Proceedings Report of the Binational Border Health Research Work Group and Expert Panel Meeting

2010 Proceedings Report of the Binational Border Health Research Work Group and Expert Panel Meeting July 21, 2010 El Paso, Texas Providing international leadership to optimize health and quality of life along the United States- México Border

Table of Contents Binational Border Health Research Work Group and Expert Panel Meeting... 2 Welcome... 2 Presentation of draft white papers... 2 Discussion of the draft IRB Report... 4 Discussion of the draft Healthy Border 2010/2020 Strategic Plan... 4 Discussion of the BHC-Centers of Excellence Consortium Alignment... 4 Discussion on plans for the Border Health Research Forum III... 5 Next Steps and Adjournment... 5 ATTACHMENT 1... 6 ATTACHMENT 2... 10 ATTACHMENT 3... 11 1

United States México Border Health Commission Binational Border Health Research Work Group and Expert Panel Meeting July 21, 2010 El Paso, Texas The United States-México Border Health Commission (BHC) convened a meeting of the Border Health Research (BHR) Work Group and Expert Panel on Wednesday, July 21, 2010, in Salons 1 & 2 of the Doubletree Hotel in El Paso, Texas. Welcome Dr. J. Manuel de la Rosa, Co-Chair of the BHR Work Group, BHC-U.S. Section, called the meeting to order on July 21, 2010. He welcomed the attendees and then introduced Dr. Dora Elia Cortés, Co-Chair of the BHR Work Group, BHC-México Section, who provided introductory remarks. Dr. Cortés opened the floor for introductions. The list of participants is appended as Attachment 1. Dr. de la Rosa reviewed the agenda and contents of the binder provided to the BHR Work Group and Expert Panel members. He provided remarks on the purpose and goals of the meeting and emphasized identifying gaps, focusing efforts on specific research topics and areas, and identifying processes (what should be researched and how should it be researched). Ms. Marjorie Petty, Regional Director, Department of Health and Human Services (HHS) Region VI, shared remarks from HHS Secretary Kathleen Sebelius, especially the work the BHC is conducting on obesity. Dr. Craig Shapiro, Director, Office of Latin America/Caribbean, Office of Global Health Affairs, HHS, provided comments on the overall work of the BHC. I. Border Health Research Forum 2009 Presentation of draft white papers Mr. Robert Guerrero, Chief, Office of Border Health, Arizona Department of Health Services, provided a brief history and the outcomes of the first Binational Border Health Research Forum in 2006 as well as actions taken between 2007 and 2009. He then reviewed the planning and abstract submission processes and the research papers that were selected for presentation at the Second BHR Forum in 2009. Mr. Mauricio Leiva, Chief, California Office of Binational Border Health, California Department of Public Health, provided an overview of the gaps in border health research that were identified and discussed at the 2009 Forum. The gaps included 1) comparative effectiveness research of community health worker programs, 2) childhood obesity and diabetes, 3) mental health and shortage of mental health workforce on the border, 4) injury prevention, particularly motor vehicle accidents and differences between states, and 5) research on cross-border use of healthcare, types of services being used and the health conditions of the individual. Mr. Leiva reviewed suggestions from forum participants for decision makers and researchers. This includes the need for true binational collaboration, translating research into policy change, and applying research to the community. 2

Other feedback from participants included 1) being binational in terms of resources, information, measurements, and prioritization, 2) initially focusing on a small number of health issues, 3) incorporating gaps, 4) mitigating barriers to binational collaboration such as institutional review board (IRB) requirements, and 5) representing qualitative and observational data in addition to quantitative data. Mr. Leiva stated a white paper has been drafted that includes the outcomes from the 2009 Forum. Dr. de la Rosa stated the draft white paper was included in the binder and feedback was welcome. He then opened the floor for questions and comments. There was discussion on several topics and three themes emerged that participants agreed should be included in the review of a border health research agenda: environmental health, impact of the political environment, and the impact of road safety. Dr. de la Rosa stated a need exists to identify how to investigate these issues as true scientists and how others can provide resources. II. Child & Adolescent Health Forum 2009 Mr. Paul Dulin, Director, Office of Border Health, New Mexico Department of Health, provided an overview of the U.S.-Mexico Border Child and Adolescent Health Forum in 2009 and the draft white paper that presents the results of the three work groups from the forum. Mr. Dulin reviewed the results of each work group, which are listed below. Best Practices (problems identified) Lack of integrated mental and behavioral health services Lack of well-trained, culturally and linguistically competent providers affecting both sides of the border Lack of available child care for single working parents Need to promote sexual health and healthy relationships Access to care for migratory population in both countries Obesity and diabetes recognized as a cross-cutting problem Suggested Research Themes Obesity and related health conditions Healthy weight for women of reproductive age and healthy weight gain of pregnant women Maternal and infant mortality The effects of border violence on children and adolescents Need for effective research applicable to resolve child and adolescent health problems Policy Priorities Create safe and healthy communities Promote universal health care Discourage cesarean sections and promote breastfeeding Promote more comprehensive and integrated health care across disciplines Treat border region as a singular epidemiological region Develop a binational information system Fully use the Commission in policy development Develop policies that address root causes and impact determinants of health Promote policies that incorporate the use of community health workers Incorporate the private sector (including maquiladoras) in policy discussion Following Mr. Dulin s presentation, discussion followed on funding for medical schools on both sides of the border. Models that can serve as potential sources for opportunities on this issue are 3

the BHC alignment with the U.S.-Mexico Border Centers of Excellence (COE) Consortium and the University of Arizona partnership with the Colegio de Sonora. Discussion of the draft IRB Report One of the action items from the 2009 BHR Work Group and Expert Panel meeting was to convene a sub-committee and further investigate institutional review board (IRB) issues. The result of these efforts was a study conducted by Dr. Maria Hilda García-Pérez, Assistant Professor, Department of Transborder Chicana/o and Latina/o Studies, College of Liberal Arts and Sciences, Arizona State University. Dr. García-Pérez provided a background on IRBs in the United States and México and then presented the study she conducted to examine the framework and operation of IRBs in both countries. The results of the study include recommendations for joint IRBs in each country and suggested actions for the BHC. The draft report was included in the binders for the Work Group and Expert Panel. Discussion followed on how IRB processes differ in México and the United States, especially that in many research institutions in México, IRBs do not exist. Dr. Gudelia Rangel, BHR Expert Panel Member, stated the results of the study will allow the BHC and other agencies to document the procedures that researchers need to take in order to conduct studies in México or the U.S. Dr. Luz Sanin, BHR Expert Panel Member, suggested the BHC communicate with research department directors at public universities about the IRB processes in both countries. It was noted a similar recommendation was included in the draft report. There was also discussion on how the BHC can serve as a communications portal for disseminating information on IRBs in both countries. Suggestions included that the BHC host forums on IRB issues and prepare documents on IRB procedures in each country and make them available to researchers in both countries. Discussion of the draft Healthy Border 2010/2020 Strategic Plan Dr. Gudelia Rangel and Dr. Cecilia Rosales, BHR Expert Panel Members, provided a brief background on Healthy Border (HB) 2010 and then presented the plans for the closeout of HB 2010 and the rollout of HB 2020. They stated the draft strategic framework was included in the binder. Discussion followed on the level of data (county, state) available in both countries, when data is made available, including social determinants of health in HB 2020, and who should be involved in developing HB 2020. Discussion of the BHC-Centers of Excellence Consortium Alignment Dr. Vidal Balderas, Clinical Assistant Professor, Department of Community Dentistry, University of Texas Health Science Center-San Antonio, stated the next steps for the COE are to be a collaborative co-leader for binational research including for the development of HB 2020. Dr. Juanita Lozano-Pineda, Clinical Assistant Professor, Department of Community Dentistry, University of Texas Health Science Center-San Antonio, provided a background of the U.S.- Mexico Border Centers of Excellence (COE) Consortium and their actions to date. Dr. Lisa Cacari Stone, Assistant Professor and Senior Fellow, Robert Wood Johnson Foundation Center for Health Policy at the University of New Mexico Health Sciences Center, stated there is a consensus among COE members to move beyond just identifying best practices and begin building a system of best practices and translating research into practice. There is also consensus among members to partner with the BHC to work on these issues. 4

Discussion on plans for the Border Health Research Forum III Dr. Cortés opened the floor for suggestions on dates and locations for the next Border Health Research Forum in 2011. She stated that during the BHR Work Group and Expert Panel meeting in 2009, there was a suggestion to hold it in México. Dr. Rangel suggested partnering with El Colegio de la Frontera Norte and holding it in Tijuana. She stated July is not a good month due to many people in México vacationing. Dr. de la Rosa suggested early June but will have to consider other obligations that agencies may have. Next Steps and Adjournment Dr. de la Rosa briefly reviewed the themes that emerged from the meeting including focusing the group on specific areas of research and setting priorities. He stated this will be the focus of the next BHR Forum in June 2011. Comments and feedback on any of the draft white papers and reports discussed during the meeting can be emailed to the BHC at bhc@borderhealth.org or to Lori Navarrete, Binational Operations Coordinator, at Lorraine.navarrete@hhs.gov. Dr. de la Rosa extended an invitation to all participants to attend the Border Health Forum immediately following the meeting at the Texas Tech Paul L. Foster School of Medicine. The BHR Work Group Co-Chairs and Mr. Dan Reyna, General Manager, BHC-U.S. Section, presented BHC commemorative coins to the BHR Work Group and Expert Panel members and other partners in attendance. Dr. de la Rosa adjourned the meeting. 5

ATTACHMENT 1 List of Participants Border Health Research Work Group Members Co-Chairs / Co-Presidentes J. Manuel de la Rosa Founding Dean Texas Tech University Health Science Center Paul L. Foster School of Medicine 5001 El Paso Dr. El Paso, TX 79905 Tel. (915) 783-5517 Fax (915) 783-5533 jmanuel.delarosa@ttuhsc.edu Dora Elia Cortés Hernández Coordinadora de la Unidad de Investigación en Salud Pública del CIDS Universidad Autónoma de Nuevo León Av. Dr. Carlos Canseco s/n y Av. Gonzalitos s/n Colonia Nitras Centro C.P. 64460 Monterrey, N.L. Tel./Fax (01152-81) 1340-4370 Directo Conmutador UANL (01152-81) 8329-4000 Ext. 1700 Tel./Fax (01151-81) 8329-1737, 1753 doraeliadech@yahoo.com brigadas@mail.uanl.mx dora.cortesh@uanl.mx Cecilia Rosales Associate Professor University of Arizona Mel & Enid Zuckerman College of Public Health Drachman Hall, Suite 219 1295 Martin Avenue Tucson, AZ 85724 Tel. (520) 626-0720 Fax (520) 626-8009 crosales@email.arizona.edu Members / Miembros Lawrence Kline Senior Consultant Division of Chest & Critical Care Medical Director, Scripps Clinic Sleep Center Associate Adjunct Professor, Dept. Molecular & Experimental Medicine, TSRI 10666 North Torrey Pines Road La Jolla, CA 92037 Tel. (858) 554-8845 Fax (858) 554-8492 Lkdoc@aol.com lkline@scripps.com Jaime León Varela Encargado del Despacho de la Dirección General de Coordinación Sectorial Secretaría de Salud Pública Blvd. Río Sonora Sur @ 159, Local 5 Esquina con California Proyecto Río Sonora C.P. 83280 Hermosillo, Son. Tel. (01152-662) 217-4132 Fax (01152-662) 217-4136 jleonv@salud.gob.mx Members Not Present / Miembros No Presentes Octavio Rodrigo Martínez Pérez Secretario de Salud del Estado de Chihuahua Calle Tercera No. 604, 3er. Piso Colonia Centro C.P. 31000 Chihuahua, Chih. Tel. (01152-614) 439-9900 Ext. 21530, 21501 Fax (01152-614) 410-3622 ocmartinez@chihuahua.gob.mx Ex-Officio Members / Miembros Ex-Officio María Teresa Zorrilla Secretaria Ejecutiva Sección de México-CSFMEU Avenida Durango # 247, 4o. Piso Col. Roma Norte, Deleg. Cuauhtémoc C.P. 06700 México, D.F. Tel. (01152-55) 3611-0765 al 68 Fax (01152-55) 5545-7776 doctorazorrilla@yahoo.com Maria Gudelia Rangel Gómez Coordinadora Estatal de Baja California e Investigadora del Departamento de Estudios de Población del Colegio de la Frontera Norte Hospital General de Tijuana Paseo del Centenario #10851, Zona Rio C.P. 22320 Tijuana, B.C. Tel. (01152-664) 634-6511 Fax (01152-664) 634-6551 grangel2009@gmail.com grangel@colef.mx 6

Ex-Officio Members Not Present / Miembros Ex-Oficio No Presentes Sam Howarth (Delegate for Alfredo Vigil) Director Office of Policy & Multilateral Health New Mexico Department of Health 1190 St. Francis Drive, S4205 Santa Fe, NM 87502-6110 Tel. (505) 827-1052 Fax (505) 827-2942 sam.howarth@state.nm.us Diana L. Coronel Martínez Directora del Programa de Atención a la Salud de la Infancia y la Adolescencia Secretaría de Salud Francisco de P Miranda 167, 1er piso México, D.F. Tel. (01152-55) 5593-1122 Ext. 266 Tel. (01152-55) 5680-1208 Ext. 275 dianacoronel75@yahoo.com.mx César M. Gómez Altamirano Director de Programa Vacunación Universal, CENSIA Francisco de P. Miranda No.177-1 Piso, Col. Merced Gómez, Deleg. Álvaro Obregón, C.P. 01600 México, D.F. Tel. (01152-55) 5680-1208 Ext. 251 etav@salud.gob.mx cmisael@yahoo.com.mx Border Health Research Expert Panel Members Expert Panel Members Present / Miembros del Panel de Expertos No Presentes John Elder Director San Diego Prevention Research Ctr. San Diego State University 9245 Sky Park Ct., Ste. 221 San Diego, CA 92123 Tel. (619) 594-2997 Fax: (619) 594-2998 jelder@mail.sdsu.edu Roberto Osegueda Vice President for Research Office of Research & Sponsored Projects University of Texas- El Paso 500 West University Ave. Admin. Bldg. Room 209 El Paso, TX 79968 Tel. (915) 747-5680 Ext. 5680 Fax (915) 747-6474 osegueda@utep.edu Maria Gudelia Rangel Gómez Coordinadora Estatal de Baja California e Investigadora del Departamento de Estudios de Población del Colegio de la Frontera Norte Hospital General de Tijuana Paseo del Centenario #10851, Zona Rio C.P. 22320 Tijuana, B.C. Tel. (01152-664) 634-6511 Fax (01152-664) 634-6551 grangel2009@gmail.com grangel@colef.mx Luz Helena Sanin Profesora Investigadora Facultad de Enfermería y Nutrición Universidad Autónoma de Chihuahua Ave. Politécnico Nacional 2714 Col. Quintas del Sol Chihuahua, Chih. 31250 Tel. (01152-614) 430-0075 y 455-9406 luzhcanada@yahoo.com Jeff Brandon Professor College of Health & Social Services New Mexico State University MSC 3446 P.O. Box 30001 Las Cruces, NM 88003-8001 Tel. (575) 646-3526 jbrandon@nmsu.edu David Warner Professor of Public Affairs LBJ School of Public Affairs University of Texas-Austin P.O. Box Y Austin, TX 78713-8925 Tel. (512) 471-6277 David.warner@mail.utexas.edu Pedro César Martínez Editor en Jefe Revista Salud Pública Facultad de Salud Pública y Nutrición Universidad Autónoma de Nuevo León Ave. Dr. Eduardo Aguirre Pequeño y Yuriria Col. Mitras Centro Monterrey, N.L. Tel. (01152-81) 1340-4890 Tel. (01152-81) 1555-3422 pcantu@faspyn.uanl.mx Vidal Balderas Clinical Assistant Professor and Director of Mobile Van Program University of Texas Health Science Center-San Antonio 7703 Floyd Curl Dr., MSC 7917 San Antonio, TX 78229 Tel. (210) 567-3209 balderas@uthscsa.edu 7

Expert Panel Ex-Officio Members Present / Miembros Ex-Oficio del Panel de Expertos No Presentes Frank Cantu Field Director Office of Rural Health Policy Border Health Division Health Resources & Services Administration, HHS 1301 Young Street, #1014 Dallas, TX 75202 Tel. (214) 767-3171 Fax (214) 767-0404 Fcantu@hrsa.gov Maria Teresa Cerqueira Chief U.S.-Mexico Border Field Office Pan American Health Organization 5400 Suncrest Dr., Ste. C-4 El Paso, TX 79912 Tel. (915) 845-5950 Ext. 2512 cerqueim@fep.paho.org U.S.-México Border Health Commission Staff U.S. Section Craig Shapiro Director Office of Latin American/Caribbean, Office of Global Health Affairs, HHS 330 C Street, SW, Switzer Building, Rm 2308 Washington, D.C. 20201 Tel. (202) 260-1733 Craig.shapiro@hhs.gov Dan Reyna General Manager HHS/OGHA 211 N. Florence, Suite 101 El Paso, TX 79901 Tel. (915) 532-1006 Fax (915) 532-1697 dan.reyna@hhs.gov Emma Torres Executive Director Campesinos Sin Fronteras 725 E. Main Street, Ste. 11 Somerton, AZ 85350 Tel. (928) 627-6677 Ecarni1@aol.com Lori Navarrete Binational Operations Coordinator USMBHC/MSA, Inc. (CTR) 211 N. Florence, Suite 101 El Paso, TX 79901 Tel. (915) 532-1006 Fax (915) 532-1697 Lorraine.navarrete@hhs.gov México Section María Teresa Zorrilla Secretaria Ejecutiva Sección de México-CSFMEU Avenida Durango # 247, 4o. Piso Col. Roma Norte, Deleg. Cuauhtémoc C.P. 06700 México, D.F. Tel. (01152-55) 3611-0765 al 68 Fax (01152-55) 5545-7776 doctorazorrilla@yahoo.com 8

Guests and Other Invitees Guest Presenters / Ponentes Invitados Paul Dulin Director Office of Border Health New Mexico Department of Health 1170 N. Solano, Suite L Las Cruces, NM 88001 Tel. (575) 528-5154 Fax (575) 528-6045 paul.dulin@state.nm.us Maria Hilda García-Pérez Assistant Professor Department of Transborder Chicana/o and Latina/o Studies, College of Liberal Arts and Sciences, Arizona State University Lattie F. Coor Hall 975 S. Myrtle Ave., Rm. 6638 Tel. (480)730-1972 Hilda.Garcia@asu.edu Juanita Lozano-Pineda Clinical Assistant Professor and Director of Predoctoral Dental Outreach Programs University of Texas Health Science Center-San Antonio MC 7917, 7703 Floyd Curl Dr. San Antonio, TX 78229 Tel. (210)567-3196 pinedaj@uthscsa.edu Robert Guerrero Chief Office of Border Health Arizona Department of Health Services 4400 E. Broadway Blvd., Ste. 300 Tucson, AZ 85711 Tel/ (520)770-3110 guerrero@azdhs.gov Mauricio Leiva Chief California Office of Binational Border Health California Department of Public Health 1615 Capitol Ave. Suite 73.720 P.O. Box 997377, MS 0500 Sacramento, CA 95899-7377 Tel. (916) 327-7744 Fax (916) 558-1762 Tel. San Diego Office (619) 688-0159 mauricio.leiva@cdph.ca.gov 9

ATTACHMENT 2 Acronyms Used in Meeting Minutes BHC U.S.-México Border Health Commission BHR Border Health Research COE Centers of Excellence HB Healthy Border 2010/2020 HHS U.S. Department of Health and Human Services IRB Institutional Review Board 10

ATTACHMENT 3 Meeting Agenda United States México Border Health Commission Binational Border Health Research Work Group Meeting Doubletree Hotel El Paso Downtown Salons 1 & 2 El Paso, TX Wednesday, July 21, 2010 8:00 A.M. 12:00 P.M. M.D.T. AGENDA 7:00 am Breakfast 8:00 8:15 am Welcome J. Manuel de la Rosa and Dora Elia Cortés 8:15 8:30 am Overview of Border Health Research Activities Drs. De la Rosa and Cortés 8:30 9:00 am Presentation of draft white papers Border Health Research Forum: Mauricio Leiva, Chief, California Office of Binational Border Health and Robert Guerrero, Chief, Arizona Office of Border Health Child & Adolescent Health Forum: Paul Dulin, Director, New Mexico Office of Border Health 9:00 10:00 am Discussion of the draft IRB Report Hilda García-Pérez, Assistant Professor, Department of Transborder Chicana/o and Latina/o Studies, College of Liberal Arts and Sciences, Arizona State University 11

10:00 10:15 am BREAK 10:15 10:45 am Discussion of the draft Healthy Border 2010/2020 Strategic Plan Cecilia Rosales, BHC Member-Arizona and Gudelia Rangel, Coordinator, Baja California Outreach Office 10:45 11:15 am Discussion of BHC-Centers of Excellence Consortium Alignment Vidal Balderas, Clinical Assistant Professor, Department of Community Dentistry, University of Texas Health Science Center-San Antonio and Juanita Lozano-Pineda, Clinical Assistant Professor, Department of Community Dentistry, University of Texas Health Science Center-San Antonio 11:15-11:45am Discussion on plans for the Border Health Research Forum III Drs. De la Rosa and Cortés 11:45 12:00 pm Next Steps and Adjournment 12:15 pm Lunch hosted by the Hispanic Centers of Excellence Consortium Border Health Research Work Group U.S. Co-Chair México Co-Chair J. Manuel de la Rosa Dora Elia Cortés Hernández Members Cecilia Rosales Jaime León Varela Lawrence Kline Octavio R. Martínez Pérez Ex-Officio Members Sam Howarth / Alfredo Vigil María Teresa Zorrilla Carcaño Gudelia Rangel Gómez César M. Gómez Altamirano Diana L. Coronel Martínez 12

Expert Panel U.S. Panel Members John Elder Jill de Zapien Jeff Brandon Hector Balcazar David Warner Roberto Osegueda Vidal Balderas Barbara Gray Frank Cantu Elena Rios Maria T. Cerqueira Patrick Kelley México Panel Members Gudelia Rangel Gómez Catalina Denman Luz E. Sanin Pedro C. Cantú Martínez Rocio M. Uresti Marin Luis A. Carrillo González Gerardo Flores Ex-Officio Members Nelly Salgado Miguel A. González Carlos Magis Rodríguez Vision Contribute to the development of a comprehensive border health research agenda for the United States México border. Meeting Objectives: 1. Conduct meeting of the BHC s Border Health Research Work Group and Expert Panel. 2. Present and discuss the border health research papers. 3. Discuss the draft IRB report. 4. Discuss the Healthy Border 2010/2020 Strategic Plan. 5. Discuss plans for the Third Border Health Research Forum (BHRF III). 13