addressing the disproportionate burden of cancer incidence and mortality among minority and medically underserved populations. The committee finds, however, that no "blueprint" or strategic plan exists to direct or coordinate this research activity (see discussion of priority setting in Chapter 4). As a result, model programs in one or more institutes are not replicated by other ICDs where indicated, some areas of research emphasis receive greater attention than others, and overall funding to address the needs of minority and medically underserved populations is inadequate. Several recommendations are therefore indicated:

Recommendation 3-1: The Office of Research on Minority Health should more actively serve a coordinating, planning, and facilitative function regarding research relevant to cancer among ethnic minority and medically underserved populations across relevant institutes and centers of NIH. To further this goal, the Office of Research on Minority Health should:

  • make criteria for Minority Health Initiative project support explicit;
  • coordinate with other specialty offices (e.g., the Office of Research on Women's Health) by participating in NIH-wide coordination efforts such as the Research Enhancement Awards Program; and
  • ensure that Minority Health Initiative funding does not supplant funding from institutes and centers for research and programs relevant to ethnic minority and medically underserved populations.

Recommendation 3-2: Research and research funding relevant to cancer among ethnic minority and medically underserved populations should be more adequately assessed (as per Recommendation 3-3) and should be increased.

Recommendation 3-3: NIH should improve the accuracy of its assessment of research that is relevant to ethnic minority and medically underserved groups by replacing the current "percent relevancy" accounting method with one that identifies studies whose purpose is to address a priori research questions uniquely affecting ethnic minority and medically underserved groups.

Although the committee found evidence that NCI sponsors significant behavioral and social science research aimed at examining the range of behavioral, psychosocial, dietary, and other factors that enhance the risk for cancer or poor cancer outcomes among ethnic minority and medically



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