Developing Research Infrastructure: the Puerto Rico Health Services Research Institute Experience Roberto E. Torres-Zeno, Ph.D. Principal Investigator Health Services Administration Department University of Puerto Rico Graduate School of Public Health AHRQ 2009 Annual Conference September 14, 2009

Acknowledgement Research project supported by grant # 6 R24 HS awarded by the Agency for Healthcare Research and Quality (AHRQ) Project Period: AHRQ Minority Research Infrastructure Support Program (MRISP)

Purpose of Presentation Identify purpose and specific aims of AHRQ award Describe partnerships between the PRHSRI and collaborating organizations Impact on health services delivery system in PR Identify challenges of developing a research infrastructure support system

Grant Specific Aims Establish and maintain an administrative structure in the Health Services Administration Department (HSAD) in the Graduate School of Public Health (GSPH) Establish a faculty development and mentoring program that will enhance the HSAD and GSPH capabilities to undertake health services research

Grant Specific Aims Formulate and conduct pilot projects in health services research that will lead toward more comprehensive investigations through the submission of proposals for external funding

Grant Specific Aims Provide methodological and technical support that will facilitate: – the identification and advancement of potential research ideas – the development of successful research proposals for external funding – conducting pilot research projects in health services research focusing on health disparities – the dissemination of research findings for policy development purposes

Pilot Research Projects Health Services Utilization Pattern of Children and Adolescents with Asthma by Health Insurance Status in Puerto Rico The Effect of Health Care Reform on Infant Mortality: The Case of Puerto Rico Psychometric Properties of the Performance of Mental Health Services for Children and Adolescents (Organizational Climate)

Pilot Research Projects Health Seeking Behavior and Complementary and Alternative Medicine Utilization Patterns in Puerto Rico: Implications for Health Policy and Administration Development of a Spanish Version of the Primary Care Assessment Tool (PCAT) Social Environment and Family Factors Associated with Childhood Obesity Among Elementary School Students in Puerto Rico

Partnerships Academia and US Federal Government – US Department of Agriculture (USDA) and Obesity Project (PI: Dr. Winna Rivera) Collaboration in Dietary Research – US Department of Agriculture Extramural Agreement Use of USDA Dietary Intake Software by PRHSRI researchers

Partnerships Academia and US Federal Government – US Department of Agriculture (USDA) and Obesity Project (PI: Dr. Winna Rivera) In exchange of technical review and updates of Puerto Rican foods and recipes in the USDA Food and Nutrient Database for Dietary Studies 4-day training provided to PRHSRI researchers on use of USDA Dietary Intake Software

Partnerships Academia and US Federal Government – Complementary and Alternative Medicine (CAM) Project (PI: Roberto E. Torres-Zeno) Access to 2007 NHIS CAM Supplement instrument (Spanish version) for cultural adaptation in Puerto Rico Technical Support by NCHS/CDC Potential use to study Puerto Ricans in the US Potential use to compare Puerto Ricans in the US vs Puerto Ricans living in the island

Partnerships Academia and PR Government – Puerto Rico Health Department Maternal and Child Health Division & Infant Mortality Project (PI: Dr. Heriberto Marín) Database provided by Puerto Rico Health Department. MCH Division Director member of PRHSRI Advisory Board. Research findings shared with MCH Division.

Partnerships Academia and PR Government – Puerto Rico Health Department Maternal and Child Health Division & PRHSRI Infant Mortality Project (PI: Dr. Heriberto Marín) Research findings shared with Commission on Evaluation of the Puerto Rico Health Care System (2006) Marín et al., The Effect of Managed Care on Prenatal Care: the Case of Puerto Rico, Maternal and Child Health Journal, 2009 Mar;13(2): Epub 2008 (May 17)

Partnerships Academia and PR Government – PR Department of Education and Obesity Project (PI: Dr. Winna Rivera) Access to elementary school children and parents for study authorized by PR Department of Education Research findings available to PR Department of Health Maternal and Child Health Division Potential projects to replicate study in other school districts

Partnerships Within University of Puerto Rico Medical Sciences Campus (UPRMSC) – Cancer Center Research proposal – Puerto Rico Comprehensive Center for the Study of HIV Disparities ($25,000 for PCAT validation on HIV populations) – School of Medicine Endowed Health Services Research Center – GSPH Human Nutrition Program (Obesity Project)

Partnerships Community Organizations and Academia – Primary Health Care Association of Puerto Rico, Inc. and PCAT Project (PI: Dr. Ruth Ríos) Access to primary care centers Access to physicians and administrators Access to patients – Future dissemination of research findings – Potential improvement of primary health care centers delivery system in Puerto Rico

Concluding Remarks  Strong partnership development  Knowledge development on health services issues  Challenges  Use findings and acquired knowledge  Dissemination  Influence health policy  Change in the delivery system  PRHSRI external funding 