# Presentation: 700242

## Minority Health Disparities at NIDA

- Lula Beatty, Ph.D.
- Special Populations Office/Office of the Director
- National Advisory Council on Drug Abuse
- September 21, 2005

##              SPO Staff 

- Ana Anders
- Pamela Goodlow
- Flair Lindsey
- LeKhessa Doctor

## Objectives 

- To describe the need for minority and health disparity programs in drug abuse research
- To discuss NIDA’s approach to addressing racial/ethnic minority and health disparities needs in drug abuse research
- To present NIDA’s major minority and health disparity programs and activities
- To identify challenges in developing and implementing minority health disparity programs

## Need

- Public Health/Science Need
- Science Workforce Need
- Adherence/Cooperation with Policy Need

## Public Health/Science Need

- Limited information on drug abuse in racial/ethnic minority populations
- Severe, long-term consequences of drug abuse and addiction experienced by racial/ethnic minority populations
- Not enough specific knowledge to inform prevention and treatment

## Science Workforce

- Not enough racial/ethnic minority researchers in drug abuse/addiction research
- Not enough racial/ethnic minority researchers conducting drug abuse/addiction research in racial/ethnic minority populations
- Not enough drug abuse/addiction researchers conducting research on drug abuse research in racial/ethnic minority populations

## Adherence with Goals and Policies  

- Congressional Directives/Interest
- White House/Departmental Initiatives
- E.g., Tribal Colleges and Universities
-     Hispanic Plan of Excellence
- NIDA Initiatives
- E.g., African American Initiative
- HBCU

## NIDA’s Responsibility

- NIDA is chief architect and supporter of the U.S. and world’s research on the health aspects of drug abuse and addiction
- About 3⁄4 of HIV/AIDS behavioral research is federally funded – NIDA, NIMH, CDC (Semaan et al., 2002)
- Must stimulate and increase the scientific knowledge base on drug abuse and addiction needed for **all** population groups

## Special Populations Office Created in 1993 To:

- Encourage and enable minority scientists participation in drug abuse research
- Encourage increased research on drug abuse in minority populations in NIDA divisions

## Through

- Stimulating and encouraging, e.g.,
- Presentations
- Publications
- Providing research experiences and preparation for research careers, e.g.,
- Diversity supplements
- Providing research opportunities and support, e.g.,
- MIDARP
- HBCU Recruited Scientist

## SPO’s Major Programs/Initiatives

- Diversity (Minority) Supplement Program
- Summer Research with NIDA
- HBCU Initiative
- Research Development Seminar Series
- Minority Institutions’ Drug Abuse Research Program

##       SPO’s Major Programs/Initiatives

- Health Disparities Strategic Plan
- African American Initiative
- Expert Racial/Ethnic Minority Work Groups
- National Hispanic Science Network
- Southern Africa Initiative

## Other Programs/Efforts 

- Minority Training and Recruitment Program (IRP)
- Co-sponsored Programs

## Diversity (Minority) Supplements

- Research Supplements to Promote Diversity in Health-Related Research
- 	http://grants2.nih.gov/grants/guide/pa-files/PA-05-015.html
- Diversity PA includes
- 	A. individuals from underrepresented racial and ethnic groups;
- 	B. individuals with disabilities; and
- 	C. individuals from socially, culturally, economically, or educationally disadvantaged backgrounds that have inhibited their ability to pursue a career in health-related research.

**Consortium on Minority Concerns**

- Jean Lud Cadet, M.D., IRP
- Dorynne Czechowicz, M.D., DCNDBT
- Lynda Erinoff, AIDS
- Dionne Jones, Ph.D., DESPR
- Catherine Mills, GMB
- Amrat Patel, Ph.D., DPMCDA
- Pushpa Thadani, Ph.D., DBNBR
- Don Vereen, M.D., OD
- Lula Beatty, SPO
- Ana Anders, SPO
- Pamela Goodlow, SPO

## Minority Supplement Awards

**New & Continuing FY 1994 – FY 2005**** **

| FY | New Awards | Continuing Awards | Total Awards |
| --- | --- | --- | --- |
| FY 1994 | 21 | 21 | 42 |
| FY 1995 | 35 | 18 | 53 |
| FY 1996 | 41 | 26 | 67 |
| FY 1997 | 34 | 28 | 62 |
| FY 1998 | 35 | 32 | 67 |
| FY 1999 |                41 |               20 | 61 |
| FY 2000 | 30 | 41 | 71 |
| FY 2001 | 38 | 23 | 61 |
| FY 2002 | 31 | 23 | 54 |
| FY 2003 | 32 | 26 | 58 |
| FY 2004 | 40 | 24 | 64 |
| FY 2005 | 40 |  |  |
| Total | 418 | 282 + | 700 + |

## New Minority Supplement Awards

**FY 1994 – FY 2004**
**Gender, Level of Support & Ethnicity**

| FY | Gender |  | Level of Support |  |  |  |  | Ethnicity |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
|  | M | F | HS | U | Pre | Post | I | Black | Hispanic | NA | PI | Asian |
| FY 1994 | 5 | 16 | 3 | 4 | 10 | 4 | 0 | 11 | 5 | 2 | 4 | 0 |
| FY 1995 | 16 | 19 | 2 | 1 | 19 | 1 | 12 | 19 | 13 | 1 | 2 | 0 |
| FY 1996 | 10 | 31 | 0 | 3 | 22 | 5 | 11 | 23 | 16 | 1 | 1 | 3 |
| FY 1997 | 15 | 19 | 0 | 4 | 12 | 8 | 10 | 18 | 12 | 0 | 1 | 0 |
| FY 1998 | 12 | 23 | 0 | 3 | 26 | 3 | 3 | 20 | 10 | 0 | 4 | 1 |
| FY 1999 | 9 | 32 | 0 | 2 | 18 | 10 | 11 | 28 | 10 | 1 | 1 | 1 |
| FY 2000 | 15 | 15 | 0 | 2 | 11 | 11 | 6 | 17 | 9 | 2 | 2 | 0 |
| FY 2001 | 11 | 27 | 0 | 2 | 22 | 8 | 6 | 23 | 9 | 2 | 2 | 2 |
| FY 2002 |     11 |     20 |    0 |    4 |   15 |    9 |    3 |     14 |     12 |      3 |      0 |      2 |
| FY 2003 | 8 | 24 | 0 | 6 | 15 | 7 | 4 | 14 | 11 | 2 | 1 | 4 |
| FY 2004 | 14 | 26 | 1 | 3 | 19 | 5 | 12 | 25 | 10 | 1 | 1 | 3 |
| Total | 126 | 252 | 6 | 34 | 189 | 71 | 78 | 212 | 117 | 15 | 19 | 16 |

## Minority Supplement Recipients Applying to NIH: 1995 and 2000

- 72 recipients
- No. and percent who submitted applications to NIH: 27, 37.5%
- No. and percent of applicants awarded NIH grants:  12, 44.4%
- No. and percent of grantees published (PubMed): 8, 66.7% of those with grants

## Summer Research with NIDA

- Created in 1997 to provide research experiences for high school and undergraduate students requiring more support from PIs
- Provides additional mentoring and logistics assistance
- Initially supported as pilot project by Office of Research on Minority Health (NCMHD)
- NIDA supported as part of Diversity (Minority) Supplement Program funds

## Summer Research with NIDA Program

-                 **FY 1997 – FY 2005**

| FY | Gender |  | Ethnicity |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- |
|  | F | M | Black
 | Hispanic | NA | API | TOTAL |
| FY 1997 | 16 | 6 | 16 | 5 | 1 | -- | 22 |
|  FY 1998 | 15 | 7 | 17 | 3 | 1 | 1 | 22 |
| FY 1999 | 31 | 8 | 31 | 4 | 3 | 1 | 39 |
| FY 2000 | 25 | 7 | 19 | 4 | 3 | 4 | 32 |
| FY 2001 | 25 | 15 | 23 | 3 | 3 | 9 | 40 |
| FY 2002 | 52 | 14 | 46 | 12 | 8 | 10 | 76 |
| FY 2003 | 48 | 24 | 43 | 11 | 5 | 13 | 72 |
| FY 2004 | 52 | 18 | 56 | 6 | 2 | 6 | 70 |
| FY 2005 | 58 | 26 | 50 | 21 | 3 | 10 | 84

 |

## Number of Summer Sites by Year

| 1997 | 20 |
| --- | --- |
| 1998 | 13 |
| 1999 | 15 |
| 2000 | 17 |
| 2001 | 17 |
| 2002 | 24 |
| 2003 | 25 |
| 2004 | 27 |
| 2005 | 32 |
|  |  |

## MIDARP

- Capacity development program, provides
- Institutional resources and support
- Faculty development
- Student development
- Research support
- New MIDARP announcement in 2005: http://grants2.nih.gov/grants/guide/pa-files/**PAR-05-069**.htmle-released

## MIDARP

- Improved MIDARP reviews
- NIDA reviewed
- Stable group of reviewers
- Clear SRA instructions
- All applications reviewed (no unscored)

## Current MIDARP Programs 

- Current programs in DBNBR and DESPR
- Florida International
- U. Central de Caribe
- Hunter College
- SUNY, Old Westbury
- Morgan State
- Hampton U.
- Charles Drew

## MIDARP Research Examples

- Inter-generational transmission of drug use between Cuban mothers and daughters   (FIU)
- Effects of drug use on the immunology system and patterns of health care among HIV seronegative and seropositive drug abusers (U. Central de Caribe)
- Neurobiology of drug addiction and impulsive behavior (Hunter)
- Investigation of the opioid-immune-stress relationship (SUNY, Old Westbury)
- Elucidate the underlying biochemical mechanisms associated with the neurotoxicity of methamphetamine (Hampton)

## Seminar Series

- Technical assistance program established in 1980s for underrepresented scientists who are ready to apply for independent awards
- Must have written concept
- Provides science and proposal development lectures, small group discussion, and one-on-one mentoring in two-session seminars (about 6 months apart)

## Seminar Series

- Mentoring provided by staff and extramural scientists
- Second session centers on mock review led by NIDA SRA
- Expectation is that application will be submitted within 6 – 12 months after last session

## Seminar Series Outcomes

- In early years, success rate reported at over 80%
- A number of participants have become NIDA and other NIH grantees

## HBCU Initiative:Selected Activities and Programs 

- HBCU Supplements
- Support annual Lonnie E. Mitchell HBCU conference on substance abuse (CSAT is lead)
- HBCU Technical Assistance Program
- Center on Drug Abuse Research Program (Howard University)
- HBCU Recruited Scientist Award

## Historically Black Colleges and Universities Recruited Scientist

- Capacity development effort at HBCU: Recruit an experienced researcher to develop research program
- Three programs:
- Allyn Howlett, NC Central
- Dorothy Browne, Morgan State
- Kathy Sanders Phillips, Howard
- Faculty and student development, e.g.,
- NC Central established training links with Wake Forest
- Morgan established links with Hopkins

## Historically Black Colleges and Universities Recruited Scientist

- Each has secured other NIH research support, e.g.,
- National Health Disparities Center awards from NCMHD
- NIDA’s Health Disparities grant and supplement
- MIDARP
- Staff/Postdoc have secured NIH awards
- Have secured other sponsored support
- Publications

## 10 Leading Causes for Blacks, 2001

-   			Black	          White 	      AI	         A/PI
- Diseases of heart	  	 1		 1	       1	            2
- Malignant neoplasms	 2		 2	       2                1
- Cerebrovascular disease 	 3		 3                 5                3
- Accidents		 4                        5                 3                4
- Diabetes mellitus               5                        6                 4                5
- Assault                             6                       19               11              10
-  (Homicide)
- HIV disease                      7                       22               16               24
- Chronic lower                   8		 4                 7                6
-  Respiratory diseases
- Nephritis, nephrotic           9		 9               10                9
-  Syndrome and nephrosis
- Septicemia                     10                       11               12               11

## Slide 34

## Reported AIDS Cases and Rates Among Female Adults 

- * Total includes 10 persons of unknown race.

**Reported AIDS Cases and Rates Among *****Female *****Adults**** **

**and Adolescents, by Race/Ethnicity, 2002****, ****US**

- Number

- %

- 7,326

- 67

- 1,928

- 18

- 1,556

- 14

- 42

- 68

- 10,930

- <1

- <1

- Race/Ethnicity

- Rate (per

- 100,000

- population)

- White, not Hispanic

- 49.1

- Black, not Hispanic

- 2.2

- Hispanic

- 11.2

- American Indian/

- Alaska Native

- Asian/Pacific Islander

- Total*

- 4.4

- 1.3

## Some Criminal Justice Facts(from Blankenship et al., 2005)

- In 2003 Blacks were 5 times more likely than whites to be in jail; true for males and females
- In 2003 39% of jail inmates were Black
- In 2003, 12.8% of all Black males aged 25-29 were in prison or jail (compared to 1.6% of white males
- In 1999, 40% of all juveniles in facilities were Black; 52% were there for drug offenses

## Some Criminal Justice Facts(from Blankenship et al., 2005)

- Between 1980 and 1995, drug offenders in state prisons increased 1000%, 1 out of 4
- Drug offenders account for more than 80% of the total growth in the federal inmate population
- 42% of federal inmates in for drugs are Black
- 30% of U.S. persons on probation are Black (drug offenses account for 1⁄4 of probation offenses)
- 41% of persons on parole are Black

- From Iguchi,  Rand, 2005. Number of reported admissions to prison for a drug offense, by race

## Iguchi, Rand, 2005. Rate of yearly prison admissions for a drug offense per 100,000 adults, by race

## Why Is Criminalization A Public Health Research Issue

- Prisons and jails are major providers of drug treatment, notably Cook and Los Angeles Counties
- Correctional facilities provide other health assessments and care, e.g., HIV
- Correctional facilities are high risk settings for promoting/encouraging risky behaviors
- Highest behavioral risk takers may be are under supervision
- Drug courts, growing alternative to incarceration, is treatment option that needs to be further explored esp. for Blacks

## African American Initiative

- Out of great concern about the disproportionate consequences of drug abuse on the African American population especially in the rates of HIV/AIDS and criminal justice involvement,
- Director initiated activity to identify ways in which NIDA can become more strategic and supportive of efforts to ameliorate HIV/AIDS and criminal justice consequences of drug abuse in the African American population.

## African American Initiative

- NIDA-wide committee established
- Committee charged to present Director with a set of recommendations addressing research needs and priorities, research training, collaborations, and outreach and dissemination activities.
- Portfolio analysis done
- Expert meeting held in October 2004 to assess status of the field

## Reducing HIV/AIDS and Criminal Justice Involvement in African Americans as a Consequence of Drug AbuseOctober 12-13, 2005

- Steve Belenko
- Faye Belgrave
- Kim Blankenship
- Ronald Braithwaite
- Lawrence S. Brown
- Victoria Cargill
- Karen Freeman-Wilson
- Robert Fullilove
- James Griffin

- Martin Iguchi
- Kevin Knight
- Vickie Mays
- George W. Roberts
- Pamela Rodriguez
- Claire E. Sterk
- Carolyn A. Stroman
- Faye Taxman
- David Vlahov
- Wendee Wechsberg
- Gail Wyatt

## African American Initiative

- $500,000 supplement program established; 44 applications received; six awards made
- Two Program Announcements are in process for FY 06:  Criminal Justice and HIV/AIDS with Office on AIDS
- Special Issue of Journal of Health Care for the Poor and Underserved to be published in November, 2005

## Membership: African American Initiative Committee 

- Jean Lud Cadet, M.D., IRP
- Gayathri Dowling, Ph.D., OSPC
- Dionne Jones, Ph.D., DESPR
- Steven Oversby, Ph.D., DPMCDA
- Carmen Rosa, M.S., CTN
- Paul Schnur, Ph.D., DBNBR
- Donald Vereen, M.D., OD
-  Lula Beatty, Chair

- Membership: African American Initiative Committee

## Racial/Ethnic Minority Work Groups

- Groups of primarily researchers and others in drug abuse programs representing the four major racial/ethnic minority populations
- Purpose is to provide advice and/or support to NIDA’s efforts at increasing racial/ethnic participation in research and improving research on racial/ethnic minority issues, specifically to address
- Researcher development needs and obstacles
- Research needs within the population
- Barriers to research
- Research dissemination

## Racial/Ethnic Minority Work Work Group Models

- Advisory/Constituency Group
- African American Researchers and Scholars
- Native American/Alaska Natives
- Asian Americans/Pacific Islanders
- Contracted Services
- National Hispanic Science Network

## Selected Accomplishments: Advisory/Constituent Groups 

- Increased member involvement in NIDA and other drug abuse research
- Mentoring, and identifying persons for NIDA programs/activities
- Networking among/across groups
- Presentations and Publications

## African American Researchers and Scholars

- Jean Oyemade Bailey, Ph.D.
- 	Professor and Director
- 	Howard University
- Faye Belgrave, Ph.D.
- 	Professor, Psychology
- 	Virginia Commonwealth University
- Ronald L. Braithwaite, Ph.D.
- 	Professor,Morehouse School of Medicine
- Lawrence Brown, M.D., M.P.H.
- 	Senior Vice President, Addiction Research and Treatment
- 	Corporation
- Julius Debro, Ph.D.
- 	Professor (Retired)
- 	University of Washington
- Roy Griffin
- 	Coordinator, Health Services
- 	Fort Worth Independent School District
- Franklin Hamilton, Ph.D.
- 	Professor, Environmental Sciences
- 	Florida A & M

- Carl Hart, Ph.D.
- 	Assistant Professor and Research Scientist
- 	Columbia University and New York State
- Ernest Quimby, Ph.D.
- 	Associate Professor, Sociology and Anthropology, Howard University
- Daniel Sarpong, Ph.D.
- 	Director and Senior Biostatistician
- 	Jackson State University
- Tony Strickland, Ph.D.
- 	Behavioral Neuroscience Research Center
- 	Charles R. Drew University
- Janet Mitchell, M.D.
- 	Addiction Research and Treatment Corp.
- Kathy Sanders-Phillips, Ph.D.
- 	Professor, Howard University
- Flavia Walton, Ph.D.
- 	Director, COSMOS Corporation
- Murelle Harrison, Ph.D.
- 	Professor/Chair, Dept. of Psychology
- 	Southern University

## Native American/Alaska Native Work Group 

- Thomas Ball, Ph.D.
- 	Oregon Social Learning Center
- LaDonna Blueeye
- 	U. of OK
- David Burgess, Ph.D.
- 	Boston College
- Raymond Daw
- 	Na’nizhoozhi Center
- Phillip Fisher, Ph.D.
- 	Oregon Social Learning Center
- Candace Fleming, Ph.D.
- 	U. of CO Health Sciences
- 	Center
- Pamela Jumper Thurman, Ph.D.
- 	CO State University’

- Clyde McCoy, Ph.D.
- 	U. of Miami
- Leo Nolan, M.Ed.
- 	Indian Health Service
- Bernard Segal, Ph.D.
- 	U. of Alaska, Anchorage
- Sally J. Stevens, Ph.D.
- 	U. of Arizona
- Jerry Stubben, Ph.D.
- 	Iowa State U.
- Roger Dale Walker
- 	Oregon Health & Science U.
- Karina L. Walter, Ph.D.
- 	U. of Washington

## Asian American/Pacific IslanderResearchers and Scholars WorkgroupMember List

**Linda Chang, M.D.**
**	**Professor, U. of Hawaii
**Denise Hien, Ph.D.**
- 	Research Scholar
- 	Columbia University
**Yih-Ing Hser, Ph.D.**
- 	Adjunct Professor
- 	UCLA
**Martin Iguchi, Ph.D.**
- 	UCLA School of Public Health Professor
- 	RAND
**Bosseba Kong, MSW**
- 	Mental Health Clinician
- 	Stanilaus County Behavioral and Recovery Services
**Ford Kuramoto, DSW**
- 	National Director
- 	National Asian Pacific American Families Against Substance Abuse

**Grace E. Macalino, Ph.D.**
- 	Tufts New England Medical Center (NEMC)
**Tooru Nemoto, Ph.D.**
- 	Associate Professor
- 	University of California, San Francisco
**Keum Pang, Ph.D.**
- 	Professor, Howard University
**Rumi Price, Ph.D.**
- 	Research Associate Professor
- 	Washington University
**Frank Wong, Ph.D.**
- 	Associate Professor
- 	Georgetown University
**Elmer Yu, M.D.**
- 	Clinical Director of General Research
- 	University of Pennsylvania/Philadelphia VAMC

## Selected Accomplishments: National Hispanic Science Network 

- Annual conference on drug abuse in the Hispanic population
- Website providing information on  Hispanic drug abuse research and researchers
- Summer research training workshop
- Publication: National Strategic Plan on Hispanic Drug Abuse Research

## NHSN 2004 Steering Committee

- Jose Szapocznik, Ph.D., Chair, U. of Miami
- Hortensia Amaro, Ph.D.
- 	Northeastern University
- Ana Mari Cauce, Ph.D.
- 	U. of Washington
- Alexander Kopelowicz, M.D.
- 	UCLA

- Joe Martinez, Ph.D.
- 	U. of Texas, San Antonio
- Patricia Molina, M.D., Ph.D.
- 	Louisiana State U.
- J. Bryan Page, Ph.D.
- 	U. of Miami
- Rafaela Robles, Ed.D
- 	Universidad Central el Caribe, Bayamon

## Health Disparities Strategic Plan

- NIH requirement
- NIH plan includes each IC plan
- NCMHD is coordinator; Determines
- Structure/format of plan
- Time for plan submission, review and revision
- Submits for public response

## NIDA’s Strategic Plan 

- Developed by NIDA-wide Committee, chaired/staffed by SPO
- Committee retained to set priorities, monitor and implement plan

## NIDA’s Health Disparities Plan Outline

- Research:
-    1: Epidemiology, Health Consequences, & Infectious Diseases
-    2: Prevention of Drug Abuse and Addiction
-    3: Treatment and Health Services
-    4: Basic and Clinical Neurosciences
- Infrastructure
- Public Information and Outreach

## NIDA’s Strategic Plan

- Developed Health Disparities Supplement Program,
- 29 awards made (4 supported by NCMHD)
- Committee encouraged/endorsed RFA released by DESPR/CAMCODA (resulted in 8 awards)
- Committee explored issues:
- Definition of health disparities
- Coding/Reporting issues

## Health Disparities Committee

- 	Ann Anderson, Ph.D., 	DPMCDAJean Lud Cadet, M.D., 	IRPDorynne Czechowicz, 	M.D., DCNDBTLynda Erinoff, AIDS   	Office
- 	Joseph Frascella, Ph.D., 	DCNDBT Steve Gust, Ph.D.
-           International Office
- 	Dionne Jones, Ph.D., 	DESPRGloria Lester, OPRM

- Catherine Mills, GMB Cindy Miner, Ph.D., 	OSPCCarmen Rosa, M.S., 	CTNPaul Schnur, Ph.D., 	DBNBRDavid Shurtleff, Ph.D., 	DBNBRDonald Vereen, Ph.D., 	OD Lula Beatty, SPO, Chair Ana Anders, M.S.W., 	SPO
- 	Flair Lindsey, SPO

## Health Disparities Conference, October 24-26, 2005 

- Plenary sessions on genetics, HIV/AIDS, criminal justice, structural factors
- Workshop sessions
- Poster sessions by new investigators and service providers
- Travel awards

## Health Disparities Planning Committee

***NIDA Staff***
- 	Lula Beatty
- 	LeKhessa Doctor
- 	Pamela Goodlow
- 	Ana Anders
- 	Joni Rutter
- 	Pushpa Thadani
- 	Dionne J. Jones
- 	Aria Davis Crump
- 	Joseph Frascella
- 	Gloria Lester
- 	Carmen Rosa
- 	Monica Jones
- 	Mark Swieter
- 	Suman Rao King

***African American Work Group***
- 	Daniel Sarpong
- 	Julius Debro
- 	Janet L. Mitchell
- 	Lawrence Brown
***Asian American/Pacific Islander Work Group***
- 	Rumi Kato Price
- 	Frank Wong
***Hispanic American Work Group***
- 	Avelardo Valdez
- 	Ana Mari Cauce
***Native American/Alaska Native Work Group***
- 	Pamela Jumper Thurman
- 	Raymond Daw
- 	Bernard Segal

## Minority Recruitment and Training Program (IRP)

- Summer program for persons in high school through college; some faculty support
- About 25 students participate each summer
- Partnered with an IRP scientist

## National Center on Minority Health and Health Disparities

- SPO is liaison to NCMHD
- Reporting requirements
- Cofunding

## National Center on Minority Health and Health Disparities Support

- 	FY                # of Projects            $ Amount
-   94		            5		       $  235,544
-   95	                      7                         485,000
-   96                          3                          152,000
-   97                          5                          575,000
-   98                          8                          712,000
-   99                          5                       1,853,357
-   00                          4                          327,400
-   01                          8                       1,473,000
-   02                          0                                   0
-   03                          2                       1,230,061
-   04                          1                          900,000
-   05                          1                          900,000
-                                          Total      $8,843,362

## Selected NIDA Meetings 

- Differential Drug Use, HIV/AIDS, and Related Health Outcomes among Racial and Ethnic Populations: A Knowledge Assessment Workshop, 2002 (DESPR, support from NCMHD and ORWH)
- Methodological issues in health disparities, 2002 (DESPR)
- July 2005 meeting with health disparities supplement and RFA grantees (DESPR and SPO)

## Support/Participate in Other Meetings: Examples

- American Psychological Association
- National Hispanic Science Network conference and training institute
- National Asian Pacific American Families Against Substance Abuse
- CPDD
- Association of Black Psychologists
- Latino Behavioral Health conference
- HBCU Substance Abuse conference
- American Society of Criminology

##  Selected Recent Publications 

- Array of material developed/supported by OSPC, e.g., NA/AI and AAPI calendars, information in Spanish
- NHSN’s Hispanic Strategic Plan, available in journal
- Drug Use among Racial/Ethnic Minorities, revised in 2003 (DESPR was lead)
- Methodological Challenges in Conducting Health Disparities Research, *Journal of Urban Health*, 2005, Dionne Jones and Aria Crump (Eds.)
- Drug Use, HIV/AIDS, and Health *Public Health Reports,* Outcomes among Racial and Ethnic Populations, 2002, Dionne Jones, Arnold Mills, and Henry Francis (Eds.)

## Selected Recent Publications

- Articles by Beatty, Wheeler and Gaither (HIV Prevention Research),  and Jones (HIV Risk Reduction Strategies) in Enhancing Research and Clinical Responses to HIV/AIDS in African Americans: Social, Psychological, and Contextual Issues, *Journal of Black Psychology*, 2004
- Book chapter by Beatty (Changing their Minds: Drug Abuse and Addiction in Black Women)  in *In and Out of Our Right Minds, The Mental Health of African American Women*, Brown and Keith (Eds.), 2003.
- Weiss, S.R., Kung, H.C. & Pearson, J.L. (2003). Emerging issues in gender and ethnic differences in substance abuse and treatment. *Current Women’s Health Reports, 3(3),* 245-253.

## Selected Recent Publications

*Journal of Health Care for the Poor and Underserved*, Beatty, Jones & Doctor (Eds.), 2005, in press.
- Beatty, L.A., Wetherington, C.L, Jones, D.J., & Roman, A.B. (2005). Substance use and abuse in girls and women. In J. Worrell and C. D. Goodheart, *Handbook of girls’ and women’s psychological health*. Oxford University Press.

## Southern Africa Initiative

- Responsive to Department’s  interest and call for assistance in South Africa (Binational Commission)
- Established in 2000 (stimulated by HBCU activity)
- Capetown meeting in Summer, 2000, attended by NIDA Director and staff and South Africa’s Deputy President and Cabinet Ministers

## Southern Africa Initiative

- Major focus on capacity development and HIV/AIDS
- Mutual research interests and possible generalizability particularly to African Americans and prison populations
- Research Supplement Program
- 11 grants supported (2001 and 2002) across divisions
- Research addressed includes:  HIV/AIDS and health in prisons, HIV prevention with women, adolescent substance use in rural areas

## Southern Africa Initiative 

- Capetown meeting in Summer, 2003 to facilitate collaborative ties between sponsors and among researchers; expand network (sponsors/participants included Ministers, Medical Research Council, HHS representative, World Health Organization, U.S. Department of State)
- Meeting of PIs is being planned by SPO and International Office to determine next steps

## Selected Current Co-sponsored Programs

- Physician Scientist Program (NCMHD)
- Longitudinal research development program for racial/ethnic minority students (starting at 7th grade)
- High school students placed in NIDA IRP during summer
- Clinical Research Education and Career Development in Minority Institutions (NCRR)
-  Specialized Neuroscience Research Program (NINDS)
- Minority Fellowship Programs (to professional associations)
- Native American Research Centers of Health (Indian Health Service)
- Summer Program at Harvard for Native American students
- 	(with NIMH and others)
- Summer internships, e.g., HACU, NAFEO, WIN

## Assessment of NIH Minority Research and Training Programs 

-      National Academy of Sciences study to
- Assess how well these NIH minority research training programs work
- Identify characteristics of successful programs, trainees and institutions
- Recommend strategies to render future assessments feasible
- Provide recommendations for a coordinated trainee tracking information system

## Difficulties Experienced

- Inadequate trainee tracking data
- Available data are not readily accessible
- Prohibition against accessing or viewing individual trainee race and gender data
- Lack of coordination among NIH minority research training IC representatives

## Conclusions

- Underrepresented minorities are entering the biomedical workforce as a direct result of the NIH minority research training programs
- Best feature is the research experience itself
- Financial support was another best feature, though needs to be increased
- Other positive features were opportunities to network and collaborate, prepare grant proposal

## Conclusions

- Mentoring needs to be improved (e.g., mundane administrative tasks)
- Half of T32 minority postdocs reported having no mentor
- Drop off of females at postdoc/junior faculty level
- Look beyond training the individual fellow to effect long-term change

## Recommendations

- By the end of 2005, the NIH director should articulate a set of clear and measurable training goals and objectives specific to minority training
- NIH should commit to the continued funding of minority-targeted research training programs
- The director of each IC should designate a single individual as minority research training programs coordinator for that IC by the third quarter of FY 2005

## Recommendations

- The NIH training director should convene a meeting of all minority training coordinators on at least a quarterly basis, beginning with the third quarter of 2005
- The committee of minority training program coordinators should establish appropriate guidelines and measures for evaluating NIH minority research training programs

## Recommendations

- Further study of the relative effectiveness of minority-targeted vs. nontargeted programs should be carried out by NIH ICs under coordination from the Office of the Director
- The director of NIH training should administer the funds for evaluation, data collection, and marketing by FY 2006

## Recommendations

- The general issues reviewed in this report should be revisited periodically at the NIH level with the next report submitted by 2009.  The OD should take the lead.
- NIH should develop a relational database that collects a minimum data set for all persons who received funding as trainees, fellows, research assistants, or postdoctorates, including those programs targeted to underrepresented minorities

## Lessons Learned at NIDA

- Supportive leadership
- Supportive colleagues
- Greatest barrier may be mistrust of us and the process
- Willingness to listen and ability to participate in difficult conversations (racism, oppression, review, criticism of NIDA, NIH and self)

## Lessons Learned at NIDA  

- Takes long-term commitment
- Requires active outreach
- Tolerance for missteps along the way
- Minority involvement leads to minority focused research
- Welcoming opportunities (e.g., for people and issues)