Despite enormous efforts to address health disparities, differences in health outcomes, disease rates and even deaths related to chronic diseases persist related to race, ethnicity and socioeconomic status. Studies have reported among Hispanics a higher prevalence of diabetes, obesity, and uncontrolled hypertension compared to non-Hispanic whites, in addition to higher death rates from diseases such as diabetes, chronic liver disease, and hypertension. The Puerto Rican subgroup has reported that it has more comorbid chronic health problems, such as heart disease, high blood pressure, stroke and diabetes, than the non-white Hispanic population. Even when Puerto Ricans on mainland are one of the Hispanic subgroups with the most health disparities, their health outcomes are better than Puerto Ricans on the island. Puerto Rico is one of the 10 most affected states and/or territory with HIV / AIDS in the United States and the first state or territory most affected for arboviruses such as Zika and Dengue. Community-Based Participatory Research (CBPR) is recognized as a critical approach to improving community health outcomes and reduce health inequities. Grounded on the results of our RCMI funded previous project, CBPR curriculum training for community leaders, we propose the creation of a novel and integrative Community Training Institute for Health Disparities (CTIHD). The main goal of the CTIHD is to establish an infrastructure for promoting health disparities research through strengthening of RCMI/PHSU researchers and their partnerships with community members to impact health disparity research, community health education, change the dynamic of Hispanic participation in research and increase translational research. CTIHD will provide training to community members founded on CBPR approach, to acquire knowledge and skills to establish and sustain community-academia research partnerships and to improve the dissemination of health education to enhance community health outcomes. Through comprehensive need and resource assessment plans, community and research team members will identify community health priorities to increase understanding of health-related risk behaviors, and determinants of chronic medical conditions. These results will inform the development of health disparities research projects with academic investigators and will guide outreach educational activities. Culturally sensitive and appropriate strategies will be integrated to disseminate research findings and community health education. CTIHD will integrate two groups: the Community Scientific Advisory Committee and the Community Trained Workforce to strengthen and ensure the community perspective in all research activities and health education, improve recruitment and retention participants' strategies, and provide support to community trainees. CTIHD is articulated with the Strategic Academic Research Training Core (START), Center for Research Resources, and the PSHU/RCMI full projects, through support to educational outreach activities, training in partnering with the community and research findings dissemination.
In Puerto Rico, the growing problems related to chronic diseases produce a negative impact on the individual quality of life and a high cost for the health system, representing a serious public health problem that merits interventions sustainable and accepted by the communities. This project aims to create an integrative platform, the Community Training Institute for Health Disparities, that provides training to members of the community to actively participate in research and community education activities to reduce inequities in health. Community members trainees will participate in research activities through partnerships with academic researchers and will disseminate educational information and research findings through outreach activities addressing problems identified in disadvantaged communities.
