DH-CHEER - Project EXPORT
Center of Excellence in Partnerships for Community Outreach Research on Health Disparities and Training (Project EXPORT)
With the awarding of the P60 Center Grant from the National Center on Minority Health & Health Disparities, the CRMH (now known as the Dorothy I. Height Center for Health Equity & Evaluation Research [DH-CHEER]) established a center of excellence in 2003. The primary focus of the originally funded P60 was gene-environment interaction focusing on health risk and migrant farm workers. The Center of Excellence original steering committee included Dr. Lovell A. Jones, principal investigator at the CRMH, and Dr. Gloria Regisford, co-principal investigator in the Department of Biology at Prairie View A & M University. This center grant provides support for long-term, multidisciplinary programs of research, education and community outreach in critical health problem areas in Houston.
Project EXPORT supports programs in DH-CHEER and the Health Disparities Education, Awareness, Research & Training (HDEART) Consortium that focus primarily on the critical problem of health disparities. A major component of Project EXPORT is to create educational programs from K-12 that are designed to increase awareness in students about the opportunity to pursue research and medicine as a career choice and to increase the number of scientists from underserved and underrepresented populations. An additional goal of Project EXPORT is to increase the numbers of minority researchers or the number of researchers interested in examining health disparities. By increasing the number of minority researchers and enhancing the ongoing partnership with the participating communities, an increase in minority recruitment and retention in clinical trials may occur.
The environmental health focus of Project EXPORT incorporates gene-environment interaction studies and community-based assessments, thereby utilizing science to address environmental health issues facing communities of color and the medically underserved. This approach was founded upon the Institutes of Medicine Report "Toward Environmental Justice: Research, Education and Health Policy Needs" (1999), which advocates the coordination of research, education and health policy making to address environmental burdens of those communities disproportionately exposed. The first primary study and two of the three original pilot projects, for which Drs. Maria Hernandez-Valero, Gloria Regisford and Denae King served as principal investigators, respectively, were coupled with educational and outreach programs. The third pilot study, with co-investigators Dr. Beverly Gor and Mr. Son Hoang, was focused on determining the health status of Asian Americans living in the Houston metropolitan area. This pilot project led to the first Asian American Health Needs Assessment in the greater Houston area. In addition, collaborative efforts are being established to also provide training opportunities for high school students and teachers, undergraduate students and the faculty from minority serving institutions. Through relationships with other academic institutions of higher learning (the Health Disparities Education, Awareness, Research & Training [HDEART] Consortium), DH-CHEER is assisting in curriculum alignment and mentoring programs to train minority and non-minority researchers, clinicians and scientists in the challenging field of minority health. Project EXPORT will constitute a center for K-12 under-represented minority students, graduate students, nursing students and postdoctoral fellows to receive training in participatory research and environmental health studies. As noted in the critique of our renewal application, "One cannot help but imagine that this is exactly the model of a cutting edge health disparities center of excellence. It is hard to imagine that there is an aspect of body, mind or culture that is not under consideration with the present investigator's holistic approach. The combination of the caliber and experience of the leadership team, along with the scope of activities and the level of collaboration, within and across institutions, makes this an outstanding application. The integration of the goals of Project EXPORT and the CRMH, which forms the basis of the present application, promises to make significant contributions to our understanding and treatment of cancer and other diseases in minority populations and the medically underserved."
The steering committee of the renewed Project EXPORT is Dr. Lovell A. Jones, (principal investigator and Director of DH-CHEER), Dr. Betty Adams (co-principal investigator and dean of the College of Nursing at Prairie View A & M University), Dr. Lizbeth Lopez-Carrillo (Mexico), Dr. Claudio Conti (The University of Texas MD Anderson Science Park-Smithville) and Dr. David Wetter (chair, Department of Health Disparities Research at MD Anderson).
The most recent research projects are:
- "Prevalence of Environmental and Genetic Risk Factors for Gastric Cancer in a Population of Mexican-American Children Residing in Texas”
Gastric cancer (GC) can be considered an indicator of health disparity since it is more prevalent in developing countries, where the mortality is higher. In Mexico, GC is the third leading cause of mortality after cardiovascular disease and lung cancer, and in the U.S., the incidence for GC is also higher Hispanics than in white Americans. The etiologic factors for GC include Helicobacter pylori (HP) infection, dietary factors and genetic susceptibility. Due to the large number of Mexican American children residing in Texas, and the high prevalence of gastric disorders that have been reported in our on-going study “Biomarkers of Genetic Susceptibility in Environmentally Exposed Migrant/Seasonal Farmworker Children (MSF Study), we propose to use a molecular and environmental epidemiological approach to assess the prevalence of the aforementioned GC risk factors among this minority population. In addition, we will develop and validate a food frequency questionnaire (FFQ) to assess the folate and vitamin B-12 intake of Mexican American children residing in south Texas. This project is led by Drs. Maria Hernandez-Valero and Robin Fuchs-Young.
- “Tobacco Control in Hispanic Americans”
Led by Dr. David Wetter, chair of the Department of Health Disparities Research, this longitudinal cohort study examines the influence of neighborhood, individual and acute intrapersonal and contextual determinants of smoking cessation among adult, Spanish-speaking, Hispanic smokers recruited from the Mexican-American (MA) Cohort Study (N=200). All study procedures, treatment materials and assessments will be conducted in Spanish. Participants will be tracked from two weeks prior to their quit date through 26 weeks post-quit date. They will be assessed for four contiguous weeks (one week pre-cessation through three weeks post-cessation) using state-of-the-science ecological momentary assessment (EMA) procedures. All participants will receive smoking cessation treatment consisting of nicotine patch therapy, self-help materials and brief in-person and telephone counseling based on our empirically-validated intervention for Spanish-speaking Hispanic smokers (Wetter et al., in press).
There have been exceedingly few studies examining the mechanisms underlying smoking cessation among Spanish-speaking or Hispanic smokers, and to the best of our knowledge, none that that have: (a) investigated the influence of neighborhoods, or (b) included the use of EMA to investigate the acute intrapersonal and contextual influences on the process of quitting. Thus, the proposed study will make a unique contribution to the field, as well as address key recommendations from major reports on smoking among minorities (USDHHS, 1998) and reducing health disparities (USDHHS,2002).
Ambitious goals, but DH-CHEER and its Center of Excellence in Partnerships for Community Outreach Research on Health Disparities and Training are ready to meet that challenge.