Minority Health Research at DCRI

In 2015, the National Institute on Minority Health and Health Disparities observed the 100-year anniversary of Booker T. Washington’s establishment of Negro Health Week, which paved the way for the modern National Minority Health Month observed each April. Inspired by Minority Health Month, the DCRI will be featuring throughout the month researchers who do work in health disparities. We expand our definition of minority to include all populations who have been historically underrepresented in clinical research.

African Americans and Latinos make up 30% of the United States population, but account for less than 10% of participants in genetic studies.

Kevin Thomas, MD
DCRI Director of Faculty Diversity and Health Disparities Research

“We know clinical trials are the cornerstone by which we inform guidelines and deliver high-quality care to patients. If trials are not as inclusive as they should be based on disease burden, then I think the DCRI is uniquely positioned to really make an important impact by increasing enrollment of populations that have been historically underrepresented."

The DCRI’s Kevin Thomas, MD, shares what inspires his research: his desire to help remedy the life expectancy gap across racial lines, of which cardiovascular disease is the number one contributor. Learn more about Thomas' work by viewing an extended cut.

DCRI Co-Chief Fellow Angela Lowenstern, MD, found that both treatment rates and outcomes are worse for women with severe symptomatic aortic valve stenosis than for their male counterparts. Learn more about this project by viewing an extended cut..

Asking the Right Questions

At the DCRI, we are advancing the field of disparities research by working to understand why disparate care exists. Through qualitative research such as interviews with patients and providers, our researchers start solving the problems they see by seeking out the cause.

The DCRI’s Julius Wilder, MD, PhD, is investigating why disparities exist in which patients make it to the liver transplant list. He is particularly interested in learning what patients believe their boundaries are so the health system can begin to address those boundaries.

The DCRI’s Kevin Thomas, MD, discusses the importance of moving past identifying and describing disparities to advancing the research by understanding the causes and moving toward solutions.

graphic showing statistics about liver transplantation disparities

Julius Wilder, MD, PhD
Assistant Professor of Medicine

“We’re really contextualizing these issues that these patients have and the experiences that they have, or at least providing an opportunity for them to describe what they perceive as their barriers to getting what they need. I believe that is what is really going to allow us to create an intervention that will have a significant and positive impact in terms of trying to address the disparities in access to liver transplantation.”

Finding the Right Answers

We work to close the gap and alleviate disparities in a variety of ways. From focusing on representation in our provider base to ensure that patients feel comfortable with their providers to designing representative clinical trials, the DCRI ensures all patients have a voice in every phase of the health care journey.

Designing Representative Clinical Trials

By striving for clinical trial enrollment to meet the population distribution and disease burden, the DCRI can be sure that its research helps to form clinical guidelines that will impact all affected patient groups.

PIONEERHFpiechart

PIONEER-HF

PIONEER-HF, led by the DCRI’s Adam DeVore, included 36 percent black patients, helping to provide "much-needed data on the use of this therapy in this population," DeVore said.

DCRI Research Together

The DCRI Research Together program brings patients and community members together with sponsors and investigators to co-design clinical research. Bray Patrick-Lake, program director for Research Together, said that ensuring underrepresented populations are involved in trial design “is key to developing high-quality studies that eliminate barriers to participation and bring value to all stakeholders.”

Building a Diverse Provider Base

DCRI researchers recognize the importance of career development in underrepresented populations and work to address issues of equality in their respective fields.

ADVANCE-UP

In his role as Assistant Dean for Underrepresented Faculty Development for the Duke School of Medicine, Kevin Thomas leads the Academic Development, Advocacy, Networking, Coaching, and Education for Underrepresented Populations (ADVANCE-UP) program.

The first cohort of ADVANCE-UP includes a diverse network of 13 faculty from eight departments fostering important discussions around the intersections of race, ethnicity, and gender.

Attracting Top Talent

The DCRI’s Pamela Douglas, MD, says that cardiology—and all medical fields—needs to be inclusive so as not to miss out on top talent and to learn to be culturally competent and meet patients where they are.

Developing Interventions to Close the Gap

DCRI researchers focus on creating interventions that will address disparities and improve outcomes in underrepresented populations.

VIVID Pilot Study

A pilot study conducted by the DCRI’s Kevin Thomas, MD, found that showing black patients an educational video about their treatment options increased the patients’ acceptance rate for treatment. A larger study to test the intervention is ongoing.

 

With usual care, 42.9% of black patients said yes to an implantable cardioverter defibrillator. The same proportion was unsure about whether to accept the treatment. By contrast, 84.6% of white patients said yes, while 15.4% were unsure. No white patients said no to treatment. After viewing an educational video that included patient testimonials, the proportion of black patients who accepted treatment increased to 60%. Meanwhile, 79.2% of white patients accepted treatment, while 4.2% declined. The intervention was shown to have a greater impact in the black patient population.

Both during Minority Health Month and year-round, DCRI researchers are working to ensure that our research transforms patient care for all individuals. We invite you to explore more of the areas in which we are advancing clinical research.

Kevin Thomas, MD
DCRI Director of Faculty Diversity and Health Disparities Research

“Once we begin to understand some of the root causes, then we start to design interventions that we believe would ultimately mitigate and help reduce some of the disparities that we see."

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