Tuesday, May 13, 2025 5/13/2025

Advancing novel methods to measure and analyze multiple types of discrimination for population health research

Award Number: R01MD012793
ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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Advancing novel methods to measure and analyze multiple types of discrimination for population health research - Project Summary Our study seeks to advance methods to measure and analyze multiple types of discrimination for population health research. We will compare novel implicit vs. conventional explicit (self-report) measures of exposure, investigate different approaches to modeling exposure to multiple types of discrimination, and test novel hypotheses using causal mediation analyses. We are motivated by profound concerns that current widely- used approaches are underestimating the impact of discrimination on population health. Our population-based study directly tackles these issues, and focuses on two health outcomes linked to current and lifetime discrimination that harm quality of life and increase risk of both chronic disease and substance abuse: psychological distress and sleep disorders. We will employ a refined version of the first- ever implicit association test (IAT) for discrimination we recently developed, along with our prior validated self-report measure that is among the most widely-used measures in health research on discrimination. To ensure 350 participants per comparison group, we will recruit 1092 adult patient members and staff randomly selected from two diverse community health centers to address the following specific aims: Aim 1. Assess exposure to discrimination using implicit and explicit (self-report) measures, using the validated brief IAT format, to enable time-efficient assessment of lifetime exposure in the US to discrimination based on: race/ethnicity, gender identity, age, sexual orientation, and weight, and assess different ways to combine individuals’ exposure to multiple types of discrimination. Aim 2. Test hypotheses about the health impact of exposure to discrimination, for single and combined measures across the social comparison groups (i.e., people of color vs. white; gender minority [GM/TGNC (transgender/non-conforming)] vs. cis-gender women vs. cis-gender men vs.; older vs. younger; sexual minority [LGBQ (lesbian/gay/bisexual/queer)/SM] vs. heterosexual; obese vs. non-obese) Aim 2.1. Test the hypotheses that the implicit and explicit discrimination measures will be independently associated with psychological distress and sleep disorders (insufficient sleep; sleep disordered breathing). Aim 2.2. Using causal mediation techniques, quantify the effects for discrimination as mediator of health inequities and determine which type and combination of discrimination measures yields the largest effects. Impact: If our hypotheses are supported, results would demonstrate that predominant measures and methods underestimate the health impacts of discrimination, and that better methods would entail use of implicit and explicit measures of multiple types of discrimination and counterfactual causal mediation techniques. We expect our study, designed for high internal validity, will significantly advance methods for feasibly measuring and rigorously analyzing, in large population-based studies, exposure to multiple types of discrimination, knowledge crucial for evidence to promote health equity, a priority for US health agencies.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $0 )
2025	2023	HARVARD COLLEGE PRESIDENT & FELLOWS OF	677 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Minority Health and Health Disparities Research	000	5	11/27/2024	NON-COMPETING CONTINUATION	$0
2025	2023	HARVARD COLLEGE PRESIDENT & FELLOWS OF	677 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Minority Health and Health Disparities Research	001	5	2/28/2025	NON-COMPETING CONTINUATION	$0
2025	2023	HARVARD COLLEGE PRESIDENT & FELLOWS OF	677 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Minority Health and Health Disparities Research	002	5	3/6/2025	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2023 ( Subtotal = $648,444 )
2023	2023	HARVARD COLLEGE PRESIDENT & FELLOWS OF	677 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Minority Health and Health Disparities Research	000	5	1/22/2023	NON-COMPETING CONTINUATION	$648,444
														Subtotal = $648,444

Issue Date FY: 2022 ( Subtotal = $651,321 )
2022	2022	PRESIDENT AND FELLOWS OF HARVARD COLLEGE	677 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Minority Health and Health Disparities Research	001	4	4/5/2022	NON-COMPETING CONTINUATION	$65,132
2022	2022	PRESIDENT AND FELLOWS OF HARVARD COLLEGE	677 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Minority Health and Health Disparities Research	000	4	1/14/2022	NON-COMPETING CONTINUATION	$586,189
														Subtotal = $651,321

Issue Date FY: 2021 ( Subtotal = $643,368 )
2021	2021	PRESIDENT AND FELLOWS OF HARVARD COLLEGE	677 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Minority Health and Health Disparities Research	000	3	1/19/2021	NON-COMPETING CONTINUATION	$579,030
2021	2021	PRESIDENT AND FELLOWS OF HARVARD COLLEGE	677 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Minority Health and Health Disparities Research	001	3	3/11/2021	NON-COMPETING CONTINUATION	$64,338
														Subtotal = $643,368

Issue Date FY: 2020 ( Subtotal = $655,121 )
2020	2020	PRESIDENT AND FELLOWS OF HARVARD COLLEGE	677 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Minority Health and Health Disparities Research	000	2	3/2/2020	NON-COMPETING CONTINUATION	$655,121
														Subtotal = $655,121

Issue Date FY: 2019 ( Subtotal = $726,645 )
2019	2019	PRESIDENT AND FELLOWS OF HARVARD COLLEGE	677 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Minority Health and Health Disparities Research	000	1	6/19/2019	NEW	$726,645
														Subtotal = $726,645

Grand Total All Awards = $3,324,899

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Advancing novel methods to measure and analyze multiple types of discrimination for population health research

Award Number: R01MD012793

ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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