East Harlem (EH) is a large minority community in northern Manhattan in New York City. Its residents are 50% Latino and 40% Black. They are poorer and experience more chronic disease and worse health outcomes than those living in almost any other community in the city. EH is located across the street (96th St.) from the Upper East Side, one of the city's healthiest and wealthiest neighborhoods. These two communities separated by a single city street, exhibit some of the largest health disparities in the United States. On a variety of health and health care measures, differences of 8 to10 fold are not uncommon. ? ? Using traditional research funding mechanisms, our research team has collaborated continuously for nearly 10 years with a variety of community groups, organizations, and individuals in East Harlem. In each instance, the research team brought its ideas to the community, with little opportunity for true participation by the community in the design and execution of the research. We have completed a number of successful research projects, including some that developed and demonstrated effective health improvement interventions. We have created new models for sustaining health improvement interventions in our community. We have not, however, had the opportunity to include community participation from the very beginning of project conception, through research design, implementation and evaluation. ? ? In this application, we have created a close partnership with Union Settlement Association, a community-based provider of a wide variety of services to East Harlem for over 100 years, and with North General Hospital, the only private, not for profit, non-academic hospital in Harlem. We worked closely with these partners and a group of community representatives to plan the application. Together, we will convene an expanded Community Action Board comprised of community members who reflect important social networks and organizations in East Harlem, and who are committed to addressing health disparities. This Community Action Board will guide the conduct of a community needs assessment using the model, Mobilizing for Action through Planning and Partnerships, developed by local health agencies and the CDC. This model was evaluated and approved during our pre-application community-based planning process. During the first year, we will work together to complete the community assessment. The assessment process will guide the partners to identify the illness or condition we will develop our pilot intervention to address and the type of intervention our community partners and research team believes most likely to yield the greatest positive impact. In the second and third grant years, we will work with our community partners to develop and test all aspects of the pilot intervention and the research design by which we propose to assess its impact. ? ?
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