A review of interventions to reduce health disparities in cardiovascular disease in African Americans.

BACKGROUND: There is a wealth of first- (type or extent) and second- (causes) generation health disparities research. Literature on health disparities interventions (third-generation research) is emerging. In this study, we compiled and qualitatively evaluated interventions to eliminate health disparities in cardiovascular disease (CVD) among African Americans. METHODS: We reviewed articles published from 1996 through 2006. Inclusion criteria were focus on CVD, African American participants, and intervention, including evaluation data. Two readers evaluated each abstract for including in the full review, and a third reader resolved incongruence. Articles with abstracts that received at least 2 votes for inclusion were reviewed in their entirety by 2 readers. Data were recorded in a Microsoft Access database. RESULTS: Of 524 abstracts identified, 111 were selected for full review. Only 33 articles were considered third-generation health disparities research by 2 readers and 23 by 1 reader. Approximately half of the interventions were in high-risk populations (low income, low education, urban) and hypertension and nutrition and physical activity were the most common focuses. Of the 33 that received 2 votes, the interventions that received the most enthusiasm from the reviewers used community-based clinics with lay health volunteers. The intensity of the intervention was not correlated with outcome. CONCLUSIONS: While not widely published, third-generation health disparities research demonstrates interventions to reduce CVD among African Americans. More of this type of research is necessary, and those results must be disseminated.

Establishing a multidisciplinary academic group to address health disparities.

Health disparities are common and a major focus of attention among health care researchers. The reasons for these disparities are several in number and broad in scope. Therefore, it will require a broad-based, multidisciplinary approach to fully understand and significantly reduce health disparities. Researchers with expertise in business and economics, public policy, education, language and communication, and social work will have to team with more traditional health researchers to achieve the desired goal. Our approach to this challenge was to develop a Health Disparities Research Group, a multidisciplinary group of university faculty with an interest in health disparities. University faculty from the disciplines mentioned above, plus others with varying amounts of research experience, have come together to form the group. In this article, we describe how this group was formed and some of its activities to assist in development of other such research teams across the nation.