Office of Health Disparities Research

Addressing Health Disparities is Our Priority.

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Wed, May 23 3:59pm · Native Voices Exhibition Coming to Mayo Clinic June 4

Native Voices: Native Peoples’ Concepts of Health and Illness, a traveling exhibition prepared by the National Library of Medicine and the National Institutes of Health, will visit Rochester, Minnesota:

June 4–July 5, 2018
Monday–Friday, 8 a.m.–5 p.m.
Siebens Building SL-104 (Hage Atrium), Mayo Clinic
Rochester, Minnesota
Free and open to the public

Native Voices explores the interconnectedness of wellness, illness and cultural life for Native Americans, Alaska Natives and Native Hawaiians. Visitors discover how Native concepts of health and illness are closely tied to the concepts of community, spirit and land.

Exhibition of Native Voices at Mayo Clinic is sponsored by Mayo Clinic’s Office of Health Disparities Research, Office of Diversity and Inclusion, Celebrate Dakota! Mayo Employee Resource Group and Mayo Clinic Libraries.

June 4 — Opening Celebration
In the spirit of unity with the Dakota and all Native tribes, Mayo Clinic will host an Opening Celebration on Monday, June 4, 5:15–5:45 p.m. on Annenberg Plaza in downtown Rochester. The celebration will feature a Welcome by Sharonne Hayes, M.D., director of Mayo Clinic’s Office of Diversity and Inclusion; a Traditional Native Ceremony with Jerry Dearly, educator for St. Paul Public Schools; a performance by the Ain-Dah-Yung Singers drum group; and a Closing by Lor Lee, director of diversity and inclusion at Mayo Clinic.

June 14 — Presentation on Healing and the Ojibwe Jingle Dress Dance
The Office of Health Disparities Research Native American Research Outreach is pleased to welcome guest speaker Brenda Child, Ph.D., of the University of Minnesota, who will present “Native Traditions of Healing and the Ojibwe Jingle Dress Dance.” The event is free and open to the public.

Thursday, June 14, 2018
Noon–1:30 pm
Mayo Building, 16th Floor Lecture Hall
Mayo Clinic, Rochester, Minnesota

Dr. Child is chair of the Department of American Studies, and president of the Native American & Indigenous Studies Association, at the University of Minnesota.

Sun, May 6 3:01pm · Mayo Clinic joins NIH in launching All of Us Research Program

On May 6, 2018, the National Institutes of Health (NIH) opened national enrollment for the All of Us Research Program. All of Us seeks to transform the relationship between researchers and participants, bringing them together as partners. Participants will be able to access their own health information, summary data about the entire participant community, and information about studies and findings. Data from the program will be broadly accessible for research.

The goal is to enroll 1 million or more volunteers, and sample communities that have been underrepresented in research, thereby making the program the largest, most diverse resource of its kind.

Mayo Clinic is one of more than 100 organizations across the U.S. that is funded by the NIH to partner in the program. In 2016, Mayo Clinic was awarded $142 million in funding over five years by the NIH to serve as the nation’s biobank.

Read the full Mayo Clinic news release.

Tue, May 1 2:45pm · Racial Disparities in Myeloma Treatment Nationwide

Blood cancer specialist Sikander Ailawadhi, M.D., was working in a county hospital in California several years ago when he became aware of a trend in cancer care that was concerning.

“I noticed patient profiles from different racial subgroups seemed to get different treatments and have different outcomes,” says Dr. Ailawadhi, a specialist in multiple myeloma and now vice chair of clinical practice for hematology on Mayo Clinic’s campus in Florida.

Those observations led to an investigation of health disparities across the country among patients with myeloma published in the journal Cancer.

Read the full story in Discovery’s Edge magazine.

Fri, Mar 9 9:17am · Mayo Clinic Diversity Efforts: Engaging With American Indian Groups, Addressing Underrepresentation of African-Americans in Research

In October 2017, the Mayo Clinic Office of Health Disparities Research’s Native American Research Outreach (NARO) program hosted a conference entitled “A Path toward Better Health among Bemidji Area American Indians.” Participants included representatives of six tribal nations, 10 Native health and social service agencies and 16 Mayo Clinic departments. The conference opened discussion between and among Mayo Clinic and the more than a dozen northern plains tribes and tribal and government agencies.

Topics included:

  • Substance and physical abuse
  • Chronic diseases and prevention
  • Mental and family health services
  • Health policy and services
  • Telehealth
  • Improved patient and intersystem communication
  • Child abuse
  • Telemedicine in oncology, virtual consultations
  • Remote coordination and interventions in brain rehabilitation
  • Minimally disruptive medical practices
  • Medical and professional education opportunities
  • Undergraduate education and training opportunities
  • Patient education resources
  • Cancer epidemiology, genetics and family studies
  • Diabetes neuropathy and neuromuscular diseases
  • Child and adolescent depression and anxiety
  • Cancer treatment trials

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Wesley Petersen, Ph.D.

Wesley Petersen, Ph.D., who directs NARO and has built relationships with participating groups in the last decade, says the conference provided an opportunity to find common ground across different values orientations, health beliefs and community health practices. “We had meaningful discussions about the tribes’ priority health concerns and how they might be addressed collaboratively through clinical expertise, education and research.”

Most of the tribes agreed to participate in an advisory board to further explore their health concerns and how to address them. Next steps include writing proposals, seeking funding to execute projects, and seeking Mayo Clinic staff to travel to Indian communities to better understand local circumstances, resources and constraints.

Dr. Petersen explains that American Indians are an underserved, health disparities population and serving them aligns with true Mayo Clinic values. “When the Mayo brothers initially expressed what has become our primary value, ‘The needs of the patient come first,’ the focus was on the people of the community and region. An individual’s health circumstance was really the only consideration that mattered.

“Going beyond the front door [of Mayo Clinic] is consistent with our values and can benefit the American Indian population’s health, allow for the appropriate dissemination of knowledge across diverse populations, and advance scientific and medical knowledge of disease, how those diseases are represented in populations and how they can best be treated across populations.”

diversityRepresented tribes and Native health, research, service and education programs:

  • Red Lake Nation
  • White Earth Nation
  • Lower Sioux Indian Community
  • Fond du La Band of Lake Superior Chippewa
  • American Indian Cancer Foundation
  • Great Lakes Inter-Tribal Council (Great Lakes Inter-Tribal Epidemiology Center)
  • Bemidji Area Indian Health Service
  • Leech Lake Band of Ojibwe
  • Mille lacs Band Ojibwe
  • Spirit Lake Nation Tribal Health
  • Ho Chunk Nation Tribal Health

Mayo Clinic addresses underrepresentation of African-Americans in medical research at Healthy Churches 2020

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Christopher Pullins, M.D., and LaPrincess Brewer, M.D., at the Healthy Churches 2020 Conference

LaPrincess Brewer, M.D., Department of Cardiovascular Medicine at Mayo Clinic’s campus in Rochester, Minnesota; and Christopher Pullins, M.D., Department of Family Medicine at Mayo Clinic’s campus in Arizona; led a medical education institute at the Healthy Churches 2020 National Conference at Hilton Head, South Carolina, in November. The three-hour session was entitled “Recruiting African-Americans to Participate in Medical Research: Methods, Models and Experiences.” Several other principal investigators from Mayo Clinic also presented.

Healthy Churches 2020 is an annual national conference for faith leaders and health professionals to increase and improve the skill and knowledge of church nurses, ministers and others responsible for leading congregational and community health ministries. Healthy Churches 2020 is an initiative of the Balm in Gilead, Incorporated, an organization that promotes health and wellness through outreach to African-American faith communities.

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Healthy Churches 2020

Dr. Brewer coordinates a cardiovascular health and wellness intervention study based in African-American faith communities — Fostering African-American Improvement in Total Health (FAITH!) in the Rochester and Minneapolis/St. Paul, Minnesota, areas. Dr. Pullins coordinates a health program at an African-American congregation in Peoria, Arizona.

Participation of Mayo Clinic investigators in Healthy Churches 2020 was sponsored by the Office of Health Disparities Research, which coordinates the work of Mayo Clinic scientists to define and address health disparities.


The above diversity efforts are among several highlighted in a recent article by the Mayo Clinic Alumni Association. Others include:

  • “New Programs to Recruit Diverse Students”
  • “Mayo Clinic School of Medicine Adds Diversity-Focused Mentorship Pilot Program in Rochester”
  • “Mayo Clinic Graduate School of Biomedical Sciences Received NIH Grant Renewal to Train Students” Underrepresented in Science”

Read the full article on the Mayo Clinic Alumni Association website.

Thu, Mar 1 2:38pm · Research Establishes Questions to Address Unmet Needs of Patients With Disabilities

To address inequities for patients with disabilities, research led by Mayo Clinic has established six essential questions for health care organizations to ask at the point of care. The broad, evidence-based questions are a first step in determining unmet needs of individual patients for whom disabilities are not always easily identified, the researchers say.

Mayo Clinic has incorporated the questions into its electronic health record, currently in use by nurses for in-patient care. Eventually, the researchers hope, the questions will be implemented throughout Mayo. There are also plans to include the questions in the international Logical Observational Identifiers, Names and Codes (LOINC) database, a standardized coding of medical laboratory tests and patient care data sets for use across health care systems.

“The majority of disabilities aren’t immediately apparent,” says John Knudsen, M.D., medical director for the Clinical Practice Office of Health Equity and Inclusion. “This is an important step toward understanding our patients’ needs in regards to disabilities, whether that’s permanent or temporary.”

The questions, published recently in The Joint Commission Journal on Quality and Patient Safety, can be used when making an appointment to identify patients who may need hearing assistance, for example. Clinicians could provide an adjustable exam table for patients with mobility issues, or communication assistance for those with difficulties being understood.

“Literature shows that people with disabilities get suboptimal care. They’re not getting the same type of preventative treatment and chronic disease management that people without disabilities are getting,” says the study’s senior author, Joan Griffin, Ph.D., a scientific director in the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery. “These are yes or no questions, they’re relatively easy, and they can then lead to deeper questions about specific accommodations.”

The cross-specialty team of researchers used a multistage process to identify and refine the questions. First, they held a focus group of 54 patients and caregivers from southeastern Minnesota and interviewed 15 health care providers. Next, national disability organization leaders and research authors participated in a panel to modify the questions. And finally, the researchers refined the questions further after interviewing 46 patients with and without disabilities.

The six essential questions are:

  • Are you blind or do you have difficulty seeing, even when wearing glasses?
  • Are you deaf or do you have serious difficulty hearing?
  • Do you have serious difficulty walking or climbing stairs?
  • Do you have difficulty remembering or concentrating?
  • Do you have difficulty dressing or bathing?
  • Using your usual language, do you have difficulty communicating (for example, understanding or being understood)?

The researchers also recommend three additional questions:

  • Because of a physical, mental, or emotional condition, do you have difficulty doing errands alone, such as visiting a doctor’s office or shopping?
  • Do you have difficulty reading or writing?
  • Due to a disability, do you need any additional assistance or accommodations during your visit?

The questions are based on U.S. Census Bureau disability questions, which were also used by the U.S. Department of Health and Human Services. But those questions were developed for large surveys of populations, not for health care organizations to identify individual patients who may need accommodations, the researchers say.

The essential questions cover the spectrum of disabilities: hearing, visual, mobility, cognitive, activities of daily living/fine motor, and communication. The additional recommended questions also cover additional activities of daily living, learning disabilities, and any disabilities that may have been missed.

The researchers did not include mental health or social disability questions among the six essential questions, though some of these disabilities may be covered by the existing questions. The focus group and interview participants had significant concerns about including a mental health question, which would be recorded in patients’ individual electronic health records, because of the stigma associated with mental health issues.

Health care organizations will have to determine which questions to ask and how frequently to ask, as disability status may change over time, the researchers say.

The research was supported by the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery. The study was led by Megan Morris, Ph.D., who was a researcher in the center at the time. Dr. Morris is now an assistant professor at the Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS) at the University of Colorado Anschutz Medical Campus.

This article originally appeared on Mayo Clinic’s Advancing the Science blog.

Mon, Feb 19 8:25am · New Study Will Engage African-American Community in Alzheimer's Outreach

While it is known that Alzheimer’s is a disease of aging, there are other factors that increase our risk for this condition. As the prevalence of Alzheimer’s rises from an estimated 5.5 million people in the U.S. to as high as 16 million in 2050, researchers are looking at how the disease affects different populations.

John Lucas, Ph.D.

For John Lucas, Ph.D., a neuropsychologist on Mayo Clinic’s campus in Florida, the population he’s most engaged with is the African-American community. African-Americans have twice the risk of whites for developing Alzheimer’s. They also tend to undergo evaluations for memory loss at a later stage in the disease process than other ethnic groups.

The delay means patients’ dementia may be significant by the time they and their care-partners seek help. Forgetfulness can also impinge on their attention to any other medical conditions, making their health worse overall.

To provide critical advances in patient care for African-Americans, Dr. Lucas is using funding awarded to Mayo Clinic from the Ed and Ethel Moore Alzheimer’s Disease Research Award to engage one local African-American community in addressing dementia.

“Our goal is to explore an innovative model for raising awareness and providing sustained education and support, both for patients and for those who are providing care for their loved ones with dementia,” he says.

The study represents an important step, not only in improving the unmet needs of Alzheimer’s patients in regard to medical care but also in bridge-building between African-Americans and the health care field.

“There’s an unfortunate history in the United States of unequal treatment in medical settings for African-Americans,” says Dr. Lucas. “People tend to be reluctant to go and be evaluated for dementia. Because of historical abuses in medical research, they may also be reluctant to participate in studies that might help find better ways of managing and treating the disease.”

The study will focus on the New Town neighborhood in Jacksonville, Florida. The early stages will involve creating focus groups comprised of patients and care-givers, community groups (such as faith groups and local businesses), and community members not affected by Alzheimer’s (such as neighbors or school groups). The focus groups will help identify the best aspects of Alzheimer’s education and support currently available in the neighborhood, as well as opportunities for improvement.

Mayo Clinic team members will then work together with neighborhood volunteers to plan, develop and implement Alzheimer’s outreach efforts chosen by the community.

“Our intent is not just to come in, ask questions, and go back to Mayo. We’ll stay and work with community members as partners, but our role is to listen to them about what they want and what they feel their community needs,” he says.

The second part of the study will evaluate the impact of this partnership on community Alzheimer’s awareness and quality of life of those directly affected by Alzheimer’s disease.

“Our hope is that this collaborative program, guided by community self-assessment and self-direction, will be more impactful and have a more sustained benefit than the traditional outreach model of raising Alzheimer’s awareness through community lectures and presentations,” says Dr. Lucas.

The study builds on Dr. Lucas’ previous research in health care disparities, which identified and corrected racial disparities in cognitive testing for dementia.

The following Mayo researchers also received funding from this year’s Ed and Ethel Moore Alzheimer’s Research Award:
—Melissa Murray, Ph.D., “Quantitative neuropathology and biochemistry of survival differences in Hispanic Americans with Alzheimer’s disease”
—Chia-Chen Liu, Ph.D., “Impact of TREM2 variants on microglial function and Alzheimer’s disease pathology”
—Heather Melrose, Ph.D., “Targeting Lrrk2 activity to modulate tau pathology”
—Mark Ebbert, Ph.D., “Identifying drug targets using long-read sequencing in Alzheimer’s disease and control brain tissue”

This article originally appeared in Discovery’s Edge magazine.

Oct 30, 2017 · OHDR names 2018 Pilot Project awardees

The Office of Health Disparities Research (OHDR) has awarded funding for three 2018 Pilot Projects that align with OHDR’s two-fold mission of advancing health disparities research and increasing minority participation in clinical trials.

OHDR is pleased to announce the following recipients of the 2018 round of Pilot Projects:

  • Megan Allyse, Ph.D., Health Care Policy & Research (Rochester): “Views of Women With Uterine Fibroids on Fertility Preservation and Restoration”
  • Samuel Antwi, Ph.D., Health Sciences Research (Florida): “Factors Affecting African American Participation in Cancer Research and Response to Return of Hepatitis Viral Load Research Findings”
  • Mark Wieland, M.D., Primary Care Internal Medicine (Rochester): “Closing the Gap: Improving Cancer Screening in Patients With Limited English Proficiency”

The selected projects represent a wide variety of disparities topics across a diverse field of medical disciplines. Dr. Allyse’s project was also selected for the “Women’s Health Pilot Award” as an outcome of a collaboration between the Mayo Clinic Office of Women’s Health Research and OHDR to encourage and expand Mayo Clinic research on women’s health in underserved populations.

Megan Allyse, Ph.D.

Samuel Antwi, Ph.D.

Mark Wieland, M.D.

 

 

Sep 29, 2017 · AACR Highlights Mayo Clinic Researcher's Study on Underrepresentation of Elderly and Ethnic Minorities in Clinical Trials

The American Association for Cancer Research featured a study, led by Mayo Clinic’s Narjust Duma, MD, in a national press release related to its 2017 Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved. Dr. Duma’s study, internally funded by Mayo Clinic, established that the elderly and ethnic minorities are underrepresented in cancer therapeutic trials, and that African American and Hispanic enrollment in such trials has declined over the past two decades. The AACR’s press release, viewable HERE, was picked up and broadcast by Eureka Alert , NewsMax Media, the American Association for the Advancement of Science (AAAS)’s EurekaAlert! science news, NewsMax Media’s newsmax health, HealthDay news, and U.S.News and World Report. OHDR Congratulates Dr. Duma on this prominent recognition!

 

 

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