Focus On Health Disparities Research

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NINDS Program Description

The NINDS is committed to reducing the disproportionate burden of neurological disease borne by underserved groups of society, including racial and ethnic minority, rural, and socioeconomically disadvantaged populations, by funding a spectrum of research from basic science through clinical studies and training the next generation of health disparities investigators.

Health disparities populations are in need of effective tailored prevention and treatment approaches. Poorer health outcomes in these populations when compared to the general US population have a dramatic impact on public health and are a significant cost to society. Supporting research to diminish health disparities in neurological disorders is inherent in the NINDS mission to reduce the burden of neurological disease, a burden borne by every segment of society.

Health Disparities and Stroke

Stroke continues to be a major focus of NINDS health disparities research efforts, as it remains one of the largest and most burdensome disparities in neurological health with substantial opportunity for improving outcomes. NINDS supports research to better understand stroke disparities and to inform development of effective interventions in specific population groups who suffer a disproportionately higher burden of stroke.

Current NINDS-supported stroke disparities research highlights:

Estimates of Funding for Various Research, Condition, and Disease Categories

Research/Disease Areas* FY 2016
(Actual)
FY 2017
(Actual)
FY 2018
Estimated
(Enacted)
FY 2019
Estimated
Health Disparities $3,093 $3,168 $3,353 $3,117

*Dollars in millions and rounded

Proceedings & Outcomes

Inclusion Research

Findings from clinical trials are applied broadly in clinical practice and inform treatment guidelines that affect the clinical care of the general population.  To ensure that new preventive, diagnostic, and treatment approaches are safe and effective for diverse subgroups represented in the population, the studies must enroll sufficient numbers of minority subjects.  The NINDS helps its grantees adhere to the NIH policy for Inclusion of Women and Minorities in Clinical Research through several activities designed to facilitate investigators' efforts to meet enrollment targets.  In addition to the activities described below, a clinical trials recruitment expert in the NINDS Office of Clinical Research works directly with the grantees and program directors on issues related to recruitment and retention.

Clinical Research United in Successful Enrollment (CRUiSE)

NINDS co-sponsored an NHLBI workshop to address successful recruitment in clinical trials. Three key areas were addressed: 1) public and professional awareness and acceptance of clinical trials; 2) human subject research policies, guidelines, and reimbursement; and 3) clinical trial enrollment experience and practice.  A significant portion of the conference addressed the barriers and solutions to improve the inclusion of minorities in clinical trials.  Seventy-five participants, including invited speakers representing clinical researchers, private advocacy groups, industry, and federal sponsors and regulatory agencies, attended.

Inclusion Research funded by NINDS

The NINDS is supporting the Northern Manhattan Initiative for Minority Involvement in Clinical Trials (U24; PI: Bernadette Boden-Albala).  This project will develop and evaluate a toolkit of "Best Practices" for the conduct of successful recruitment of racial and ethnic minorities in neurological clinical trials.

Resources and Tools

REGARDS is a large cohort study evaluating the causes of racial and geographic differences in stroke mortality and cognitive decline in the United States.

NOMAS is a prospective population-based study of stroke incidence, risk factors, and prognosis in a multiethnic, urban population.

The Columbia University's SWIFT (Stroke Warning information and Faster Treatment) study identifies actions/barriers toward optimal "Stroke Preparedness" within a multiethnic community.

The BASIC project is a population-based study that examines the magnitude and etiologies of the stroke health disparity between Mexican Americans and non Hispanic whites.

The SHARE study is a behavior change, educational intervention study aimed at primary stroke prevention for Mexican Americans and non Hispanic whites in Corpus Christi, Texas. SHARE is a partnership between University of Michigan researchers and the Diocese of Corpus Christi.

Hip Hop Stroke is a musical multimedia stroke literacy intervention designed to raise stroke awareness and behavioral intent to call 911 for acute stroke.