ࡱ> 5( / 0DArialngsRomanppxO 0DTimes New RomanppxO 0 DWingdingsRomanppxO 0@ .  @n?" dd@  @@`` pm4>> **..6789:;<=>?@ABCDEFGHKJL M NOPQSTUVWXYZ[\]^_`abcdefghijkl 0AA@8)*ʚ;ʚ;g4HdHdO 0ppp@ <4dddd<v 0pw 0___PPT10 L___PPT9.&?  %\+Diversity Issues in ResearchCharlotte Brown, Ph.D. Associate Professor of Psychiatry Western Psychiatric Institute and Clinic PMBC Summer Institute, Pittsburgh, PA May 28, 2009P The Problem  (Racial/ethnic disparities in health status and health care continue Cannot be accounted for by SES Our ability to address disparities is limited by low rates of participation of racial/ethnic minorities in health research Changing demographics of the US Must be able to serve diverse populations&**$Mental Health Research as an Example%%Effective treatments are available for many common psychiatric conditions (e.g., depression, anxiety) National call for more effectiveness research with emphasis on real-world settings with diverse populations (National Advisory Mental Health Council, 1999) Recent mandates by National Institutes of Health to increase minority participation in federally funded clinical trials (1994) Need to develop effective models for training researchers to conceptualize, collaborate, and implement research studies in a culturally competence manner For many areas of health research, this represents a paradigm shift?Engaging Diverse Communities in a Process of Scientific Inquiry@@#More complex than the concept of recruitment Requires that researchers develop and foster an openness to understanding the values and interests of the groups they want to study Typical approach is to develop the research study and recruit Assumption: The research has intrinsic value because it is scientifically sound Assumption: Research has intrinsic value that everyone should recognize < Question\How do I get minorities to understand the value of this work and to participate in my study?$]Q AnswerYou don t! ReframeHow can I engage with potential research participants to identify mutual value in the work that I do so that they would be willing to engage in this process of scientific inquiry?6 (f 1We cannot define the value of our work for others22TOur work has to have value for research participants It is our job as researchers to begin the process of finding out what different groups might value in the work that we do Research participants vary in the reason that they participate in research What are the benefits of research Broad or specific Example: Free treatment for depression@"9"9   BCommunities/populations will vary in their awareness of the problem Appropriate strategies to cope with the problem Formative research strategies may be needed to identify the individual s understanding of the problem and perceived needs Example: Depression is often attributed to life stress Improvement in life circumstances are viewed as appropriate remedy Effective engagement may require raising awareness first tDZ0ZzZZZD0z  &Formative strategies can tell you where to begin in the engagement process Collaboration is a critical element Collaboration involves mutuality Researchers must recognize their own cultural identities Professional identity, organizational culture Racial/ethnic identity, social class identity Lo"9]o"9]  Communities/participant s may place value on opportunities not directly related to the research Training for staff Referrals Direct source of information about resources available at researcher s university Assistance with their own projects&``  Find out about prior research experience Try to avoid those pitfall s Be aware that there may be concerns about you committing the same offenses Get feedback about current research experience Incorporate changes as needed into future research implementation projects Seek consultation Community experts Professional experts)ZhZ/ZKZZ'Z)h/K'   Commonly Identified IssuesMistrust Historical mistreatment Current negative experiences with the health care system Benefit to the community as a whole If the treatment is effective, will it really be made available to the community SustainabilityL ]` ]`Commonly Identified Issues4Communication with community about research findings in a responsible way Comparison Group Treatment as Usual may be no-treatment for underserved populations Randomization Increased education about the research process Participants rights Need for a comparison group to determine which treatment is superior V[Q[Q  Commonly Identified IssuesStudy design Intervention vs. observational Sampling Approach Population-based studies vs. community-based recruitment Type and timing of contacts Cultural adaptations to study recruitment issues`9M9MCommunity Involvement pMany consider this essential May be challenging for researchers because it often involves moving outside your usual comfort zone interpersonally social and cultural values experiences authenticity is important Inclusion of minority investigators-may be a plus, but Remember that relationships are not transferable The relationship with the PI is often most important \PRP7PgPR7g Relationship building is key in working with community agencies and community-based groups Determine the fit between your goals and theirs Be clear about the limits of what you can do Turn mistakes into opportunities for learning and change&[[ Models of Community Research .  Hatch, J. et al., Community Research: Partnership in Black Communities. American Journal of Preventive Medicine, Supplement to V.9 (6) 1993 R " dH'Advice or Consent GiversAccess- consultant or advisor who works for a human service agency and usually lives outside the community Community Role community members have no influence and are unaware of purpose of the research Outcome research is community-based but fails to achieve optimal involvementcOEcOE  *Gate Keepers and Endorsers of the ResearchAccess Identify influential people (churches, clubs, fraternal orders, civic associations) Community Role Research design is explained to endorsers Outcome Research is community-based but the community role is essentially apssivetT*JT*J Deliverers of ResearchAccess Contact influential community leaders Community Role Ask for guidance in hiring community people to work for the research project Outcome Research is community based but not community-involved. Members do not have a significant rolet&M_&M_ >Active participants in the direction and focus of the research??#NAccess Community members are collaborators Community Role Community members provide input in the direction, design, focus, goals, conduct, analysis and use of the study findings Outcome Research is community-based and community-involved as well. The community members are aware and part of the decisions and direction of the research.$x$x  / !"#$%&'() * + , - ./01234567p  0` 3ff` @@̙f|` 4-̙w^33f` fx3` N3` 33f̙` ̙̙f3` Ab3 Ab3f3ffH` f4fZX>?" dd@'~?oUd@nF p@n`o n?" dd@   @@``PT   @ ` `-p>> "  ` (    60̎ "  `P  T Click to edit Master title style! !$  0ώ " `  RClick to edit Master text styles Second level Third level Fourth level Fifth level!     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(2 N6Charlotte Brown, Ph.D..-@Arial>??-. 92 S6!Associate Professor of Psychiatry.-@ArialH??-. C2 W6(Western Psychiatric Institute and Clinic.-@ArialH??-. ?2 \6%PMBC Summer Institute, Pittsburgh, PAn.-@Arial??-. 2 `6 May 28, 2009.-՜.+,0H    On-screen ShowUPMC' ArialTimes New Roman WingdingsCascadeDiversity Issues in Research The Problem%Mental Health Research as an ExampleSlide 4@Engaging Diverse Communities in a Process of Scientific Inquiry QuestionAnswerReframe2We cannot define the value of our work for others Slide 10 Slide 11 Slide 12 Slide 13Commonly Identified IssuesCommonly Identified IssuesCommonly Identified IssuesCommunity Involvement Slide 18 Models of Community Research Slide 20Advice or Consent Givers+Gate Keepers and Endorsers of the ResearchDeliverers of Research?Active participants in the direction and focus of the research  Fonts UsedDesign Template Slide Titles#_ 9Tim CarrollTim Carroll  !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnoprstuvwxyz{|}~Root EntrydO)Current UserSummaryInformation(q2PowerPoint Document(DocumentSummaryInformation8