This three-year project combines planning activities and pilot intervention research to develop replicable interventions to improve the health of working and middle class African-Americans in Durham, North Carolina. Based on published (albeit limited) data on local health disparities, and on the prior experiences of the research team, the project will likely focus on the management of type 2 diabetes and hypertension in African American adults. It is likely that the interventions will also emphasize developing social supports within and across social class lines as a vehicle to achieve sustainable improvements in health. In keeping with the principles of community-based participatory research (CBPR), however, the determination of disease focus, as well as the intervention design and strategy, will be made through a CBPR planning process. The project has five stages: 1) Establish operating norms and an agenda for the Community Advisory Board (CAB) that will promote informed, effective, and collaborative consensus-based decision-making by the CAB and project team; 2) Assess community needs, assets, health priorities, and existing health initiatives; and develop a plan to implement and test an intervention to create sustainable changes in the health of African-American adults, and in community-level and health system factors impacting their health; 3) Implement pilot intervention research; 4) Disseminate findings to the Durham community, and develop and submit a full intervention research plan; 5) Disseminate findings to the larger health services community. Relevance: The literature documents significant disparities between the health status and health care of White Americans and African-Americans. The proposed project will contribute to our knowledge of disparities and how to reduce them in two ways. First, despite the fact that racial disparities exist within the middle class, most interventions and most CBPR projects have focused on working-class African-Americans. Second, the project will develop interventions that address social factors within and outside the health care system that appear to contribute to health disadvantages in the African American population. ? ?
