Funding of Hispanic/Latino Health-Related Research by the National Institutes of Health: An Analysis of the Portfolio of Research Program Grants on Six Health Topic Areas.

Hispanics/Latinos are expected to constitute 25% of the U.S. population by 2060. Differences in the prevalence of health risk factors, chronic diseases, and access to and utilization of health-care services between Hispanics/Latinos and other populations in the U.S. have been documented. This study aimed to describe and analyze the landscape of Research Program Grants (RPGs) funded by the National Institutes of Health (NIH) between 2008 and 2015 involving Hispanic/Latino health research in six health condition areas-asthma, cancer, dementia, diabetes, liver/gallbladder disease, and obesity-and to identify opportunities for continued research in these areas. Using an NIH internal search engine, we identified new and renewal Hispanic/Latino health RPGs searching for specific Hispanic/Latino identifiers in the Title, Abstract, and Specific Aims. We used descriptive statistics to examine the distribution of funded RPGs by NIH disease-based classification codes for the six health condition areas of interest, and other selected characteristics. The most prominent clusters of research subtopics were identified within each health condition area, and performance sites were mapped at the city level. Within the selected time frame, 3,221 Hispanic/Latino health-related unique RPGs were funded (constituting 4.4% of all funded RPGs), and of those 625 RPGs were eligible for review and coding in the present study. Cancer and obesity were the most commonly studied health condition areas (72%), while studies on mechanisms of disease-biological and non-biological-(72.6%), behavioral research (42.1%) and epidemiological studies (38.1%) were the most common types of research. Most of the primary performance sites were in California, Texas, the northeastern U.S., and Illinois. The predominance of mechanistic, behavioral, and epidemiological studies in our analysis poses opportunities to evaluate knowledge gained and their clinical application, explore new research questions, or to update some methods or instruments. The findings of the present study suggest opportunities to expand research in understudied mechanisms of disease that could explain differences in prevalence of conditions like diabetes and cancer among different heritage groups. In addition, our findings suggest that the impact of interventions or policies designed to reduce health disparities, innovative multi-level interventions, implementation and dissemination studies, the role of health information technology on health outcomes, and the intersectionality of individual, sociocultural, geographic, and other factors on health outcomes, among others, are understudied approaches, which could potentially advance research in Hispanic/Latino health and contribute to the achievement of better health outcomes in this diverse population.

Research Capacity Strengthening in American Samoa: Fa'avaeina le Fa'atelega o le Tomai Sa'ili'ili i Amerika Samoa.

Capacity-building partnerships are central to the sustainable development goals (SDGs), the UN's blueprint for achieving global health equity. The UN Permanent Forum on Indigenous Issues endorses the SDG and underscores the need for global partnerships that respect local leadership and culture. Innovations that weave or integrate Indigenous and Western knowledges are emphasised. These recommendations guided the INdigenous Samoan Partnership to Initiate Research Excellence (INSPIRE). INSPIRE is led by investigators from American Samoa and supported by US co-investigators. In project year one, INSPIRE queried: What weaving approaches are feasible for promoting community access to INSPIRE's research hub and for training Indigenous researchers? Weaving procedures involved interlacing Samoan and Western knowledges. Cultural tailoring strategies were used to customise communications. Formative evaluation suggests the feasibility of INSPIRE's efforts. Evidential tailoring provided information on American Samoa (A.S.) social determinants of health; trainees indicated increased research commitment. Linguistic and sociocultural relevance tailoring were positively received; trainees reported increased interest in research praxis and initiated an A.S. research capacity-strengthening model. Social work assured knowledge parity in development/delivery of the training curriculum and culturally safe discussions on social determinants of health, territorial status and Samoan survivance. Findings are context-specific yet offer considerations for capacity-strengthening partnerships seeking to advance health equity.

The National Institute on Minority Health and Health Disparities Research Framework.

We introduce the National Institute on Minority Health and Health Disparities (NIMHD) research framework, a product that emerged from the NIMHD science visioning process. The NIMHD research framework is a multilevel, multidomain model that depicts a wide array of health determinants relevant to understanding and addressing minority health and health disparities and promoting health equity. We describe the conceptual underpinnings of the framework and define its components. We also describe how the framework can be used to assess minority health and health disparities research as well as priorities for the future. Finally, we describe how fiscal year 2015 research project grants funded by NIMHD map onto the framework, and we identify gaps and opportunities for future minority health and health disparities research.

Santería as Informal Mental Health Support Among U.S. Latinos with Cancer.

This article explores and examines Santería's function as a culturally congruent informal mental health support that assists U.S. Latinos to cope with the psychosocial sequelae of living with cancer. Research has demonstrated that Santería serves as a mediating institution for many Latinos. The tradition functions as both a religion and a health care system within various Latino subgroups and has functioned as an informal mental health service in occurrences of health versus illness.

Challenges and strategies in recruiting, interviewing, and retaining recent Latino immigrants in substance abuse and HIV epidemiologic studies.

The growth of immigrant populations in the United States over the past 20 years has increased the need to enhance understanding about the risk factors that influence their substance abuse and HIV risk behaviors. Today, Latinos account for the largest majority of immigrants gaining entry into the United States. As the largest and fastest growing minority subgroup in the United States, they bear a disproportionate burden of disease and death compared to non-Latinos. Latinos are confronted with escalating HIV and substance-abuse problems, particularly Latinos between the ages of 18-34. This paper is based on our longitudinal study on the drug using and HIV risk behaviors of 527 recent Latino immigrants between the ages of 18-34 who have lived in the United States less than 1 year. The data collection activities of this study have provided insights in identifying, recruiting, interviewing, and retaining Latinos in community-based studies. Strategies, such as utilizing a combination of translation techniques, ensured the development and implementation of culturally appropriate questionnaires. Respondent-driven sampling facilitated identifying participants. Establishing rapport and trust was critical for interviewing, and maintaining a tracking protocol was most important for retention. The lessons learned from this study can guide substance abuse and HIV researchers when recruiting, interviewing, and retaining recent Latino immigrants in future epidemiologic studies.

Meeting Chamorro women's health care needs: examining the cultural impact of mamahlao on gynaecological screening.

Peoples of Micronesia customarily seek western medical care only when needed and not typically as a preventive care. There is a subtle reluctance to resorting to available modern biomedical practices. This article discusses cultural aspects of Chamorro women's preventive health-seeking behavior. It specifically examines the effect that the Chamorro cultural value of mamahlao, or a sense of shame, has on women getting Papanicolaou (Pap) tests and other ways mamahlao dissuades modern-day Chamorro women from seeking preventive gynecological care. A purposive sample of fifteen Chamorro women living on Guam participated in this exploratory study. A semi-structured interview was administered and included questions on what mamahlao means to them, appropriate versus inappropriate reasons why women should get annual Pap tests, and the relationship between mamahlao and modesty in women. The interviews revealed women's concerns with shame, religion, and morality in their health-seeking behavior. The study suggests that for a Chamorro woman, seeking gynecological care can have negative symbolic connotations thereby for creating a sense of shame or mamahlao, in the woman.

Estructura de las prestaciones odontologicas en un efector del sistema de la seguridad social: Cordoba, Argentina / Structure of dental services demand in a social security system: Córdoba, Argentina

Se describen los resultados de una investigación dirigida a estimar la naturaleza, magnitud y distribución de las prestaciones odontológicas realizadas por la Dirección de Assistencia Social del Personal Universitario (DASPU) en el período de 1988-1990, a partir de una muestra representativa de la población de beneficiarios. El mayor consumo de servicios odontológicos se registró en el grupo de 25-44 años (40,3 por ciento del total), aunque las prestaciones por persona/año aumentaron conforme a la edad de los afiliados. La ocurrencia más alta de prestaciones se observó en Operatoria Dental y Prótesis (50,2 por ciento del total). Las prácticas en Odontología Preventiva fueron de muy baja frecuencia (1,2 por ciento) y las menos solicitadas corrspondieron a Odontopediatría (0,3 por ciento). Un 31.8 por ciento de las prestaciones se ralizaron en los servicios propios de la DASPU, predominando las del rubro Ptótesis. En efectores externos (62,8 por ciento), las más frecuentes fueron las de Operatoria Dental. Se concluye que las prestaciones odontológicas demandadas fueron principalmente curativas y reparadoras. La reorganización del Servicio de Odontología puede aumentar la eficacia y eficiencia del funcionamiento del sistema

Estructura de las prestaciones odontologicas en un efector del sistema de la seguridad social: Cordoba, Argentina / Structure of dental services demand in a social security system: Córdoba, Argentina

Se describen los resultados de una investigación dirigida a estimar la naturaleza, magnitud y distribución de las prestaciones odontológicas realizadas por la Dirección de Assistencia Social del Personal Universitario (DASPU) en el período de 1988-1990, a partir de una muestra representativa de la población de beneficiarios. El mayor consumo de servicios odontológicos se registró en el grupo de 25-44 años (40,3 por ciento del total), aunque las prestaciones por persona/año aumentaron conforme a la edad de los afiliados. La ocurrencia más alta de prestaciones se observó en Operatoria Dental y Prótesis (50,2 por ciento del total). Las prácticas en Odontología Preventiva fueron de muy baja frecuencia (1,2 por ciento) y las menos solicitadas corrspondieron a Odontopediatría (0,3 por ciento). Un 31.8 por ciento de las prestaciones se ralizaron en los servicios propios de la DASPU, predominando las del rubro Ptótesis. En efectores externos (62,8 por ciento), las más frecuentes fueron las de Operatoria Dental. Se concluye que las prestaciones odontológicas demandadas fueron principalmente curativas y reparadoras. La reorganización del Servicio de Odontología puede aumentar la eficacia y eficiencia del funcionamiento del sistema (AU)