Center For Health And Urban Minorities (Chum) Receives An $8 Million Program Project Grant From The National Institutes Of Health
Diabetes, Hypertension and Dementia in Washington Heights to Be Targeted
NEW YORK (May 15, 2008) – As with the disease itself, there are generally two types of diabetes patients. There are those who have the time, resources and support to devote their full attention to diabetes by educating and arming themselves with the latest knowledge in order to manage the disease on a daily basis, and then there are those too challenged by the basics of mere survival (e.g., paying rent, making sure the kids are fed, etc.) to devote any significant amount of time to managing the disease. The latter group may benefit from support in caring for themselves and their illness.
Community Health Workers (CHWs) interview a mock patient at CHW training hosted by Alianza Dominicana in Washington Heights.
Enter the Center for Health and Urban Minorities (CHUM), which earlier this year received an $8 million Program Project Grant from the National Institutes of Health to undertake three health studies in the Washington Heights community. In addition to studying the role of community health workers in helping local residents manage their diabetes care while assisting them with other life challenges, one study will be devoted to studying dementia in urban populations and the third will be devoted to treating high blood pressure in community-based settings through local senior centers.
Olveen Carrasquillo, M.D., M.P.H, associate professor of clinical-general medicine and health policy & management, is the director of CHUM. Since its inception five years ago, CHUM has conducted and supported research, training, education, and community partnerships aimed at improving the health of Latinos and African-Americans in northern Manhattan.
Now, with this latest extended funding from NIH, a team of community health workers are being selected and trained at Alianza Dominicana, a local community based organization. They will then fan out into the community to speak to patients about their own diabetes care. According to Dr. Carasquillo, the conversation that will begin with these minority populations in earnest later this year will not start with the nuances of insulin management or diet, but rather with, “How is your (adolescent) son doing?” and “What (community-based) services can we steer him to so that he find the job he needs?”
These questions go beyond the immediate scope of the disease and get to the core of everyday survival in one of the most expensive cities on earth, Dr. Carasquillo says. “Once you address some of the primary, non-disease concerns first, then that paves the way for a serious talk about diabetes – and a hard look at what the individual challenges are, he says.
Key phrases generated during CHW training sessions at Alianza Dominicana. In the diabetes study, Carrasquillo and his team are training seven Community Health Workers (CHWs). Then, as part of the project, Dr. Carrasquillo will randomize 360 patients, half of whom will receive the CHW intervention. The goal is to see how pivotal the visits and intervention of trained CHWs are in improving the self-treatment of diabetes in the home, where it is often most critical. The project will be offered at no-cost to the study participants.
Similar approaches are being taken in the hypertension project, which will take place in senior centers and will enroll 200 patients – half of who will be randomized to a therapeutic lifestyle change intervention involving group classes and individual motivational interviewing sessions. The third project led by Jose A. Luchsinger, M.D., Florence Irving Assistant Professor of Medicine and Epidemiology, is a cognitive study focused on the role of diabetes on dementia and will be following 500 elders. Participants enrolled in the diabetes and hypertension studies will be followed for 12 months. The cognition study will last for four years.
“These approaches, tested through rigorously designed clinical trials, could potentially serve as the national model for delivering health care in populations where the foremost concern of the day might not be the disease itself, but other basic needs that are not being met and which sometimes take precedence over basic health care,” said Dr. Carasquillo.
As the largest Latino social service provider in northern Manhattan, Alianza Dominicana is a non-profit community development organization that partners with local youth, families, public and private institutions. Founded in 1987, Alianza has developed neighborhood-based initiatives using comprehensive and integrated services that attend to children, youth and families' multiple needs. The mission is achieved through strategic partnerships, developing and implementing model programs, providing protection to those in need and creating opportunities for social and economic empowerment.
“One powerful example of a potentially life-changing strategic partnership is Alianza’s role in this very important study being undertaken by CHUM at Columbia University Medical Center,” said Moises Perez, founder and executive director of Alianza Dominicana. “Alianza has opened its doors to the Washington Heights community by offering a trusted and safe place in which to train the dedicated team of Community Health Workers that is participating in this study.”
To learn more or to enroll, please visit http://www.cumc.columbia.edu/dept/chum/
Columbia University Medical Center provides international leadership in basic, pre-clinical and clinical research, in medical and health sciences education, and in patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians & Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Established in 1767, Columbia’s College of Physicians & Surgeons was the first institution in the country to grant the M.D. degree. Among the most selective medical schools in the country, the school is home to the largest medical research enterprise in New York State and one of the largest in the country. For more information, please visit www.cumc.columbia.edu.