Upon completion of the STAR Leadership Program, scholars will be required to develop a competitive pilot project proposal in minority health and health disparities. TCHD will conduct rigorous peer-review to select 3-5 new pilot projects each year to fund investigator-initiated minority health and health disparity research. We will also support pilot project awardees for the successful completion of their projects adhering with NIHMD research framework by providing post-award support including institutional resources (eg., access to core facilities, statistical expertise, manuscript and grant writing support).
Cohort 1
Big Data Analysis to Characterize Triple-Negative Breast Cancer, Jin Lui
Triple-negative breast cancer (TNBC) is a health disparity disease with no approved targeted drugs, disproportionately affecting African American women. In this application, we will bring the exciting new breakthroughs in big data analysis and artificial intelligence algorithms into the research of TNBC to identify key features of TNBC. Our efforts will help to better understand the contribution of the TNBC disparity from multiple domains, identify novel genomic-specific TNBC targets, and advance precision medicine for the treatment of TNBC patients.
Evaluating the difference in tumor homing capacity of bioengineered serum-derived exosome-nanosystem (Nanoexos) among racially distinct populations for tailored TNBC therapy, Amalendu Ranjan
Recent studies show breast cancers like the triple negative breast cancer (TNBC) affect populations disproportionally resulting in disparities. Such disease related disparities point to the urgent need for an advancement in the treatment of clinically diagnosed breast cancer with special attention to tailoring therapeutic dosage regimen towards such disparities in racially distinct populations.
In this proposal, we will bioengineer Cabazitaxel (CAB) loaded polymeric nanoparticles coated with exosome membranes (Nanoexos) for improved targeting to the metastatic TNBC niche. Further, we will validate the targeting potential and efficacy of Nanoexos and also evaluate the difference in targeting potential of Nanoexos derived from populations of different race/ethnicities in mouse model systems. This would provide us critical information that will be utilized to design and tailor chemotherapeutic regimens for racially distinct populations.
In this proposal, we will bioengineer Cabazitaxel (CAB) loaded polymeric nanoparticles coated with exosome membranes (Nanoexos) for improved targeting to the metastatic TNBC niche. Further, we will validate the targeting potential and efficacy of Nanoexos and also evaluate the difference in targeting potential of Nanoexos derived from populations of different race/ethnicities in mouse model systems. This would provide us critical information that will be utilized to design and tailor chemotherapeutic regimens for racially distinct populations.
Intakes of calcium and magnesium and obesity in African American and Hispanic young women, Menghua Tao
The proposed study is to investigate associations between calcium and magnesium intakes and obesity, possible nutrient-nutrient interactions between calcium and magnesium on obesity, as well as associations between socioeconomic status and acculturation and obesity among young African American and Hispanic women utilizing existing data from NHANES 2001-2014. The proposed study will contribute to elucidate the effects of micronutrients, calcium and magnesium, on obesity in young women, improve our understanding about how socioeconomic and cultural status have impact on diet intakes of these micronutrients in obese young women, as well as to have potential important implication for developing race/ethnicity-specific obesity prevention strategies for young women.
Cohort 2
Surrogate decision-making communication in the intensive care unit, PI Dr. Marian Gaviola
Patients admitted to the intensive care unit (ICU) are sometimes unable to make decisions about their care and may instead rely on close relatives or friends who act as surrogate decision-makers (SDMs). Thus far, studies have shown that health disparities occur on a patient-level in the ICU. To our knowledge, no studies have characterized the intersections of health disparities related to gender, race, health literacy and language barriers with perceived stress in the ICU, confidence in decision-making skills, and communication in this setting. Additionally, structured communication tools have been implemented in healthcare settings among healthcare providers (HCPs) with an ultimate goal of increasing patient safety. We propose conducting a project with 2 aims: characterize the needs, barriers, and attitudes of SDMs when communicating with HCPs in the ICU; and assess the feasibility of adapting communication tools for use by SDMs in the ICU. The long-term goal is to develop communication skills among SDMs in the ICU and empower them to advocate for the care of their family member, improve patient-clinician relationships, and enhance medical decision-making. At this time, we are actively recruiting for participants in the study.
Preliminary Assessment of Visuomotor Profiles in Hispanic Children with Autism, PI Dr. Haylie Miller
Autism Spectrum Disorder (ASD) occurs in an estimated 1 in 59 people, but is only diagnosed in around 1 in 99 Hispanic children. This difference is likely a result of health disparities that could be reduced if more objective assessments were available. Non-social symptoms of ASD, like atypical use of vision and impaired motor control, can be measured earlier and more objectively than social-communication symptoms. We want to understand how Hispanic families with ASD get a diagnosis, and what they know about non-social symptoms of ASD. We also want to measure non-social symptoms of ASD in Hispanic and non-Hispanic children using mobile eye-tracking and a portable balance testing system. We have begun forming a Community Task Force of parents, community leaders, and clinicians to help us engage with families through their existing social networks. We will begin holding focus groups and data collection sessions in February, and are currently recruiting families who may be interested in participation.
Postnatal Education through a Health Literacy Lens: Evaluating the Usability of Postnatal Education to Prevent Maternal Morbidity & Mortality, PI Dr. Teresa Wagner
Maternal Mortality is a global public health issue with local urgency. In 2015, the U.S. maternal death rate was 26.4 per 100,000 per live birth; more than double the 1987 U.S. rate of 7.2 deaths per 100,000 births. In Texas, the rate is 14.6 per 100,000 live births; although, still unacceptable and disparities exist. Few studies have looked at the effect of health literacy (ability of people to understand and use health information) on maternal complications and death. In one study, African American new moms 1) have difficulty communicating with their providers; and 2) felt instructions did not translate to their community setting. A woman's ability to use discharge instructions may depend on the large volume given, culture, degree of sleep deprivation, physical and emotional changes, possible side effects of medicines, and low health literacy. Women may not understand if symptoms after birth are normal or abnormal and thus, should go to the doctor or hospital.
We hypothesize that instructions are too complex and lack cultural sensitivity. We propose to conduct the following specific aims: AIM 1. Assess current readability, understandability and cultural sensitivity of information given to moms after birth. AIM 2. Determine women’s ability to access, understand, appraise and apply postnatal care instructions through one-on-one interviews to evaluate current education after birth. Therefore, improving postnatal instruction health literacy and cultural sensitivity will help new mothers understand possible problems and possibly reduce maternal complications and death. Currently, we have completed the review of materials and are now embarking on the interviews of new moms.
