to investigate ethnically appropriate interventions, including culturally competent and linguistically appropriate approaches.

Finally, while the committee found evidence of a significant portfolio of training programs designed to increase the numbers of ethnic minority investigators in cancer-related research fields, there is little evidence that NCI or NIH has undertaken a thorough assessment of training programs to determine whether these programs are producing adequate numbers of ethnic minority researchers in all appropriate cancer research fields (e.g., behavioral and social sciences, epidemiology, genetics, and cell biology), and to determine whether training programs have resulted in the increased representation of ethnic minorities in cancer research fields. Further, there is little evidence that guidelines or other training criteria have been established by NCI or NIH to ensure that all trainees receive high-quality instruction and mentoring. Such efforts would improve the planning and implementation of future training programs.

Research Priority Setting

Establishing priorities among areas of research and scientific inquiry is a complex process that has been addressed in greater detail in a prior IOM study authored by the Committee on the NIH Research Priority-Setting Process (Institute of Medicine, 1998). In general, the present committee supports the recommendations of that previous committee. In particular, the committee supports the recommendations that diversity and public representation on NIH's advisory panels should be increased. The presence of such diverse viewpoints can yield greater benefits for NIH, as well as for the public at large (e.g., greater public support for scientific programs, and greater attention to the needs of medically underserved populations).

The establishment of the NCI Director's Consumer Liaison Group represents an important step toward this goal, for which NCI should be commended. The committee finds, however, that there has been inconsistent progress in increasing the numbers of scientists, consumers, and community members from and representing ethnic minority and medically underserved communities on NCI advisory panels and committees. Such representation is a critical component of larger efforts to increase constituency input in priority setting and public accountability at NCI. Inclusion of members and representatives of ethnic minority and medically underserved groups on decision-making panels, however, is not sufficient in and of itself to ensure that the concerns of these groups are addressed within NCI. The impact of ethnic minority and medically underserved groups on the advisory and priority-setting process should be evaluated to ensure that policy changes follow from increased representation.



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