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$2.8M grant spawns minority aging research  by Cindy Abole Public Relations In a continuing effort to support research that identifies and reduces health disparities among minority populations within the Palmetto state, the Department of Biometry and Epidemiology won a $2.8 million, five-year research grant from the National Institute on Aging/National Institutes of Health.  The grant establishes the South Carolina Resource Center on Minority Aging Research (RCMAR) for supporting studies aimed at understanding issues important to the health of older minority populations in the state. Focusing on African Americans, the state’s largest minority group, RCMAR has the long-term goal of building an infrastructure to develop new minority investigators conducting research designed to improve the health and well being of older African Americans in South Carolina.  In the later years of the grant, there will also be programs developed to address health issues for aging Hispanics since this minority group is present in South Carolina in increasing numbers. “The RCMAR grant is different from a traditional research grant,” said Barbara C. Tilley, Ph.D., principal investigator for the grant and professor and chair, Department of Biometry and Epidemiology.  “The focus is on developing infrastructure rather than on conducting a large research project.“  The latest research reveals that African American men and women are affected by disease about 10 years earlier than their Caucasian, non-Hispanic counterparts, resulting in higher and earlier mortality among blacks. These differences, according to Tilley, are multifaceted and complex. She hopes that more emphasis on mentoring minority investigators to study and understand cultural differences, and developing programs addressing the health disparities of older minorities in South Carolina, will contribute to reducing this age-related disparity in early mortality. The RCMAR program consists of four cores: administrative; measurement and methods; community liaison and investigator development. According to Tilley, one barrier in improving research on the health of older blacks is the tools used to measure health outcomes.  Often these tools are developed and tested on younger people who are not African-American or Hispanic. Thus the tools can over-or underestimate treatment benefits or even eligibility for treatment. The measurement and methods core is headed by Arch Mainous, Ph.D., and is aimed at studying instruments used for diseases common in older minorities. The community liaison core is a partnership with South Carolina State University. The  core is led by James Walker, Ph.D. Walker has extensive experience in involving rural African-Americans in health programs. He has a network of agricultural extension agents in rural areas able to assist with contact of potential participants for pilot investigators’ projects.  To develop new minority investigators, each year the grant will support three pilot projects, all related to aspects of health disparities affecting African- Americans, age 55 and older. Investigators will be chosen from around the state. During  the course of the grant, 15 minority pilot investigators will gain experience and  training to enable them to submit  their proposals and independent grant applications.  Geriatric psychiatry  research fellow Warachal Faison, M.D., feels fortunate to be selected as one of the grant’s first pilot investigators.  “Dr. Tilley’s grant is tailored to focus on health disparities,” said Faison, praising the one-on-one mentoring and development of fundamental research skills. “Its premise challenges and trains young investigators like myself to grow and become successful academic researchers.” Through the investigator development core led by Alberto Santos, M.D.,  the pilot investigators meet weekly as a group with  Santos, Simpson, Tilley and other RCMAR team members as needed to evaluate their progress, discuss problems and offer solutions. They also are free to meet and contact with the grant collaborators for assistance  and as resources. Key to the development of pilot investigators is teamwork of many collaborative efforts from specialists who contribute their expertise from the Department of Psychiatry and Behavioral Sciences, Neurology, and Family Medicine, Medicine, College of Pharmacy, etc. Other team members represent established research programs already affiliated with specific African American populations, including the Sea Island Genetic African- American Family Registry (Project SUGAR), the African American Study of Kidney Disease and Hypertension (AASK) study, and the S.C. Geriatric Education Center.  Tilley expects that the pilot studies will lead to larger projects by the pilot investigators, funded by other sources.  These larger projects will hopefully result in culturally-informed disease treatment and prevention programs and health promotion strategies; improve-ments to individual/group/community-based interventions resulting in more optimal health outcomes for older minority populations.  “I consider this grant award to be a major accomplishment for Dr. Tilley’s team of collaborators,” said John Raymond, M.D., associate provost for research. “The RCMAR positions MUSC to be a leader in addressing a poorly understood research question...that is ‘What are the effects of ethnicity on the process of aging?’ The grant will mobilize South Carolina’s investigators and health care providers to strive to better understand the aging process in the state’s minority populations. It should lead to new insights into the normal aging process and diseases associated with aging.”  “Our most immediate challenge is simply to make good in what we promised to do,” Tilley said, who is currently working with her team to establish a network of mentors to support this and other research programs. “We need to be facilitators to pilot investigators in order for them to become funded researchers in their own right. We also need to continue to identify and recruit promising new investigators.”  Tilley believes that the RCMAR grant is just one piece in the MUSC collaborative research network aimed at understanding and improving health disparities among black South Carolinians.  The grant follows the AHRQ-funded Excellence Initiative for Eliminating Health Disparities in Blacks in South Carolina directed at health care providers and complements other research like Project EXPORT, a new program teaming MUSC and South Carolina State University as partners to investigate metabolic syndrome and its affect with younger African-American teens and adults, and the Health-e-AME program.   2002 pilot investigators for RCMAR grant Dr. Warachal Faison (College of Medicine, Department of Psychiatry/Division of Geriatric Psychiatry) will study the impact of Alzheimer’s disease on elderly African-Americans. Her research will investigate the decision-making process of African Americans to participate in studies involving treatments for Alzheimer's disease. She will specifically focus on the decision-making process of African-American caregivers of loved ones with Alzheimer's disease.  Dr. Michelle Norman (College of Health Professions, Communication Sciences Disorders-Speech Language Pathology) research will evaluate test differences of functional language measurements between elderly African-American and Caucasian adults affected by aphasia, an impairment that affects one’s ability to comprehend words as a result of a brain injury or stroke. Pam Mazyk (College of Pharmacy) plans to study the relationship between renin levels and angiotensin converting enzyme inhibitor (ACEI) dosage levels in the management of heart failure treatments, specifically African-Americans diagnosed with congestive heart failure. RCMAR Grant Collaborators Barbara Tilley, Ph.D., Biometry/Epidemiology; Arch Mainous III, Ph.D., Family Medicine; James Walker Jr., Ph.D., South Carolina State University; Alberto Santos, M.D., Psychiatry/Behavioral Sciences; Rebecca Antley, Biometry/Epidemiology, program coordinator, CHAMP-RCMAR; Amy Blue, Ph.D., College of Medicine; DeAnna Cheek, MD., Medicine/Nephrology; Esther Forti, Ph.D., R.N., College of Health Professions, S.C. Geriatric Education Center; Daniel Hoskins, Hollings Cancer Center; Jerome Kurent, M.D., General Internal Medicine/Geriatrics; Stephen McLeod-Bryant, M.D., S.C. Department of Mental Health; Kit Simpson, Dr.PH., College of Pharmacy/Center for Healthcare Research; Daniel Smith, Ph.D, Psychiatry/Adult Services; Ida Spruill, Endocrinology, Diabetes and Medical Genetics; Aljoeson Walker, M.D., Neurology/Ophthalmology; Jane Zapka, ScD., visiting professor, UMass. Med Center.       Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to petersnd@musc.edu or catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Community Press at 849-1778.