MODIFICATION
R -- Special Issue of Health Services Research Journal - Response to Questions
- Notice Date
- 3/7/2011
- Notice Type
- Modification/Amendment
- NAICS
- 541990
— All Other Professional, Scientific, and Technical Services
- Contracting Office
- Department of Health and Human Services, National Institutes of Health, National Library of Medicine, 6707 Democracy Blvd., Suite 105, Bethesda, Maryland, 20894, United States
- ZIP Code
- 20894
- Solicitation Number
- 11-025-SRE
- Archive Date
- 3/22/2011
- Point of Contact
- Sheila R. Edmonds, Phone: 3014966546, Sally Boakye, Phone: 301-496-6546
- E-Mail Address
-
sheila.edmonds@nih.gov, boakyes@mail.nih.gov
(sheila.edmonds@nih.gov, boakyes@mail.nih.gov)
- Small Business Set-Aside
- N/A
- Description
- Response to Vendor Inquiries AMENDMENT #1 RESPONSE TO VENDOR INQUIRIES Please see attached document. **************************************** In accordance with FAR Parts 12 and 13, the National Institutes of Health (NIH) Office of the Director (OD) Office of Behavioral and Social Sciences (OBSSR) intend to procure professional services on a sole source basis from Health Services Research Journal, a flagship publication of the Health Research and Educational Trust to publish a special issue on "Methodological Considerations for Measuring Health Care Disparities." The period of performance shall be from date of award through 9/30/2011. Objective: The Office of Behavioral and Social Sciences Research (OBSSR) furthers the mission of NIH by emphasizing the critical role that behavior and social factors play in health, health care, well-being. OBSSR serves as the focal point for coordination and development of policies, goals and objectives in the behavioral and social sciences at NIH. OBSSR is also a liaison between the NIH intramural and extramural communities, other Federal agencies, academic and scientific societies, national voluntary health agencies, the biomedical research community, the media, the general public on matters pertaining to behavioral and social sciences research. OBSSR's vision is to bring together the biomedical, behavioral, and social science communities to work more collaboratively to solve pressing health challenges facing our nation. OBSSR's plan includes facilitating: a) the next generation of basic behavioral and social sciences research: b) transdisciplinary "team science" that brings together the biomedical, behavioral, and social-ecological perspectives; c) research that integrates the systems and multiple levels of analysis; d) the translation, implementation, dissemination, and maintenance of best practices to strengthen the sciences of dissemination, put what is known into widespread practice, reduce the burden of chronic disease and help eliminate inequities in health and health care. OBSSR proposes to support and fund the development of a special issue of Health Services Research (HSR). The overall goal of the special journal issue is to focus on challenges in the measurement of racial/ethnic disparities in health care and innovative approaches for addressing these challenges to help move the field forward. Background Information: Racial and ethnic disparities persist in the United States in many areas of health care (Institute Of Medicine [IOM], 2002; Agency for Healthcare Research and Quality [AHRQ], 2009), despite numerous private and public efforts to reduce these disparities. Soon after the IOM Report Unequal Treatment (IOM, 2002) systematically documented disparities in multiple segments of the health care system, Congress mandated tracking disparities through the annual National Healthcare Disparities Report produced by the Agency for Healthcare Research and Quality, with an emphasis on trends in disparities across health care sectors. While numerous studies assess racial and ethnic disparities in health care and sessions on the topic are among the best attended at national health policy and public health conferences, there is urgency in the field to move beyond documenting disparities to identifying new strategies for reducing disparities. Advances in measurement and methodological approaches used in disparities research are needed to realize this goal. There are numerous methodological challenges related to identifying racial/ethnic disparities, tracking them over time, understanding underlying mechanisms leading to disparities, and evaluating the effects of policies to reduce disparities. While innovative techniques have been developed, widespread use and further development of cutting edge methods have been hampered by a lack of transdisciplinary collaboration and communication about emerging approaches. A special issue of HSR dedicated to challenges in the measurement of racial/ethnic disparities in health care and innovative approaches for addressing these challenges would help move the field forward. Specifically, the special issue would provide an overview of the methodological issues inherent in measuring, tracking, and identifying disparity reducing initiatives, and present considerations of and possible solutions to these complex problems of measurement with input from multiple disciplines. The set of proposed papers reflect work begun at a conference "Methodological and Conceptual Issues in the Measurement of Healthcare Disparities" convened in February 2010 by the Advanced NIMH Disparities Center of the Center for Multicultural Mental Health Research (Margarita Alegria, PI) at Cambridge Health Alliance, and the Harvard Catalyst Health Disparities Research Program (John Ayanian, Director). This conference included presentations and transdisicplinary dialogue among researchers who approach racial/ethnic disparities from multiple lenses, including sociology, health services research, economics, medicine, statistics, geography, and public health. Building on this conference, the special issue of HSR would address various measurement and methodological challenges in disparities research from diverse disciplinary perspectives as a resource for health services and disparities researchers, students, and policymakers. The overarching themes of this special issue will be to: 1) Present and discuss measurement challenges in research on mechanisms of health care disparities from diverse disciplinary perspectives; 2) Disseminate recent innovations in disparities measurement and methods; and 3) Provide guidance to health services researchers on measurement and tracking of health care disparities in diverse contexts. Purpose of the Agreement: The purpose of this agreement is to provide support for the planning and production of a Special Issue on Methodological Considerations for Measuring Health Care Disparities in the Health Services Research (HSR) journal. This agreement provides funding to support the staff time of the publisher in planning and preparation activities for the special issue. This includes staff time for planning activities to include solicitation of authors, coordination and preparation of journal layout and content, and support for ongoing planning and editorial management meetings. All activities will occur in consultation with the Editors of the special issue. All funds will be transferred directly to HSR for the stated purpose. Below is a summary of the papers proposed for this special issue: I. Measuring "Race" in Disparities Research A. Accuracy of Race/Ethnicity Data - Alan Zaslavsky, PhD (HMS), Professor of Health Care Policy, John Ayanian, MD, MPP (HMS), Professor of Medicine Research on patterns of health and health care that uses Medicare data often relies on racial/ethnic identification in Medicare enrollment files. Previous research (Arday et al., 2000) showed that racial/ethnic identification was fairly reliable for Blacks and Whites but not for other groups, but has not been updated to reflect improvements in CMS data over the last 10 years. Using a very large database (over 600,000 responses) from recent CAHPS surveys of Medicare beneficiaries, we compared self-identification (using the 1997 OMB standard) to CMS enrollment database data. We find that identification of Hispanics continues to have low sensitivity. Furthermore the Hispanics identified in CMS databases differ in age, geographical distribution, and significant characteristics of health and in health care experiences from Hispanics not so identified. Thus while the former represent a group of interest in disparities studies they cannot be considered representative of all Hispanics. Similar issues apply for Asian-Americans. B. Race, Geographical Ancestry, and Disparities in Disease Risk: Measurement Error - Alexandra Shields, PhD (MGH), Assistant Professor of Medicine As genomics research continues to advance, more information about the prevalence of genotypes that affect individual risk of developing a disease or response to treatment across "populations" is being generated. Some have argued that genetic differences across groups may account for a substantial portion of racial/ethnic disparities in disease prevalence and clinical outcomes. The measurement of "race" in health services research has been a longstanding methodological concern; the use of racial categories in genomics research is far more complex and controversial. This paper addresses problematic issues of measurement in the literature on "racial" differences in risk of disease or response to treatment based on allele frequency differences across "populations," and discusses the implications of these methodological issues for future health disparities research. II. Measuring Health Care Disparities A. Implementing the IOM Definition of Healthcare Disparities to Identify, Track, and Understand Mechanisms of Disparities: A Guide for Health Services Researchers - Benjamin Cook, PhD (CHA), Instructor in Psychiatry; Margarita Alegria, PhD (CHA, HMS), Professor of Psychology; Thomas McGuire, PhD (HMS), Professor of Health Care Economics; Alan Zaslavsky, PhD (HMS), Professor of Health Care Policy Numerous definitions and methods have been proposed and used to measure disparities. These authors propose an IOM method of disparities and there has been some uptake of the use of these methods. However, while there has been diffusion of these methods, the widespread use of IOM-concordant methods has not been realized. The authors present a guide to implementing disparities methods in two contexts: 1) implementing the IOM definition of disparities to identify and track health care disparities over time (rank and replace, propensity score, and reduced models); and 2) identifying and understanding underlying mechanisms that are driving disparities (decomposition techniques and mediation analyses). The authors present best practices for each context, and weigh the pros and cons of alternative methods. B. Rethinking Disparity Measure: Assessing the Role of Causality in Disparities Estimation - Xiao-Li Meng, PhD (HU), Whipple V. N. Jones Professor of Statistics, Harvard University; Julia Lin (CHA); Margarita Alegria, PhD (CHA), Professor of Psychology; Naihua Duan, PhD (CU & NYSPI), Professor of Biostatistics Much of the literature on measuring disparity emphasizes the need to making a fair assessment. For example, in assessing health care disparities across racial groups, adjustment is needed for existing differences in clinical needs. Whereas the rationale for such fairness considerations is clear, it is much less clear how to actually carry out an adjustment that substantiates the fairness as intended, instead of providing an apparent "equality" based on meaningless or even misleading adjustments. The very common practice of creating a counterfactual population by simply making a minority population's variables for adjustments (e.g., clinical needs) to have the same distribution as that from a reference population (e.g., White), while holding everything else unchanged, suffers exactly that problem because it effectively ignores the natural dependence between the variables to be adjusted and those not to be adjusted (e.g., nativity). Summarizing the findings in Duan, Meng, Lin, Chen, and Alegria (Statistics in Medicine, 2008, 3941-56) and more recent work, this paper demonstrates the danger of such misguided adjustments and the need to consider causal relationships among adjustable and non-adjustable variables in order to construct counterfactual populations that can substantiate the fairness as intended. C. International Comparison of Methodologies used in Disparities Research - Jason Beckfield, PhD (HU) Assistant Professor of Sociology; Sigrun Olafsdottir, PhD (BU) Assistant Professor of Sociology, Harvard University Cross-national comparative research on health disparities has been hampered by a number of methodological challenges, including a lack of comparable data on health care systems, health disparities, and socioeconomic position. This paper reviews the motivations for comparative research on health and healthcare disparities, and discusses recent advances in the measurement and modeling of social inequalities in health and healthcare across different countries. The threats to causal inference that are common in comparative research will be reviewed, and recent comparative research will be discussed, with the aim of advancing new lines of inquiry that place disparities in a comparative context. III. Approaches to Gain New Insight into the Mechanisms Leading to Health Care Disparities A. Neighborhood Context, Social Determinants - Jennifer Haas, MD, MPH (BWH), Associate Professor of Medicine, David Williams, PhD, MPH (HSPH), Florence and Laura Norman Professor of Public Health, Kellee White, PhD, MPH, Assistant Professor of Epidemiology and Biostatistics, Arnold School of Public Health, The University of South Carolina Increasingly, there is substantial interest in the documentation of the role of place in shaping the delivery of health care. Recent evidence demonstrates that the quality, accessibility, availability, and affordability of healthcare resources often reflect the geographic distribution of race/ethnicity or income in a neighborhood. However, emerging complexities in measurement and analysis have implications for understanding, interpreting, and addressing inequities. In this article, we critically evaluate the relation between health care disparities and neighborhood contextual factors. With a particular emphasis on racial/ethnic residential segregation, the authors will summarize the extant empirical research and highlight key measurement and methodological challenges. Suggestions for future research directions and the implication for policy solutions and interventions will be discussed B. Jointly Addressing Race/Ethnicity and Socioeconomic Status in Health Disparities Research: The Case of Lung Cancer - David R. Williams, PhD, MPH (HSPH), Florence and Laura Norman Professor of Public Health, K. Vish Viswanath, PhD (HSPH), Associate Professor of Society, Human Development and Health, and other researchers from the Lung Cancer Disparities Center This paper will describe a framework for understanding and addressing the joint contribution of SES and race/ethnicity to disparities along the continuum of lung cancer. It emphasizes the importance of multiple vulnerabilities and the need to examine how racial/ethnic status combines additively and interactively with SES and other social statuses to facilitate or restrict exposure and response to risk factors and resources relevant for lung cancer. We show how this approach can provide a clearer picture of the contribution of SES to disparities across the continuum of lung cancer and facilitate assessment of how much of the observed racial/ethnic disparities in lung cancer are due to SES. It will also shed light on the dynamic and interdependent processes that are operative when race and SES combine to affect patterns of risks and resources and privilege and disadvantage that can affect health risks across different social contexts. In addition, this approach can facilitate the delineation of the factors that contribute to any residual effect of race and enhance our ability to identify clear targets/avenues for effective intervention. We will show how studying race/ethnicity and SES differences together, in lung cancer and health status and heath service use more generally, can begin to facilitate the identification of the potential avenues of improving overall population health that apply to all groups, and the conditions under which race/ethnic targeted interventions are indicated. Efforts to understand and effectively address disparities in health status and improve overall population health must target both socioeconomic and racial/ethnic disparities. C. CBPR - LeRoi Hicks, MD, MPH (BWH), Assistant Professor of Medicine, Denise De Las Nueces, MD (BWH), Clinical Fellow in Medicine This paper will review all available clinical trials incorporating CBPR methodology since 2003. Its goals are to assess published descriptions of the extent of community involvement, rates of successful participant recruitment of minority populations, types of interventions assessed via CBPR and success in changing clinical or behavioral outcomes. D. Vignettes in Ethnic/Racial Health Disparities Research - Alexander Green, MD, MPH (MGH), Assistant Professor of Medicine, Sheri Lapatin (CHA), Ligia Chavez (UPR), Marta Gonzalves (CHA); John Ayanian, MD, MPP (HMS), Professor of Medicine; Margarita Alegria, PhD (CHA); This paper will address vignettes as a useful and appropriate methodology to tackle questions of healthcare disparities. It will explore the particular utility of vignette methodology, in that they easily allow alteration of specific aspects of a vignette case subject (i.e., race/ethnicity or gender) and thereby make it possible to explore difference in judgments according to these aspects by clinicians or patients. The paper will also shine a light on implicit bias as a controversial issue, and explore question of the validity of vignettes as a good predictor of individual action. E. Disparities in Mental Health Services: Results from the Collaborative Psychiatric Epidemiological Survey - Margarita Alegria, PhD (CHA), Professor of Psychology, Julia Lin (CHA); Chih-nan Chen, Research Associate, Center for Multicultural Mental Health Research; Naihua Duan, PhD (CU & NYSPI), Professor of Biostatistics, Colombia University; and Xiao-Li Meng, PhD (HU), Whipple V. N. Jones Professor of Statistics, Harvard University In this study we estimate the extent of mental health service disparities using innovative methods to adjust for differences between African Americans/ Latinos and non-Latino Whites in mental and physical health status. We also explore the role of sociostructural, contextual, and health system factors as potential mechanisms of mental health service disparities. These findings can be used to target resources, develop coherent public policies, and inform guidelines aimed at making mental health prevention and treatment services more responsive and sensitive to the needs of ethnic/racial minorities. The NLAAS, NCS-R, and NSAL samples were developed using integrated methodology as part of the NIMH Collaborative Psychiatric Epidemiology Surveys allowing us to pool the three data sets for all reported analyses. Our findings suggest that when we adjust the minorities to have the same level of mental health clinical needs as the non-Latino whites given their SES status, we see that African Americans use significantly less services than non-Latino whites (28% versus 38% respectively) and Latinos use services at a comparable rate (39%) as non-Latino whites. We proceed to evaluate how insurance, education, and geography can help explain the disparity. Our results suggest that different interventions will need to be implemented for the different minority groups to eradicate service disparities FEDERAL ACQUISITION REQULATION (FAR) CLAUSES FAR 52.212-4 Contract Terms and Conditions-Commercial Items FAR 52.212-5 Contract Terms and Conditions Required to Implement Statutes and Executive orders SOLE SOURCE JUSTIFICATION HSR is a peer-reviewed scholarly journal that provides researchers and public and private policymakers with the latest research findings, methods, and concepts related to the financing, organization, delivery, evaluation, and outcomes of health services. Rated as one of the top journals in the fields of health policy and services and health administration, HSR publishes outstanding articles reporting the findings of original investigations that expand knowledge and understanding of the wide-ranging field of health care and that will help to improve the health of individuals and communities. Published six times a year plus two special supplements, it is the flagship publication of the Health Research and Educational Trust, which has a 60-year-history of conducting research, education and demonstration projects relevant to hospitals and health care systems and the communities they serve. Additionally, it is the official journal of AcademyHealth, the professional home for health services researchers, policy analysts, and practitioners, and a leading, non-partisan resource for the best in health research and policy. As such, HSR is uniquely positioned and qualified to implement this project. Therefore, in the best interest of the government this purchase order should be awarded to Health Services Research Journal. This is not a Request for Quotation (RFQ), nor is a RFQ available; however, all responsive sources may submit a proposal in a timely manner which will be considered by NLM. Firms interested in responding to this notice must be able to provide the referenced service as specified above. Responses must be in writing and must be received electronically at the Government infrastructure by 3:00 PM EST on Monday, March 7, 2011. Proposals must include pricing information and should reference Synopsis No. NLM-11-025/SRE and should be submitted to sheila.edmonds@nih.gov. Inquiries regarding this procurement shall be submitted electronically to sheila.edmonds@nih.gov and shall be received by 11:00 AM EST on Monday, March 7, 2011.
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