# Enhancing Health Literacy in Surgery (EHLIS) to Eliminate Surgical Disparities for African-Americans with Inflammatory Bowel Disease (IBD)

> **NIH NIH K23** · UNIVERSITY OF ALABAMA AT BIRMINGHAM · 2020 · $144,249

## Abstract

PROJECT SUMMARY
Rationale: In the United States, over 3.1 million people suffer from inflammatory bowel disease (IBD) which
includes Crohn’s Disease and Ulcerative Colitis. Most patients will require major surgery in their lifetime. As the
incidence of IBD rises in racial/ethnic minority populations, surgical disparities are emerging with significantly
worse outcomes for African-Americans compared to whites. Recent data has suggested a potential role of health
literacy in determining surgical outcomes (and disparities), but, to our knowledge, no literacy-based interventions
in surgery exist. This project aims to address surgical disparities through the development of a health literate
surgical care program to eliminate disparities for African-Americans with IBD. These project goals would support
the core missions of the NIHMD and Healthy People 2020 in achieving health equity for all patients.
Objectives: My long-term career objective is to become an independent researcher focused on identifying,
understanding and eliminating surgical disparities. Through this career development award, my remaining gaps
in knowledge and skills will be filled through a personalized three-year training program that will include didactics
(for an MSPH), mini-sabbaticals and mentorship by an experienced mentor team. These plans will support my
research goals: (i) to identify factors that impact health literacy in current surgical care programs and (ii) to
develop a health literate and culturally-competent surgical care program through stakeholder engagement.
Design and Methods: Our study will use a mixed-method formative research approach with significant
stakeholder engagement. Guided by the Health Literacy and Outcomes Framework, we will first use qualitative
methods (key informant interviews/focus groups) to identify gaps in current surgical care that may impact an
African-American IBD patient’s capacity to obtain, process and understand surgical information (Specific Aim
1a). We will then develop stakeholder-centered quantitative assessments to confirm the qualitative findings
(Specific Aim 1b). We will finally use an iterative multidimensional stakeholder engagement process to design a
health literate surgical care program (“Enhancing Health Literacy in Surgery” or EHLIS) (Specific Aim 2). We will
conduct this study at a high-volume, tertiary-care IBD center that serves a high-proportion of African-Americans
with IBD. The results of this study will provide the data for an R21 submission to examine EHLIS feasibility,
which, in turn, will inform a larger randomized trial (R01/PCORI).
Significance: In conjunction with my career development/training plans, this project will inform the development
of a health literate intervention focused on improving surgical outcomes and eliminating disparities in African-
American IBD patients undergoing major surgery. Lessons learned could have much broader implications in
other surgical populations as surgical disparities exist ...

## Key facts

- **NIH application ID:** 9934227
- **Project number:** 5K23MD013903-02
- **Recipient organization:** UNIVERSITY OF ALABAMA AT BIRMINGHAM
- **Principal Investigator:** Daniel I Chu
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $144,249
- **Award type:** 5
- **Project period:** 2019-08-01 → 2022-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9934227

## Citation

> US National Institutes of Health, RePORTER application 9934227, Enhancing Health Literacy in Surgery (EHLIS) to Eliminate Surgical Disparities for African-Americans with Inflammatory Bowel Disease (IBD) (5K23MD013903-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9934227. Licensed CC0.

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