# Effects of Hospital-Community-Public Health Integration on Racial and Ethnic Disparities in Mental Health

> **NIH NIH R01** · UNIV OF MARYLAND, COLLEGE PARK · 2022 · $132,686

## Abstract

SUMMARY
The number of persons 65 years of age and older with Alzheimer’s disease and related dementias (ADRD) in
the United States is expected to reach 13.8 million by 2060. Funded by the NIMHD (R01MD011523), our
studies have identified the effectiveness of care coordination and system integration are essential to promote
population health for racialized populations. Fully functioned system-wide integration requires appropriate
health information technology (HIT) capacity. Compared to urban and suburban areas, rural areas have a
higher percent of older adults, a higher incidence of health disparities, and substantially poorer health care
infrastructure, including HIT adoption and telehealth capabilities. The COVID-19 pandemic is having a major
impact and will change the landscape of HIT use in the long run. As more investments are directed toward
developing and strengthening telehealth capacity in rural areas, it is both an opportune and critical time to
assess HIT infrastructure and system integration. Yet, evidence is lacking. Our recent preliminary findings
suggested that hospital-based HIT infrastructure that aims to improve care coordination and patient
engagement are effective to reduce rural and urban disparities among ADRD patients. Encouraged by these
findings, our team, with expertise in health care coordination HIT, aging, disparities, rural health, and ADRD
research, is committed to building this pilot project to comprehensively investigate rural and urban disparities of
access to such effective HIT infrastructures among ADRD patients, with a focus on racialized Black and Latinx
ADRD patients. Our central hypothesis is that racialized rural ADRD patients encounter substantial barriers to
access HIT infrastructures; and policy initiatives, such as Accountable Care Organizations (ACOs), can be
designed to encourage HIT investment in rural areas and improve access to HIT for this vulnerable population.
Specifically, we will investigate the access to hospital-based HIT functions among the racialized rural aging
population with ADRD and risk factors of ADRD (Aim 1), and examine the extent to which that ongoing policy
initiatives, such as ACO models, can improve hospital HIT adoption in underserved rural areas to reduce urban
and rural and racial and ethnic disparities. Results of our study are expected to (1) identify barriers to access
HIT infrastructure among racialized rural populations with ADRD and ADRD risk factors, and (2) provide
evidence for ACO design that can encourage HIT adoption to promote treatment effectiveness and continuity
and patient engagement for the ADRD population, and engage health care providers in promoting population
health among people who have risk factors for ADRD. The COVID-19 crisis has underscored the critical role of
HIT and strengthening HIT and public health systems in rural areas has become even more critical. Our study
will provide timely evidence pertinent to system design.

## Key facts

- **NIH application ID:** 10498912
- **Project number:** 3R01MD011523-05S1
- **Recipient organization:** UNIV OF MARYLAND, COLLEGE PARK
- **Principal Investigator:** Jie Chen
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $132,686
- **Award type:** 3
- **Project period:** 2017-07-12 → 2024-02-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10498912

## Citation

> US National Institutes of Health, RePORTER application 10498912, Effects of Hospital-Community-Public Health Integration on Racial and Ethnic Disparities in Mental Health (3R01MD011523-05S1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10498912. Licensed CC0.

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