Sara Wilcox - US grants

[unreadable] DESCRIPTION (provided by applicant): Building on a 3-yr partnership, the Palmetto Conference of the AME Church and three state Universities in South Carolina will partner for this study. The specific study aims are to: (1) use a community-based participatory research (CBPR) approach to engage church leaders in developing a combined physical activity (PA) and nutrition intervention, (2) test the 18-mo intervention that targets social, cultural, and policy influences within the church, (3) assess the role of pastor support of and participation in the intervention, and (4) disseminate the program across the state and more broadly. A CBPR approach will guide all study activities. Representatives from each partnering organization will participate in monthly planning meetings in year 1. The logic model will be used to build consensus about the scope of the program, process evaluation, and project management. Two waves of interventions will be conducted, beginning in year 2. In total, 13 clusters of churches (60 churches within them) will be randomized to an immediate or delayed intervention. The 18-month intervention, based on social ecology and the trans-theoretical model, will target the social, cultural, and policy environments within the church to support increased PA and the DASH diet (low fat and sodium, high F&Vs and grains). Local health committees and key church decision makers (pastors and church cooks) will be trained to implement the program. Primary outcomes, measured at baseline and 18- months, are blood pressure (SBP, DBP), PA (self-reported mins/wk); and F&V consumption (svgs/d). Secondary outcomes are PA (accelerometer mins/wk), fat and fiber-related behaviors, and stage of change. A total of 15 participants from 18 small churches, 25 participants from 30 medium churches, and 50 participants from 12 large churches will be recruited for measurements (N = 1620). Accelerometer readings will be collected from a sub-sample (N = 620), and a comprehensive process evaluation will be conducted. Faith-university partnerships provide a way to deliver health promotion messages in a culturally and ethnically relevant manner. Interventions that result from these partnerships have great potential to contribute to eliminating health disparities, a Healthy People 2010 objective. The inclusion of PA, use of a CBPR approach, engagement of church decision makers, and focus on the church's social, cultural, and policy influences make this project innovative. [unreadable] [unreadable] [unreadable]

[unreadable] DESCRIPTION (provided by applicant): Building on a 3-yr partnership, the Palmetto Conference of the AME Church and three state Universities in South Carolina will partner for this study. The specific study aims are to: (1) use a community-based participatory research (CBPR) approach to engage church leaders in developing a combined physical activity (PA) and nutrition intervention, (2) test the 18-mo intervention that targets social, cultural, and policy influences within the church, (3) assess the role of pastor support of and participation in the intervention, and (4) disseminate the program across the state and more broadly. A CBPR approach will guide all study activities. Representatives from each partnering organization will participate in monthly planning meetings in year 1. The logic model will be used to build consensus about the scope of the program, process evaluation, and project management. Two waves of interventions will be conducted, beginning in year 2. In total, 13 clusters of churches (60 churches within them) will be randomized to an immediate or delayed intervention. The 18-month intervention, based on social ecology and the trans-theoretical model, will target the social, cultural, and policy environments within the church to support increased PA and the DASH diet (low fat and sodium, high F&Vs and grains). Local health committees and key church decision makers (pastors and church cooks) will be trained to implement the program. Primary outcomes, measured at baseline and 18- months, are blood pressure (SBP, DBP), PA (self-reported mins/wk); and F&V consumption (svgs/d). Secondary outcomes are PA (accelerometer mins/wk), fat and fiber-related behaviors, and stage of change. A total of 15 participants from 18 small churches, 25 participants from 30 medium churches, and 50 participants from 12 large churches will be recruited for measurements (N = 1620). Accelerometer readings will be collected from a sub-sample (N = 620), and a comprehensive process evaluation will be conducted. Faith-university partnerships provide a way to deliver health promotion messages in a culturally and ethnically relevant manner. Interventions that result from these partnerships have great potential to contribute to eliminating health disparities, a Healthy People 2010 objective. The inclusion of PA, use of a CBPR approach, engagement of church decision makers, and focus on the church's social, cultural, and policy influences make this project innovative. [unreadable] [unreadable] [unreadable]

DESCRIPTION (provided by applicant): Since 1993, the vision of the University of South Carolina Prevention Research Center (USC PRC) has been Physically Active People in Active Community Environments. Crafted jointly with its community committee, Sumter County Active Lifestyles (SCAL), the specific aims of the USC PRC for 2009-2014 are: 1. Conduct a core community-based participatory research (CBPR) project. The overall goal of the USC PRC core CBPR project is to determine the effectiveness of a 12-month multi-level intervention on walking behavior and health-related outcomes in a cohort of 250-325 adults living in five underserved communities consisting of a high proportion of African-Americans and families below the poverty level. The project will explore the impact of the intervention on social norms, capital, cohesion, and support for PA in these areas. 2. Engage the community and key partners in USC PRC efforts. The USC PRC engages individuals in SCAL coalition as the community committee. SCAL, comprised of over 30 persons representing diverse community interests, will continue to engage members of underserved Sumter County communities in core research and capacity-building activities, and continue as the lead organization for the partnership, as they have done since 1998. 3. Maintain an integrated set of strategies, including electronic channels, to disseminate research findings to diverse audiences, including researchers, public health practitioners, and community partners. 4.The USC PRC will work with SCAL and an external advisory board to develop, implement, and replicate a Community Advocacy and Leadership Program (CALP) to develop skills of grass-roots leaders in underserved communities in Sumter County and elsewhere in SC. Through a series of 8 workshops and year-long technical assistance, the CALP will support local groups in their efforts to effectively advocate for positive changes in their communities in support of physical activity and health. Peer Mentors will be trained to provide technical assistance, thereby increasing the likelihood of being able to disseminate the program. 5. Evaluate center activities. The USC PRC will use designated resources to assess the CALP and other center activities, and collect data related to the National PRC Performance Indicators. RELEVANCE (See instructions): With a focus on low income, predominantly racial/ethnic minority underserved communities, the center-level and core research endeavors will greatly assist with reducing individual and social disparities in PA behavior and overall health, and will provide a firm foundation of evidence and experience to support the researchers'and community's ability to secure additional funding and expand the impact on eliminating health disparities.

DESCRIPTION (provided by applicant): Nearly three-quarters of African American women and half of non-Hispanic White women of childbearing ages in the US are overweight or obese. About one-half (46%) of pregnant women exceed gestational weight gain recommendations. This problem is significant because excessive gestational weight gain is a strong risk factor for new or persistent obesity in women and increases a woman's risk for maternal complications. Furthermore, accumulating observational studies show that higher maternal gestational weight gain is associated with higher offspring birth weight, which persists in childhood, adolescence, and young adulthood. Novel intervention approaches have the potential to help overweight/obese financially disadvantaged women achieve healthy weight control during and after pregnancy and improve the health of their offspring. Our experienced multidisciplinary team will build on our promising R21 feasibility study to address the following specific aims: (1) examine the impact of a lifestyle intervention on gestational weight gain and postpartum weight loss in overweight and obese women, (2) examine the impact of the intervention on physical activity (PA), dietary intake, and quality of life (QOL), (3) examine race differences in total gestational weight gain, PA, dietary intake, and QOL; and (4) examine the impact of the intervention on offspring adiposity. Pregnant women (N=500) women, half African American and half White, will be recruited from seven obstetric clinics in Columbia, South Carolina and randomized to a lifestyle intervention (n=250) or standard care (n=250). The lifestyle intervention, grounded in Social Cognitive Theory, will target regular body weight self-monitoring and increasing PA and healthy dietary practices in pregnancy and postpartum. The lifestyle program will start within 15 weeks gestation and will continue through 6 months postpartum. In pregnancy, the intervention will consist of an individual session followed by 12 group-based sessions augmented with 12 podcasts, telephone follow-up, and social media support. In postpartum, the intervention will consist of an individual session (at 6 weeks) followed by 16 podcasts, telephone calls, and social media support until 6 months postpartum. All women will be assessed early in pregnancy (d15 weeks), at 32 weeks gestation, and at 6- and 12-mos postpartum, and offspring will be assessed at 6- and 12-mos. The study is innovative because it incorporates critical components that are missing in the larger literature. Namely, it is theoretically grounded, fully targets PA in addition to healthy eating, objectively measures PA, spans pregnancy to postpartum, includes racially and socioeconomically disadvantaged women who are overweight or obese, is powered to assess race differences in intervention effectiveness, considers the intergenerational linkage on childhood obesity, and integrates state-of-the-art behavioral strategies and approaches combined with innovative intervention channels (i.e., podcasts and social media support), all tailored to a unique population of women from a southeastern state with poor maternal and child health indicators.

DESCRIPTION (provided by applicant): Together, physical inactivity and poor diet make up the second leading modifiable cause of death in the US. Racial disparities in these behaviors and associated health outcomes present major public health challenges. The specific aims of the USC PRC for 2014-2019 build on a long and successful history of applied research and practice in underserved communities: 1) grow the Center infrastructure; 2) engage communities, state and local health departments, and other stakeholders to inform our activities; 3) implement an integrated set of strategies to disseminate Center research findings, products, and programs; 4) contribute to the development of skilled community members and public health professionals through training and technical assistance; 5) evaluate Center activities and outcomes; and 6) conduct an applied public health prevention research project. Achievement of these aims will lead to the following long-term outcomes: 1) increased translation of research into practice and policy; 2) improved environmental and system-wide strategies; 3) widespread use of evidence-based programs and policies; 4) enhanced community capacity for health promotion and disease prevention; 5) increased skilled public health professionals and community members; 6) expanded resources for applied public health research; and 7) increased recognition of and support for USC PRC research and activities. The USC PRC's applied research project will study the dissemination and implementation of an evidence-based program shown previously to significantly increase physical activity and fruit and vegetable intake in churches in South Carolina (Faith, Activity, and Nutrition; FAN). Guided by two theoretical frameworks, the specific aims of the applied research project are to: 1) examine the adoption and reach of FAN in churches and organizational factors associated with adoption; 2) characterize implementation fidelity and multilevel factors associated with implementation; 3) describe organizational maintenance of FAN and factors associated with maintenance; and 4) study the effectiveness of FAN. In Phase 1, we will randomize churches in a rural county with a high proportion of African American residents to receive training in FAN from a community health advisor (n=40) or to be part of a delayed intervention control group (n=20). This phase will allow us to study dissemination and implementation in a range of diverse religious denominations and gain greater understanding of how local coalitions can reach faith-based communities as settings for intervention. In Phase 2, we will work with two large faith denominations in SC, including one that is predominantly African American, to disseminate the program statewide. This phase will allow us to identify key considerations in program dissemination, adoption, and implementation and to examine the potential for broader geographic dissemination. Increasing physical activity and fruit and vegetable consumption are important goals of the CDC's Winnable Battles and the National Center for Chronic Disease Prevention and Health Promotion's environmental approach to preventing chronic disease and promoting health.

DESCRIPTION (provided by applicant): Low access to healthy food is associated with poor diet and increased obesity. The scarcity of healthy food outlets in disadvantaged communities has led to local and national initiatives to increase healthy food access. It is unknown if locatin supermarkets or other outlets for healthy foods in these areas, called food deserts, will improve diet quality. One such food outlet is the food hub, an outlet for locally produced food that typically have healthy food access, local food security, economic development and community education and training as goals. They are an alternative to supermarket chains that are often unwilling to locate in areas of high poverty. The goal of this research is to evaluate th impact of a food hub in a food desert community in South Carolina. The food hub will include a farmers' market, urban farm, mobile market, cafe and classrooms for community nutrition education and culinary arts job training. It will employ 23 local people and seeks to increase access to local produce and other food products produced on-site. The study will enroll 280 primary food shoppers from the surrounding community and 280 from a control group from a distant community matched on characteristics such as poverty, racial composition and access to healthy food. In-person interviews will be conducted with the 560 participants before the food hub's opening and again at 12 and 24 months to assess dietary intake, body weight, perceptions of the community food environment and food shopping habits, as well as a number of other social and attitudinal measures related to dietary choices. Global Positioning System and Geographic Information Systems technology will be use to assess the two communities' food environment and to calculate measures such as distance from participants' residences to various types of food outlets (for example, grocery store, convenience store, farmers' market , and fast food restaurant). Additional analyses of sales figures and questionnaires from shoppers present on randomly selected days at the food hub's farmers' market will indicate if residents of the surrounding food desert represent an increasing proportion of customers. Community leaders will provide their impressions of the food hub's impact on the community and its successes and challenges through focus groups and interviews.

DESCRIPTION (provided by applicant): Nearly three-quarters of African American women and half of non-Hispanic White women of childbearing ages in the US are overweight or obese. About one-half (46%) of pregnant women exceed gestational weight gain recommendations. This problem is significant because excessive gestational weight gain is a strong risk factor for new or persistent obesity in women and increases a woman's risk for maternal complications. Furthermore, accumulating observational studies show that higher maternal gestational weight gain is associated with higher offspring birth weight, which persists in childhood, adolescence, and young adulthood. Novel intervention approaches have the potential to help overweight/obese financially disadvantaged women achieve healthy weight control during and after pregnancy and improve the health of their offspring. Our experienced multidisciplinary team will build on our promising R21 feasibility study to address the following specific aims: (1) examine the impact of a lifestyle intervention on gestational weight gain and postpartum weight loss in overweight and obese women, (2) examine the impact of the intervention on physical activity (PA), dietary intake, and quality of life (QOL), (3) examine race differences in total gestational weight gain, PA, dietary intake, and QOL; and (4) examine the impact of the intervention on offspring adiposity. Pregnant women (N=500) women, half African American and half White, will be recruited from seven obstetric clinics in Columbia, South Carolina and randomized to a lifestyle intervention (n=250) or standard care (n=250). The lifestyle intervention, grounded in Social Cognitive Theory, will target regular body weight self-monitoring and increasing PA and healthy dietary practices in pregnancy and postpartum. The lifestyle program will start within 15 weeks gestation and will continue through 6 months postpartum. In pregnancy, the intervention will consist of an individual session followed by 12 group-based sessions augmented with 12 podcasts, telephone follow-up, and social media support. In postpartum, the intervention will consist of an individual session (at 6 weeks) followed by 16 podcasts, telephone calls, and social media support until 6 months postpartum. All women will be assessed early in pregnancy (d15 weeks), at 32 weeks gestation, and at 6- and 12-mos postpartum, and offspring will be assessed at 6- and 12-mos. The study is innovative because it incorporates critical components that are missing in the larger literature. Namely, it is theoretically grounded, fully targets PA in addition to healthy eating, objectively measures PA, spans pregnancy to postpartum, includes racially and socioeconomically disadvantaged women who are overweight or obese, is powered to assess race differences in intervention effectiveness, considers the intergenerational linkage on childhood obesity, and integrates state-of-the-art behavioral strategies and approaches combined with innovative intervention channels (i.e., podcasts and social media support), all tailored to a unique population of women from a southeastern state with poor maternal and child health indicators.

Physical inactivity and poor diet combined are a leading modifiable cause of death in the US. Racial disparities in these behaviors and associated health outcomes present major public health challenges. The USC PRC, working toward the vision of Communities that Support Physical Activity and Healthy Eating for All People, has established a long and successful history of applied research and practice in underserved communities. The specific aims of the USC PRC for 2019-2024, which will be conducted in partnership with the Center's Community Advisory Board (CAB), are to: 1) strengthen the infrastructure of the Center and the capacity of staff and investigators, 2) establish a Center research and translation agenda, engage translation partners, and conduct activities to support the translation of research findings into public health practice, 3) use innovative communication channels to disseminate knowledge and products and to promote the Center and its activities, 4) provide prevention research training to students, partners, and community members, and 5) participate in the PRC Network and collaborate with partners to increase the Network's collective impact. Achieving these aims will allow us to meet the short- and intermediate-term outcomes of the CDC PRC Program and contribute to the long-term outcome of widespread, sustained and scaled-up use of evidence-based programs and systems-wide population health strategies. The USC PRC's core research project is a quasi-experimental, national implementation study of Faith, Activity, and Nutrition (FAN), an evidence-based program unique in its focus on policy, systems, and environment change in churches. Guided by three theoretical frameworks, and with the input of CAB members and translation partners, the specific aims of the core research project are to: 1) develop a web-based approach to prepare church committees to carry out FAN, and promote its availability to churches across the country, 2) deliver the web-based training and support to churches, and examine factors associated with its adoption, 3) examine implementation fidelity, factors associated with implementation, and organizational (church) change, 4) evaluate the costs of hosting and administering the web-based training and support, church costs of training and implementation, and the relationship between church costs and implementation outcomes, and 5) identify and engage key translation partner(s) to house and administer FAN web-based implementation training and support to enhance future reach and sustainability. Implementation aims will be examined through church committee and pastor surveys (registration, baseline, 12 months) in 100 predominantly African American churches in the US. Organizational (church) change will be examined through member surveys (baseline, 12 months) in 20 of these churches (N=600 members). Increasing physical activity, improving dietary intake, and promoting health equity are key goals of the NCCDPHP's environmental approach to preventing chronic disease and Healthy People 2020. Churches are vital but underutilized institutions for health promotion that can contribute to reaching these national goals.