The over arching goal of this program project grant (PPG) is to move beyond the identification of African American/Caucasian health-related disparities to understanding the disparities within the African American population and identifying solutions designed to address these health issues. Our theme is to improve the process of health care delivery for African Americans by addressing issues and interventions related to providers and provider patient interactions. PPG investigators will test new interventions and, if the interventions are successful, move the interventions forward to state-wide implementation. Knowledge in South Carolina (SC) will contribute to the reduction of health disparities for African Americans in the nation. The unique state database linking patient and provider information provides data essential to the PPG goals. The PPG will also engage new minority and non-minority investigators in minority health research. The projects include: Project 1 (Reducing the Racial Disparity in CV Americans with hypertension. Project 2 (Economic Access to Anti-retroviral (ARV) Prescription Drugs & Adherence To ARV Guidelines for African American Medicaid enrollees with AIDs or HIV-Disease in SC) focusing on increasing the number of providers treating to current guidelines. Project 3 (An Exploration of Racial Differences in End-of-Life Care Preferences Among the reasons with providers and patients. Project 4 (A Randomized Trial of a Pharmacist-intervention to increase prescription refills.) Include: Pilot Project 1 (Implementing Successful Managed Care Models of Healthcare Delivery in a Low Income Underserved African American Patient Population with Type 2 Diabetes) assesses provider acceptance of group visits or lay educator approaches and, if acceptable to providers, pilot tests these strategies. Pilot Project 2 (a Pilot Program to Provide AHRQ Guidelines Concordant Care to African Americans with Type 2 Diabetes Mellitus and Depression) tests a provider intervention to increase compliance with guidelines for treating depression using a diabetes nurse educator. Pilot Project 3 (Improving the Evaluation of Therapist Adherence to Multi-systemic Therapy with Ethnically Diverse, Adolescent Drug Offenders). The three new investigators are mentored through Investigator Development Core C. All PPG investigators receive support for access to the state data, statistical analysis, assistance in the design and analysis of economic data assistance in data management, and assistance in assessing patient/provider satisfaction from the biostatistics/Data Core B. Core A provides the administrative and advisory structure.
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