and Quality (AHRQ) in order to optimize the reach, effectiveness, and access of the CERSGs among underserved populations. Based on systematic reviews, CERSGs provide summaries of the evidence comparing methods for treating a wide range of medical conditions. The proposed project specifically seeks to develop tailored CERSGs on heart disease targeted toward African Americans in Indiana, given the existing disparities among racial/ethnic groups in the area of heart disease, and the prevalence of heart disease among African Americans in the state of Indiana (Indiana State Department of Health, 2006). The CCA uses community-based participatory strategies and channels to identify problems and corresponding solutions from within the local communities (Dutta-Bergman, 2004a, 2004b;Dutta, 2008, 2009). This project will utilize the participatory principles of the CCA to locate decision making in the hands of the local community, thus emphasizing the participatory capacity of the community in problem identification, development of knowledge resources, and articulation of solutions. As a result, local community members and leaders are equipped to tailor message strategies that will work in their neighborhood, complemented with channel selection strategies that are shaped by the needs and articulations of the community. The academic partner collaborates with the community partner in the creation of resources and in the development of community capacities that would then be utilized by community members in the development and delivery of solutions. Both ownership and ideas are local-not the product of experts who lack credibility among members of the underserved population. The goal of the academic partner is to foster collaborative spaces and create community capacities for community-based decision making (Dutta, 2006, 2007, 2008). The overall goal of this project is to demonstrate the value of community-driven CCA for tailoring of CERSGs as a viable mechanism for expanding their impact in underserved populations through partnership with a local community organization - the Indiana Minority Health Coalition (IMHC). Given the prevalence of heart disease among African Americans in Indiana and the health disparities that exist in the realm of heart disease, we propose to develop CCA processes in collaboration with IMHC and its local community affiliates to develop and disseminate tailored CERSGs on treating heart disease. In order to develop community-based collaborative processes for the creation of tailored messages, we propose to build a health disparities hub (HDH) that will serve as a platform for collaboration and participation among community members, also becoming a key resource in community capacity building, given the low uses of health technologies among African Americans. Through the use of community-based focus groups, in-depth interviews, community-based message tailoring workshops and community-based message review workshops, we expect to have achieved the following specific aims: 1) Developed and tested the culture-centered approach (CCA) for training local leaders of an African American community on how to tailor CERSGs related to hypertension and how to develop a strategy for creating awareness of these tailored CERSGs that will work in their local context. This process will be designed so that it can be utilized for a broad range of local leaders of diverse underserved populations;2) Developed and tested the health disparities hub (HDH) that can be accessed by community leaders seeking to tailor CERSGs and distribution mechanisms for their local populations. While time and resources will limit what we place on this hub to the condition of hypertension and to information about the local African American community, the platform and its architecture are designed to accommodate information about multiple clinical conditions and underserved populations;3) increased the use of tailored hypertension CERSGs in underserved African American communities in Indiana. While we believe that the first two aims are very important, their value depends on whether this project also leads to greater use of important information about hypertension that improves health in a specific community.
The goal of the proposed project is to use a community-based approach to modifying Comparative Effectiveness Research Summary Guides that offer information comparing different interventions for treating a wide range of medical conditions. The research team will collaborate with the Indiana Minority Health Coalition and its affiliates in Lake and Marion counties in Indiana to develop tailored guides on heart disease for African Americans. In order to accomplish this goal of developing and disseminating tailored messages, the research team will create a technology hub for posting information, collaborating online, offering feedback and building technology-based community infrastructures.
