Building Successful Research Infrastructures: Lessons Learned in Achieving and Measuring Success

Slide Presentation from the AHRQ 2008 Annual Conference

On September 10, 2008, Daniel L. Howard, Ph.D., made this presentation at the 2008 Annual Conference. Select to access the PowerPoint® presentation (240 KB).

Slide 1

Building Successful Research Infrastructures: Lessons Learned in Achieving and Measuring Success

• Institute for Health, Social, and Community Research at Shaw University (IHSCR)
• Presented by:
  • Daniel L. Howard, Ph.D., Professor of Health Policy and Director
  • Institute for Health, Social, and Community Research at Shaw University
• This project was supported by a grant from the Agency for Healthcare and Quality Research (AHRQ) (R01 HS 13617)

Slide 2

Outline of Presentation

• Brief update on the Minority Research Infrastructure Support Program (M-RISP) funded SUMMER Center
• Discuss how success is defined
• Discuss sustaining infrastructure development
• Brief update on the IHSCR
• Challenges/Lessons learned
• Short term effect of the M-RISP
• Long term effect of the M-RISP
• Future plans

Slide 3

Research Support

• Shaw University M-RISP Minority Elderly Research (SUMMER) Center. (R24 HS013353). Shaw University. DHHS AHRQ M-RISP. Principal Investigator (PI): DL Howard. 9/30/02-9/29/05. $1,201,567.00
• Shaw University M-RISP Minority Elderly Research (SUMMER) Center Renewal (2 R24 HS013353). Shaw University. DHHS AHRQ M-RISP. PI: DL Howard. 12/1/05-11/30/09. $1,094,055.00

Slide 4

Why Minority Elderly Research?

• PI was familiar with topic.
• Some Shaw faculty had expertise in topic.
• PI was familiar with available dataset.
• PI strength was in secondary data analysis.
• PI, with the assistance of mentor, could put together several reasonable studies.

• In other words, assess your strengths and go with that!

Slide 5

Specifically, the two components of the SUMMER Center are:

• To establish institutional infrastructure support for research development to strengthen and enhance the capability of Shaw faculty members to undertake health services research; and
• To support individual investigator research projects focused on the elimination of health disparities which will, in turn, lead to increases in health knowledge and will form the basis for Shaw faculty to become more competitive in extramural research.

Slide 6

SUMMER Center Structure

• Administrative Core
• Methods Core focusing on Statistics and Measurement Issues
• Ongoing Seminar Series
• Training Component for Shaw faculty
• Seven (7) Research Projects

Slide 7

"Where did my doctor go?"

"Where did my doctor go?" The impact of physician workforce transitions on the disruption of longitudinal physician-patient relationships in a racially diverse sample of elders

• Publications:
  • Konrad, Thomas R., Daniel L. Howard, Lloyd J. Edwards, Anastasia Ivanova, and Timothy Carey. Physician-Patient Racial Concordance, Continuity, and Patterns of Care for Hypertension. American Journal of Public Health 2005 Dec. 25(12):2186-90.
  • Howard, Daniel L., Carol D. Bunch, Wilberforce O. Mundia, Thomas R. Konrad, Lloyd J. Edwards, M. Ahinee Amamoo, and Yhenneko Jallah. Comparing United States Vs. International Medical School Graduate Physicians Who Serve African American and White Elderly. HSR: Health Services Research 41:6 (December 2006).

Slide 8

Physician Patient Racial Concordance and Continuity of Care Among Elders and its Effect on Medical Interventions for Symptomatic Prostate Health Problems

• Publications:
  • Howard, DL, Edwards, BG, Whitehead, K, Amamoo, MA and Godley, PA. Quality and Severity of Lower Urinary Tract Symptoms Among African American Elders. Journal of Health Disparities Research and Practice Vol. 1, No. 2, Winter 2007, pp.73-91.
  • Howard, DL, Edwards, BG, Whitehead, K, Amamoo, MA and Godley, PA. Racial Differences in the Healthcare Seeking for Lower Urinary Tract Symptoms. Journal of the National Medical Association Vol. 99, No.4, pp.404-411, April 2007.
  • Howard, DL, Taylor, YJ, and Ross, LE. Differences in Lower Urinary Tract Symptoms (LUTS) Treatment and Mortality among African American and White Elderly Men. Journal of the National Medical Association (in press).

Slide 9

Regional Study of Incontinence and Stage I-IV Pressure Ulcers Among African American Nursing Home Residents

• Publications:
  • Boyington JE, Howard DL, Carter-Edwards L, Jallah, Y,Gooden KM, Busby-Whitehead J. Racial differences in resident characteristics and UI prevalence in nursing homes in the southeastern United States (MDS Atlanta Region). Nursing Research Vol. 56, No.2, March/April 2007.
  • Erdem N, Howard, DL, Carter-Edwards L, Gooden KM, Amamoo, MA. and Busby-Whitehead J. Racial disparities in the nursing home management of urinary incontinence in the southeastern United States. Journal of Aging and Gerontological Sciences (in press).
  • Howard, DL, Taylor YJ. Racial and Gender Differences in Pressure Ulcer Development among Nursing Home Residents in the Southeastern United States. Journal on Women and Aging (in review).

Slide 10

The Effect of Racial Congruity, Continuity of Care, Health Care Utilization on Physical Function Among African Americans and Caucasians with Stroke and Diabetes

• Publications:
  • Boyington JEA, Howard, DL, Holmes. DN. Self-rated health (SRH), ADL and Mobility Limitations among black and white stroke survivors of the NC EPESE population. Journal of Aging and Health (in press).
  • Kim, MM, Howard, DL, Kaufman, JS, and Holmes, D. Predicting medication use in an elderly hypertensive sample: Revisiting the Established Populations for Epidemiologic Studies of the Elderly study. Journal of the National Medical Association (in press).

Slide 11

Social Constructions of Cultural Meaning and Reasons for Caregiving in African American Families

• Examination of the relationship of Diabetes and Hypertension to the Onset of Eye Disease, Specifically Cataracts and Glaucoma, among African Americans
• Depression Among African-American Elderly in Long-Term Care

Slide 12

How is success defined?

• The Historically Black College and University (HBCU) administration defines it as: "Hey we got the money!"
• (There is no concern regarding the research; now the light bill can be paid.)
• The PI defines it as: "Now I finally made it!"
• (Writing a successful grant application is seen as the crowning achievement rather than realizing that the real work has just begun.)
• AHRQ defines it as meeting the mission of the agency and showing a worthwhile investment of federal funding.
• EVERYONE HAS TO BE ON THE SAME PAGE

Slide 13

Is there congruency between how you define success and how AHRQ defines success?

• Did you complete the research project(s)?
• Did you disseminate the results in conferences?
• Did you publish the results?
• Did you do enough to justify a renewal? / Are you going to apply for a renewal?
• Were you renewed?
• How many involved faculty can now submit their own grants?
• How many involved students are now interested in graduate school?
• Has the research development been sustained?

Slide 14

How do you sustain research infrastructure development?

• Conduct a research needs assessment
• Collaboration, collaboration, collaboration
• Seek more funding
• Seek out strong co-investigators
• Let everyone know what you are doing
• You have to think beyond the completion of individual research projects toward putting in place infrastructure that will help replicate productivity.
• THINK BIG!!!

Slide 15

Mission Statement

• To become a national leader in the multidisciplinary empirical investigation of diverse issues that affect the health and well-being of minorities, particularly African Americans, their families, and the communities in which they live.

Slide 16

The Institute will:

• Develop a collective of proficient researchers involved in health-related areas of research.
• Conduct scientifically sound and relevant minority health and health disparity research.
• Enhance collaborations with Research I level universities and other institutions.
• Provide leadership to Shaw in developing a university focus toward public health.

Slide 17

About the IHSCR:

• Organized in 2003
• In 2006, officially recognized as a Department of Shaw University
• Constitutes the largest Department of the University
• Composed of 35 individuals including PhD-level investigators, Master's level public health professionals, and administrative staff
• Established research collaborations with academic institutions including University of North Carolina at Chapel Hill (UNC-CH), Johns Hopkins University, Duke University, University of Michigan, Wake Forest University, and Morehouse Medical School
• Has secured funding for research totaling more than $20 million dollars

Slide 18

Other Current Funding Sources

• National Institutes of Health (NIH), National Center on Minority Health and Health Disparities (NCMHD)
• National Institutes of Health, National Center for Research Resources
• U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services
• U.S. Department of Defense, Congressionally-Directed Medical Research Programs

Slide 19

Sentinel Events

• In 2002, Shaw University was the only university in the nation to hold two NIH NCMHD-funded Project EXPORT grants (P60 and R24).
• Carolina-Shaw EXPORT Center identified as "showcase model" by external Scientific Program Advisory Committee of national research experts.
• Renewal of the Project EXPORT Center of Excellence for 5 more years.
• Renewal of the SUMMER Center grant for 4 more years.
• Eleven IHSCR investigators and staff have secured external research funding beyond the initial funding provided by AHRQ M-RISP.
• Daniel L. Howard, Ph.D., was recipient of the 2006 Minority Access National Researcher Role Model Award.
• IHSCR hosts second major research conference, September 26, 2008.
• New 32,500 sq. ft., $5.3 million IHSCR Building completed September 2008.

Slide 20

Untitled

• IHSCR researchers have published twenty-two (22) manuscripts in leading peer-reviewed scientific journals.
• Additionally, IHSCR researchers have nine (9) manuscripts "accepted and in press" in leading peer-reviewed scientific journals.
• Moreover, IHSCR researchers have nine (9) manuscripts "in review" in leading peer-reviewed scientific journals. (Twenty-eight (28) are "in various stages of process").
• IHSCR investigators have made fifty-one (51) conference presentations at professional, national, and state meetings.

Slide 21

Challenges

• Heavy teaching loads of Shaw faculty/Ensuring release time for research for Shaw faculty
• Authorship Issues
• Manuscript review, submission and tracking issues
• Renewing partnership leadership and faculty
• Continuing to enhance the infrastructure of the university to support research activities
• Moving from Infrastructure Enhancement to Research
• Adjusting to the ebb and flow of funding to support research priorities

Slide 22

Lessons Learned

• Leadership starts with the PI.
• Quality preparation is essential for junior faculty seeking to become researchers/Recruit researchers with a commitment and ability to complete studies and produce publications.
• Hold technical assistance research meetings with junior faculty.
• Proper delegation to highly trained, experienced, eager individuals is key to sustained quality program (Support and Administrative staff).
• Establish priorities and use them as a guide as you expand your operations.
• Proper communication is essential and ongoing. Always put your thoughts, ideas, and plans in writing.
• Careful planning and organization will yield the most success/Implement a documented system for assessing, measuring, and evaluating progress and providing feedback.
• Sustaining support for a new research venture requires tangible results.

Slide 23

How has M-RISP Impacted Research in the Short Term

• Initiated a firm foundation for research at Shaw.
• Elevated research activities on Shaw's campus.
• Increased the volume and level of scholarly research conducted.
• Created an environment for attracting top level researchers.
• Facilitated the creation of the Center for Survey Research and the Center for Biostatistics and Data Management within the IHSCR.
• Established collaborative seminar series, skill building and mentoring sessions with UNC-CH.
• Assisted the pursuit of additional grant funding.
• Increased publications in peered reviewed journals.
• Increased presentations at scientific conferences.

Slide 24

How has M-RISP Impacted Research in the Long Term

• Has helped the IHSCR become a national leader in health services research
• Has enhanced Shaw's and the IHSCR's infrastructure to support research
• Has increased collaborations with more Research 1 Level Institutions
• Has facilitated the expansion of research to other health related areas
• Has increased research visibility

Slide 25

Future Plans

• To become a national leader in minority health, health services, and health disparity research by expanding our research endeavor into various substantive health areas

Slide 26

Research Infrastructure Development Articles

• Carey, TS, Howard, DL, Goldmon, M, Roberson, JT, Godley, PA, and Ammerman, A. Developing Effective Inter-University and Community Partnerships to Address Health Disparities. Academic Medicine 2005 Nov. 80(11):1039-45.
• Carey, TS, and Howard, DL. The development of the field of health disparities research: the role of cross-disciplinary and institutional collaboration. Harvard Health Policy Review Vol. 8, No. 1, pp.136-144, Spring 2007.
• Walker, TA, Howard, DL, Washington, CR, and Godley, PA. Development of a Health Sciences Library at an HBCU: Laying the Foundation for Increased Minority Health and Health Disparities Research. Journal of the Medical Library Association 95(4) October 2007.
• Howard, DL, Boyd, C, Walker, TA, Kalsbeek, WD and Godley, PA. Investigating health disparities: Survey research infrastructure at a historically Black college/ university. Journal for Healthcare of the Poor and Underserved (revise and resubmit).
• Howard, DL, Walker, TA, Boyd, C, Nelson, D, Washington, C and Godley, PA. Getting from A to IRB: Developing an Institutional Review Board at a Historically Black College and University (HBCU). Journal of Empirical Research on Human Research Ethics (in review).