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Archived
June, 2007


FY 2004 Annual Plan
for the Hispanic Agenda for Action (HAA) & the Educational Excellence for Hispanic Americans (EEHA) Initiatives

Centers for Disease Control and Prevention (CDC)
Agency for Toxic Substances and Disease Registry (ATSDR)

Report

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Executive Summary

This report presents the Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry’s (CDC*) FY 2004 Annual Plan for the White House Initiatives on Educational Excellence for Hispanic Americans (EEHA).  It provides the overarching goal identified by the agency under which measurable objectives will be achieved during the time period, the amount of funds to be distributed to minority institutions and other minority entities, the number of institutions/other minority entities that will be reached through awards and program activities during this period, the types of programs by categories of funding that will be targeted, and potential barriers and accomplishments of the programs.

The overarching goal for CDC’s FY 2004 plan to address the Hispanic Agenda for Action and the Educational Excellence for Hispanic Americans (HAA/EEHA) is “to promote health and quality of life by reducing the disproportionate burden of preventable diseases, death and injury among Hispanic/Latino populations.” Inherent in this goal is the need to assess and address the health disparities within the Latino subgroups.  Four specific objectives target activities that are aligned with achieving our overall goal:

orange square Objective 1 - Increase the number of minority-serving institutions of higher education, national and minority organizations and community-based organizations that receive funding and support to address health disparities among specific racial and ethnic populations.
orange square Objective 2 - Increase the number of minority-serving institutions of higher education, national and minority organizations and community-based organizations that receive funding and support for infrastructure development to facilitate instruction and research.
orange square Objective 3 - Increase funding and support to minority entities for domestic and international training opportunities (fellowships, internships, scholarships and other support) for racial and ethnic minority students, parents and faculty.
orange square Objective 4 - Increase technical assistance, training and capacity building that will enhance information technology, health promotion, program design, and research development among minority entities, including public and private partnerships.

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CDC's Spanish web site, CDC en Español, continues to grow and expand its services to Spanish speaking customers, and to provide a template for working with all other than English speaking populations.
*Note: References to CDC refer also to ATSDR throughout this plan.
CDC’s Centers, Institutes and Offices, (CIOs) are aware of the diversity within the Hispanic/Latino populations.  This diversity can be categorized in many ways, including, race, ethnicity, class, socioeconomic status, and immigration status and length, among many others.  Each of our CIOs is poised to incorporate into their missions and plans of action specific strategies and activities that will begin to address the challenge of serving this uniquely diverse population.
 
The National Center for Health Statistics (NCHS) has been the source of much of the data that describe significant disparities in health, reflecting a decades-long effort to address these issues in major national data systems.  The Centers for Disease Control and Prevention (CDC) has an “inclusion” policy, as does Department of Health and Human Services (HHS), which mandates that the collection of racial and ethnic data is an important consideration.  Many population-based data systems, such as the National Health Interview Survey and the National Health and Nutrition Examination Survey (NHANES), make concerted efforts to oversample minority populations to increase the reliability of the estimates drawn from scientific data on these groups.  To ensure the participation of these groups, we also make special outreach efforts, such as targeted promotional materials for the NHANES.
 
Some examples of data from NCHS that indicate relative and absolute health disparities are: infant mortality and life expectancy; prevalence of and risk factors for hypertension, diabetes, and kidney disease; health insurance coverage and access to care; and smoking and other health behaviors.  NCHS provides data that allows for the interaction of race and other social, behavioral, and environmental factors.  This will allow us to better understand the experience of minority groups in the health care system.  NCHS will host a Data Users Conference in July 2004 that will provide workshops to assist researchers, policymakers, academics, and other data consumers in using NCHS data.
 
Established in 1981, CDC’s Epidemiology Program Office (EPO) provides a cross-cutting focus in public health communications; applied research and methodology; public health training; surveillance and informatics; and global health.  Because of this focus on core activities, EPO’s mission primarily focuses on the internal changes in the general scope of public health over time.  In addressing its work, EPO is dedicated to working with multiple partner organizations; health care providers; third -party payers; corporations; industries; and local, state, federal, and international health and welfare agencies.
 
EPO fills a critical role in communicating public health messages through publications and other communication venues, including the Morbidity and Mortality Weekly Report, and its serial publications; the Guide to Community Preventive Services; and the Epidemic Information Exchange program.  As a catalyst for scientific discourse, EPO provides support in epidemiology, behavioral and social sciences, prevention effectiveness, social determinants of health, community-based participatory research, surveillance, aberration detection, statistical methodologies, evaluation of public health and health-care databases and systems, and managed care research.  EPO is on the cutting edge of innovative technologies that run secure and responsive systems to detect emerging public health problems.  Such systems include the National Electronic Disease Surveillance System (NEDSS) and the newly revised EpiInfo and its adjunct computer software.
 
Through its public health training programs, EPO serves CDC and the world by providing a cadre of well-trained public health professionals.  Training opportunities include the Epidemic Intelligence Service program, Preventive Medicine Residency program, Public Health Prevention Service program, Public Health Informatics fellowship, Prevention Effectiveness fellowship, undergraduate and graduate medical electives, Knight Journalism Fellowship, International Field Epidemiology Training Program, and other Fellowships and internship programs for international students.
 
With its emphasis on “real world” training after degree attainment, EPO is in an optimal position to influence the development and education of minorities interested in public health.  During development of EPO= priorities for FY 2004, decisions were made to concentrate on the development of strategies to enable EPO's training programs to better recruit and serve all minority groups, as well as increase opportunities for participating with minority institutions and their programs.
 
The Agency for Toxic Substances and Disease Registry (ATSDR) will continue to fund and expand activities related to environmental health curriculum at the University of Texas Health Science Center at San Antonio/Regional Academic Center in the Lower Rio Grande Valley.
 
CDC’s National Institute for Occupational Safety and Health (NIOSH) is the federal agency responsible for conducting research, making recommendations for the prevention of work-related disease and injury, and providing training programs in the field of occupational safety and health, as mandated by the Occupational Safety and Health Act of 1970.  NIOSH strategies include financial support and technical assistance for training, research and development with emphasis on specific minority populations, and minority outreach and recruitment.  NIOSH plans to continue providing financial support for occupational safety and health research opportunities for minority students and faculty.  Awards will be given in the form of internships, inter-personnel agreements or other means of faculty support, research projects and collaborations with minority-serving institutions and organizations.  NIOSH plans to link an HSHPS or HSI and an HBCU with one of our external education and research partners to jointly work on occupational safety and health research; fund Potential Extramural Project (PEP) requests with minority-serving institutions or organizations to address health disparities among specific racial and ethnic populations; and provide technical assistance among minority entities through mentorships and collaborations with minority organizations and/or institutions.
 
CDC’s National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) will be funding the American Association for Health Education (AAHE).  This organization addresses health education, HIV prevention and other important health problems among college students, faculty and personnel from HSIs and HBCUs.
 
CDC’s National Center for Infectious Diseases (NCID) plays a crucial role in maintaining our border population’s health.  NCID will continue funding the Border Infectious Disease Surveillance Project (BIDS) for collaborations with Mexico along the U.S. – Mexico border. NCID will also be sponsoring an International Conference on Women and Infectious Diseases.  This conference will address issues related to minority and women’s health.
 
NCID will also continue to focus on the Hispanic/Latino Initiative aimed at reducing infectious disease morbidity and mortality among Latinos, in particular reducing health disparities experienced by Hispanic/Latino population groups.  We will continue our collaborations with HSHPS in supporting internship programs, and providing technical support. In addition, NCID will continue support of the Annual Symposium on Career Opportunities in Biomedical Sciences.  One of the principal goals of the Symposium is to introduce minority students to the many rich, varied and rewarding opportunities available in the field of Biomedical Sciences.  NCID will also continue to recruit minority students for its James A. Ferguson Summer Fellowship Program.  This program is designed to increase students’ knowledge of public health, knowledge of racial and ethnic health disparities, knowledge of public health career paths and the mechanisms to pursue such careers, interest in the study of infectious diseases, and to help students gain skills in communicating public health information.
 

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Summary statement on funds projected for Hispanic/Latino activities
in FY 2004
Although CDC data systems are not specifically geared to identify programmatic activities by racial/ethnic categories nonetheless it is projected that in FY 2004 CDC will award approximately $7,884,054 for specifically identified activities focused on Hispanic Latino health.  It is anticipated that approximately 91,492 people from the different Latino populations will benefit directly from these awards and related activities.
 
Hispanic/Latino representation in the CDC workforce
Hispanic representation at the CDC workforce is increasing over time.  The CDC/ATSDR's Recruitment and Retention Plan has been incorporated in the "Diversity in Action Framework for CDC/ATSDR."  This document will provide the framework that will assist CDC/ATSDR to attract and retain a workforce that mirrors the diversity of the populations that we serve and to aid in the development and sustainability of a multi-culturally sensitive workplace environment that values and respects diversity.  This document was developed and endorsed in 2000 and is currently being revised to include diversity initiatives that would assist CIOs to enhance their Hispanic/Latino representation and to actively recruit for other under-represented minority groups.
 
Summary statement on barriers/challenges

In today’s pressing environment, filled with multiple priorities, CDC and its CIOs continually assess our ability to provide quality service to all our constituents.  Decreased funding by partners and states impact our ability to address all of our goals with equal resources.  The dramatic increase in the Hispanic/Latino populations, with unique language and cultural needs, in particular, presents a challenge.  However, through such efforts as CDC en Español, CDC is quickly tailoring its work to the needs of the Hispanic/Latino populations.

 


 

ANNUAL PLAN FOR MINORITY INITIATIVES
Agency Goals, Objectives, Strategies, and Activities
HAA/HSI FY 2004


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CDC/ASTDR HAA/HSI Initiative Goal:
To promote health and quality of life by reducing the disproportionate burden of preventable disease, death and injury among specific racial and ethnic populations.
 
Objective 1:
Increase the number of minority-serving institutions of higher education, national and minority organizations and community based organizations that receive funding and support to address health disparities among specific racial and ethnic populations.
 
  National Center for Injury Prevention & Control (NCIPC)
  Strategies/Activities:
  Continue to fund injury prevention research and prevention interventions that target or benefit Hispanic populations at IHEs and to increase similar projects at HSHPS and HSIs.
  National Academic Centers of Excellence on Youth Violence – Fund two academic institutions to forge partnerships between universities and communities to translate research into effective prevention practices designed to reduce youth violence.

Child Violence, Adult Victimization, Injury, and Health –Test the hypothesis that an adverse family environment is a more important predictor of adult outcomes than childhood victimization, and examine the extent to which race, ethnicity, and gender moderate relations between the two.

Occupant Protection Program for a Diverse Populations –Study dissemination research into interventions for preventing unintentional injuries related to motor vehicle crashes.

Injury Risk Management for Young Children - Describe the nature of injury risk and management among Latino and non-Latino white children in response to environmental and maturational changes during childhood. This will result in a model of Injury Risk Management for young children.

Promoting Biculturalism to Prevent Youth Violence –Pilot test a Latino youth violence and suicide prevention intervention that counters acculturation risk by promoting bicultural coping skills and family cohesion.

Suicide Risk During Transition to Early Adulthood – Improve understanding of the etiology of suicide risk by providing a longitudinal approach covering more than a three-year span of time with five repeated measures.

Readiness to Change and Desist from Partner Violence – Predict readiness to change and desist from intimate partner violence.

Adult Violence Linkages in Youth with Disabilities – Develop demographic and epidemiology data on child abuse and neglect and childhood disability from a database of adults who resided at Boys Town from 1978 to 2000.

Latino Community Development Agency, Inc. – Evaluate multiple interventions aimed at reducing the incidence and severity of Intimate Partner Violence and Sexual Violence among Latinos in metropolitan Oklahoma City.

Legal Rights and Responsibilities – Evaluate prevention and early intervention program for 9th graders to end domestic violence among that focuses on legal rights and responsibilities.

Men of Color Fatherhood Education and Violence Prevention Project – Collaborate to prevent intimate partner violence and sexual violence in African American and Latino families through parenting.

Preventing Intimate Partner and Sexual Violence – Evaluate project which serves victims, perpetrators, and child victims/witnesses of intimate partner and sexual violence through localized service networks comprised of community-based programs.

Preventing Intimate Partner and Sexual Violence – Implement a program for the prevention and early intervention of sexual violence and intimate partner violence in a population of HIV-infected individuals enrolled in care and their children.

Preventing Intimate Partner and Sexual Violence – Evaluate a coordinated community response to prevent IPV in Houston, TX through collaboration with the major providers of early intervention for batterers.

Sexual Violence Prevention Program For Perpetrators –Evaluate outcomes of project RESTORE, a prevention and education intervention targeting perpetrators of non-penetration sexual offenses and sexual assaults by known assailants at the time of their first contact with the criminal justice system for sex crimes.

Family Intervention for Suicidal Youth: Emergency Care – Collaborate to complete a rigorous evaluation of an ED-based, Family Focused Intervention for Suicide Prevention.

Promoting Healthy Relationships – Evaluate the Safe Dates curriculum as a means of addressing the problems of intimate partner violence and sexual violence and encouraging health relationships.

Parenting Program Attrition and Compliance Efficacy Trial – Evaluate a child maltreatment prevention effort aimed at promoting parenting effectiveness and child coping-competence in preschoolers, as a means of reducing risk of child maltreatment and related adverse developmental outcomes.

Parenting Program Attrition and Compliance Efficacy Trial – Evaluate a child maltreatment program which examines the extent to which a motivational interviewing intervention has an impact on retention, treatment compliance, and long-term outcomes in families with a history of, or who are high risk for, child physical abuse.

Multisite Youth Violence Prevention Evaluation Project – Evaluate a common violence prevention program in two separate middle schools, one as the experimental group and one as the control group.

National Academic Centers of Excellence on Youth Violence Prevention – Fund four academic institutions to build the scientific infrastructure necessary to support the development and widespread application of effective youth violence interventions.

State Injury Prevention/Program Development and Surveillance – Fund state injury programs to implement core injury functions including data collection and technical consultation to public health professionals, injury advocates, local, state and national organizations.

Child Abuse Prevention – Fund three states to prevent child sexual abuse by establishing or strengthening a statewide partnership of organizations to conduct a statewide inventory of existing child sexual abuse prevention programs.

Domestic Violence Prevention Enhancement and Leadership through Alliances –Fund nine states to conduct statewide needs assessments and inventories of coordinated community responses, highlighting prevention activities, and to establish advisory boards to assist in the design of allied DV programs.

Child Maltreatment Surveillance –Fund five states to collaborate with stakeholders to obtain information on all potential abuse and neglect-related deaths in the state, to develop universal definitions for Physical Abuse, Neglect and Emotional Abuse; and to review cases using these definitions.

National Violent Death Reporting System – Fund six states to collect data from medical examiners’ reports, crime lab reports, law enforcement data system uniform crime reports, and death certificates; and to develop incident-based relational databases that links data on violent deaths from multiple sources.

Intimate Partner Violence Surveillance –Funds two states to develop comprehensive surveillance systems of data collection, tracking, and reporting on the prevalence, characteristics, predictive factors, and types of injuries sustained by women due to violence in intimate relationships.

TBI Surveillance and Follow-up Registry – Fund 12 states to collect data and conduct follow up studies to track and monitor traumatic brain injuries (TBI), to link people with TBI to information about access to services, and to find ways to prevent TBI-related disabilities.

Dissertation Awards for Minority Doctoral Candidates— Assist and encourage minority researchers to become active in the conduct of violence-related studies through a targeted effort.

 


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  Office of the Director/ Office of Minority Health (OD/OMH)
  Strategies/Activities:
  Continue to support and coordinate the HRSA/CDC Interagency agreement to support the three annual migrant stream forums.
  Measures:
    Maintain or increase funding level from FY 2003.
    Maintain or increase workshops, presenters, activities related to CDC’s goals focused on eliminating health disparities.
    Develop collaboration between CIOs and minority entities involved in the migrant stream forums (e.g. migrant community health centers).
   
  National Center for Chronic Disease Prevention & Health Promotion (NCCDPHP)
  Objective 1a
  Strategies/Activities:
  Continue to fund national non-governmental organizations to implement HIV prevention programs that address the needs of Hispanic youth.
  Measures:
    Maintain or increase funding from FY 2003
  NCCDPHP
  Objective 1b
  Strategies/Activities:
  Provide technical assistance to minority-serving institutions of higher education.
  Increase collaboration between tobacco control programs and CBOs and institutions of higher education.
  Provide technical assistance so grantees can pursue additional revenue sources for funding projects.
  Increase participation with Hispanic Association of Colleges and Universities (HACU) and Bacchus & Gamma, a College Peer Tobacco Education Network.
  Measures:
    Demonstrate alliances with state and local departments and organizations.
    States will have competitive funding of local projects.
    Fund grantees who strive to reduce the use of tobacco and promote cessation among college students.
    Increase participation with Bacchus & Gamma.
   
  National Institute for Occupational Safety & Health (NIOSH)
  Strategies/Activities:
  Continue to fund the HRSA/CDC Interagency agreement to support the three annual migrant stream forums.
  Measures:
    Continue to fund and support the HRSA/CDC Interagency agreement to support the migrant stream forums.
    Maintain or increase workshops, presenters, activities related to CDC’s goals focused on eliminating health disparities.
    Develop collaborations between NIOSH divisions and minority entities involved in the migrant stream forums.
   
  National Center for HIV, STD, & TB Prevention (NCHSTP)
  Strategies/Activities:
  Support HSIs in conducting research and evaluations which will improve our intervention programs targeting Hispanic populations.
  Measures:
    Increase funding to HSIs.
   
 

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  Objective 2:
  Increase the number of minority-serving institutions of higher education, national and minority organizations and community based organizations that receive funding and support for infrastructure development to facilitate instruction and research
     
    Office of the Director (OD)/Office of Minority Health (OMH)
    Strategies/Activities:
    Continue to fund and support the HSHPS, Inc., via the CDC/HSHPS cooperative agreement.
    Measures:
      Increase funding annually by 19% (FY 2002 funding was $349,000).
      Increase funding to HSHPS to specifically support the HSHPS research clearinghouse project.
      Increase funding to the HSIs by 19% (FY 2002 funding was $13,405,229).   
     
    National Institute for Occupational Safety & Health (NIOSH)
    Strategies/Activities:
    Continue funding the Hispanic Serving Institutions (HSIs) at the FY 2002 funding level or higher. 
    Measures:
      Continue funding for three training project grants and one education and research center at HSIs: University of Miami, University of Puerto Rico, Trinidad State Junior College, and the UCLA School of Public Health.
       
     

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  Objective 3:
  Increase funding and support to minority entities for domestic and international training opportunities (fellowships, internships, scholarships and other support) for racial and ethnic minority students, parents and faculty.
     
    National Institute for Occupational Safety & Health (NIOSH)
    Strategies/Activities:
    Support and fund training and internship programs with a track record for targeting, attracting and supporting significant numbers of Hispanics/Latinos (e.g. HSHPS and HACU interns).
    Measures:
      Increase the number of HACU or HSHPS interns funded in FY 2002 from six to eight. 
       
     

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  Objective 4:
  Increase technical assistance, training and capacity building that will enhance information technology, health promotion, program design, and research development among minority entities, including public and private partnerships. 
     
    CDC en Español Multilingual Services Team
    Strategies/Activities:
   

Increase CIO participation and funding to support the provision of information in Spanish (and dozens of the most spoken languages in the United States) to promote health and quality of life among Hispanics and other racial and ethnic populations.

    Create a training program through the CDC Corporate University to offer foreign language classes and cross cultural awareness training programs to help epidemiologists, field staff, international travelers, senior management, and other CDC staff to meet CDC Goal (no such training program currently available).
    Actively participate as museum tour guides to give foreign visitors a tour of the museum and CDC facilities in their respective language.
    Make accessible to the public through the Internet a CDC approved glossary of terms in Spanish (and other languages as they becomes available) for the public and private partnerships to consult.
    Provide a centralized mechanism of multilingual services for all CDC staff to be able to have information translated to dozens of languages, obtain interpretation services, and produce voiceover, video, web site development and desktop publishing in dozens of the most spoken languages in the United States as per latest census data.
    Measures:
      Increase funding level from FY 2003.
      Increase participation/involvement from CIOs to have more information translated to different languages.
      Increase number of translations (by word count) completed for each CIO.
      Increase CDC en Español website statistics.
      Increase CDC en Español Listserv membership around the world.
      Increase number of web pages and web sites available in different languages at the CDC.
      Increase number of conferences/events where information in different languages from all CIOs is promoted.
       
    Agency for Toxic Substances & Disease Registry (ATSDR)
    Strategies/Activities:
    Provide environmental health training for Hispanic students and health professionals.  Address the environmental health and environmental medical needs of Hispanic populations.
    Measures:
      Increase funding levels by 5% above FY 2003.
      NCIPC expends more than $7 million to provide technical assistance to grantees conducting Hispanic-related injury prevention interventions in violence, unintentional injuries, and acute care related projects such as Traumatic Brain Injury and Spinal Cord Injury Prevention.  In FY 2002, NCIPC committed $16,851 in funds to train minority students and injury professionals.
     
    National Institute for Occupational Safety & Health (NIOSH)
    Objective 4a
    Strategies/Activities:
    Fund and support infrastructure development to facilitate research at an HSHPS or HSI related to health disparities.
    Measures:
      Support a collaboration project among students and faculty at an HSHPS or HSI and one of NIOSH’s external research and education partners.
    NIOSH
    Objective 4b
    Strategies/Activities:
    Support a surveillance project related to agriculture that addresses the NORA priorities of Agriculture and Special Populations, as well as the NIOSH Surveillance Strategic Goal Three “to strengthen surveillance of high risk industries and occupations, and of populations at high risk.”
    Measures:
      Continue funding the “Health Survey of Minority Farm Operators” surveillance project which provides insight into the prevalence of occupational health problems among ethnic and racial farm operators and allows NIOSH to target interventions to address problems.
    NIOSH
    Objective 4c
    Strategies/Activities:
    Fund a project that will enhance the NIOSH capacity to serve Hispanic Americans.
    Measures:
      Continue funding the NIOSH Spanish Information Dissemination Project which focuses on identifying occupational safety and health issues facing Spanish-speaking workers and their employers identifies occupational safety and health information currently available to Spanish-speaking workers and identifies the best methods to communicate occupational safety and health information to Spanish-speaking populations.
     
    National Center for Chronic Disease Prevention & Health Promotion (NCCDPHP)
    Strategies/Activities:
    Continue to fund the Hispanic/Latino Network to provide direct services and technical assistance to CBOs for the education, treatment, and prevention of tobacco use; develop a cultural specific cessation guide.
    Measures:
      Maintain or increase FY 2003 funding; conduct workshops, presentations and convene forums as necessary related to eliminating tobacco-related health disparities; conduct focus groups to determine best-practices for counter-advertising and assess cessation strategies.
     
    National Center for HIV, STDs, & TB Prevention (NCHSTP)
    Strategies/Activities:
    Increase the number and skills of Hispanic health professionals in public health through faculty and student development programs.
    Measures:
      Increase the number of Latino health professionals supported through various programs from previous year.
       

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