Roberto E. Torres-Zeno, Ph.D. Principal Investigator Health Services Administration Department

1. 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

2. Acknowledgement • Research project supported by grant # 6 R24 HS014060-06 awarded by the Agency for Healthcare Research and Quality (AHRQ) • Project Period: 2003-2009 • AHRQ Minority Research Infrastructure Support Program (MRISP)

3. 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

4. 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

5. 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

6. 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

7. 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)

8. 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 AssessmentTool (PCAT) • Social Environment and Family Factors Associated with Childhood Obesity Among Elementary School Students in Puerto Rico

9. 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

10. 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

11. 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

12. 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.

13. 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):187-97. Epub 2008 (May 17)

14. 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

15. 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)

16. 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

17. 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 • http://www.prhsri.rcm.upr.edu