ABSTRACT Systemic Lupus Erythematosus is a significant chronic disease with morbidity and mortality in primarily young women of color. Our current P30 CCCR grant “Improving Minority Health in Rheumatic Diseases” is composed of three cores, administrative, methodology and patient resource. These cores provide the infrastructure for studies directed at understanding the pathogenesis of lupus and scleroderma as a method to achieve better diagnostics and treatments for these diseases. In this Administrative Supplement to the P30 we are proposing two specific projects focused on decreasing ethnic disparities in lupus to be performed at MUSC and the University of Alabama at Birmingham. The first project is to provide awareness, education and early screening in young African American females through programs and efforts at Historically Black Colleges and Universities in South Carolina and Alabama. The second project is to utilize a patient advocate for high risk African American female lupus patients based on missed appointments, medication non adherence and ER visits at both institutions. The advocate will work with the patients to improve these parameters believing that such navigation in lupus will be as successful as similar efforts in HIV. We also propose an enhancement effort consisting of a pilot project each year for both institutions, a mentoring program for junior investigators in health disparities and cross institutional sharing of expertise. The CCCR program does not include projects, but only cores. We propose to utilize this supplement mechanism to pursue projects we believe will have direct impact on ethnic disparities in lupus.

PROJECT NARRATIVE There are significant disparities in morbidity and mortality in lupus between African American women and Caucasian women. Our CCCR P30 is centered on addressing these disparities by providing the research infrastructure including patient samples and methodologic support. This supplement will support two direct interventions at MUSC and UAB in young African American women by awareness programs and screenings at Historically Black Colleges and Universities. A second approach is by providing a patient navigator for high risk African American patients to decrease missed appointments, enhance medication compliance and decrease emergency room visits and hospital admissions. A research enhancement program is also proposed.