HPDP receives $1.5 million to develop diabetes self-management education toolkit

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Alice Ammerman, DrPH

CHAPEL HILL, NC – The Center for Health Promotion and Disease Prevention (HPDP), a CDC Prevention Research Center, at the University of North Carolina at Chapel Hill was awarded a $1.5 million contract to develop a national toolkit for public health and clinical providers to assure that people with diabetes have access to evidence-based education and support programs to help manage their condition.

Diabetes self-management education and support (DSMES) programs aim to prevent or delay the complications of diabetes. While proven to be cost-saving and have a positive impact on diabetes-related outcomes, DSMES programs remain underutilized among patients and health care professionals. The goal of this project is to expand access to DSMES programs to ensure that all people with diabetes are able to receive the care they need. The research team will market the programs to state health departments to help the health departments distribute the program across their states.

UNC investigators Alice Ammerman, DrPH, director of HPDP and professor of nutrition in the Gillings School of Global Public Health, Thomas Keyserling, MD, MPH, professor of internal medicine in the School of Medicine, Carmen-Samuel Hodge, RD, PhD, research assistant professor of nutrition at Gillings, Greg Randolph, MD, MPH in the department of pediatrics at the School of Medicine and Hugh Waters, PhD, associate professor in the School of Nursing will be partnering with Population Health Improvement Partners (PHIP), People Designs, RTI International, and the RTI-UNC Consortium for Implementation Science (CIS) on this project. The project is funded by the Centers for Disease Control and Prevention.

“We are delighted to have this opportunity to work with partners at the CDC and with our colleagues in the clinical and public health communities through this project,” said Ammerman. “The DSMES programs have the potential for enormous positive impact if we can develop, implement, and market a Toolkit that helps overcome the challenges provider, patient, and system levels.”

The research team will develop a strategic marketing plan for the toolkit to make sure that all audiences who could benefit from this project will be reached. Diabetes professionals across the United States will be trained to use these tools through a series of webinars and in-person training sessions.

“This toolkit will be a one-stop resource for creating, implementing, sustaining and maintaining a DSMES program that meets the highest quality standards set by the American Diabetes Association and the American Association of Diabetes Educators,” said Joanne Rinker, Senior Director For Community Health Improvement at PHIP.  “We look forward to completing this work over the next 3 years and how it will impact access to diabetes self-management education.”

The UNC Center for Health Promotion and Disease Prevention is a Prevention Research Center funded by the Centers for Disease Control and Prevention.


Media Contact: Sonya Sutton, ssutton@unc.edu; 919-966-4118

Newly funded project will ease parental concerns and help providers recommend HPV vaccine to help prevent cancer


Noel Brewer, PhD (Photo courtesy of UNC Gillings School of Global Public Health)

CHAPEL HILL, NC –  The human papilloma virus (HPV) vaccine has been available for a decade, but many adolescents do not receive the vaccine, putting them at risk for several cancers. A new project at the University of North Carolina at Chapel Hill will develop a step-by-step strategy to ease concerns from adolescents and their parents and recommend vaccination to help prevent cancer in future generations.

The project will be led by Noel Brewer, PhD, professor of health behavior at the Gillings School of Global Public Health. He is a member of UNC’s Lineberger Comprehensive Cancer Center and a chair on the National HPV Vaccination Roundtable. The research funding is from the Prevention Research Center Program at Center for Disease Control and Prevention to the UNC Center for Health Promotion and Disease Prevention.

This innovative multi-level study will build on communication theory, clinical experience, and several years of research by Brewer’s team to identify effective messages and to refine a step-by-step strategy for effectively recommending HPV vaccination. The research team will enhance one promising strategy, the EASE approach, which helps providers address parental concerns and effectively recommend vaccination.

“Most parents want to follow their providers’ advice about HPV vaccination,” said Brewer. “But when concerns come up, research doesn’t yet tell us what the best way to address them. We will develop messages that parents and providers both agree are effective.”

Although the EASE approach is promising, it lacks several key features: data about its impact and effectiveness, specific messages to address parents’ HPV concerns, and emphasis on high quality provider information. The research team plans to amend these shortcomings in the EASE approach in order to achieve the main goal of providing a therapeutic connection between providers and parents, which will ideally raise the frequency of vaccinations for a generation largely at risk.

Brewer added one of the most effective ways to start a conversation about adolescent vaccines is for the provider to inform parents that the child is due for meningitis, HPV and Tdap vaccines.  The research will help providers take the next step when parents have questions.

“Increasing HPV vaccination may prevent as many as 50,000 new cases of cancers,” said Brewer.  “Our research will help the nation meet the Healthy People 2020 goal of 80% of adolescents ages 13-15 having received the full course of HPV vaccination.”

The study is based at the UNC Center for Health Promotion and Disease Prevention in Chapel Hill and funded by the Prevention Research Center Program (PRC) at the Centers for Disease Control and Prevention. HPDP has been a Prevention Research Center for the entire 30-year history of the program. The HPV project is of one the PRC’s Special Interest Projects, which focus on priority public health issues using additional funding for prevention research. For more information on SIPs, please visit the Centers for Disease Control’s website.

Nathan Klima

Media Contact: Sonya Sutton, ssutton@unc.edu; 919-966-4118

Building a partnership in Hertford County, NC with Community Health Workers


The Carolina Heart Alliance Networking for Greater Equity (CHANGE) is testing an innovative program to encourage healthy habits and reduce the risk forheart disease by engaging community health workers (CHWs) to bridge the gap between clinical and community services.

Researchers from the UNC Center for Health Promotion and Disease Prevention (HPDP), a Prevention Research Center funded
by the Centers for Disease Control and Prevention, have partnered with the local health department, federally qualified health center and community leaders to test this approach in Hertford County, NC for the CHANGE project. Hertford County is located in northeastern North Carolina, about 2.5 hours from the University of North Carolina at Chapel Hill. The area has an active farming community and other major employers include a privately run prison near the county seat of Winton and poultry processing plants. The community also has a strong public health infrastructure, including the Hertford County Public Health Authority, the Roanoke-Chowan Community Health Center and the North Carolina Area Health Education Center (AHEC).


Click here to watch a video of one of our CHANGE community health workers describe the project.

The HPDP research team is led by Sam Cykert, MD, and Jennifer Leeman, DrPH. The CHANGE project builds on the PRC-developed Heart-to-Health intervention, which has been proven effective when delivered by clinicians, but hadn’t been tried with CHWs.

The research team chose Hertford County because of its rural and low-income population rural and low income and has high rates of unhealthy behaviors. They also chose Hertford because both Dr. Cykert and Dr. Leeman have worked with the community in the past and knew the Public Healthy Authority and Community Health Center would be great partners.

“RCCHC has been particularly good at reducing cardiovascular risk within the clinical realm,” said Cykert. “By connecting CHWs to the clinical world, it provides a great opportunity to reach into the community and not only improve health for those already at risk but to touch family members and others with lessons on diet and other heart healthy habits.”

After choosing Hertford County, the investigators sought out community leaders and public health practitioners to form a community advisory board to advise the process. They spent a year adapting the intervention and developing a plan for its implementation with the advisory team, and hired two community health workers in the fall of 2015.

Taylor Myers and Nikita Moore are both natives of Hertford County who have a keen interest in working in public health and helping their communities.  Myers applied for the position after completing her undergraduate degree in health promotion, and said she was thrilled when she got the job.

“I was very excited, because prevention and intervention is what I always dreamed of doing,” said Myers.  “Helping people to be more educated about health, especially around here, was very exciting. The most exciting part is being able to build a close relationship with a patient, because I can spend more time with them than a doctor or nurse might be able to.”

In addition to recruiting participants from the community, the project recruits through health care providers, and nurses and clinic staff provide potential participants information about the project. If the patient consents to follow-up, then Myers or Moore calls the patient to set up an initial appointment.  Moore works with individuals who relay their interest through community organizations so her recruitment venues expands the primary prevention scope beyond the clinic and those who already have a diagnosis. Myers is based at the Roanoke-Chowan Community Health Center and Moore is based at the health department in nearby Winton.

“I always tell patients that I’m like the middle man between a nurse and a doctor,” said Myers.  “I’m not a nurse and I’m not a doctor, and I have more time with my patients than a doctor;  I’m allowed up to an hour and a half with them. That allows me to build a strong relationship with my patients.”

Myers has worked with 11 CHANGE participants who have completed the program. Those participants have said they enjoyed the program and have had good outcomes.  The CHWs meet with participants four times throughout the program and take their blood pressure and health measurements at the beginning and end to see what changes have occurred.

She said that the partnerships built through CHANGE have helped to connect patients with resources in their communities, and that she felt those partnerships and relationships would last after the project is completed in 2019.

The next step for the project is to expand to a second community in 2017. The team will continue to use the CHW model and will be looking for CHWs in the new community to continue the work started in Hertford County.

The CHANGE project is the Applied Research Project of the UNC Prevention Research Center, based at HPDP. The Prevention Research Centers is a network of 26 academic research centers in 24 states that study how people and their communities can avoid or counter the risks for chronic illnesses, such as heart disease, obesity, and cancer. They identify gaps in research and develop innovative approaches to improving public health that can be shared broadly with public health partners.  HPDP was one of the first three PRCs funded in 1986, and has been part of the PRC network for the entire 30 years of the program.

De Marco receives Provost Engaged Scholarship Award for research

Tony Locklear, Molly De Marco, Daniella Uslan, and Alexandra Lightfoot celebrate De Marco's award for engaged research

Tony Locklear, Daniella Uslan, Molly De Marco and Alexandra Lightfoot celebrate De Marco’s award for engaged research

Molly De Marco, PhD, Research Fellow and project director in the UNC Center for Health Promotion and Disease Prevention (HPDP) and research assistant professor of nutrition at the UNC Gillings School of Global Public Health, has received the 2016 Office of the Provost Engaged Scholarship Award for engaged research.

The award is one of several public service awards presented on March 30th by the Carolina Center for Public Service in a ceremony at the Carolina Club.

De Marco directs the U.S. Department of Agriculture-funded “SNAP-Ed UNC: Healthy Food for All in North Carolina” project, which provides nutrition education to people eligible for SNAP benefits (formerly known as food stamps) in  Duplin, Orange, Lenoir, Sampson, Rockingham and Warren counties. She leads interventions that include the implementation of 18 community gardens and collaborates with three farmers markets to remove barriers to customers’ using SNAP benefits. She also works with the farmers market to increase the number of sites serving summer meals to children and families.

“Molly’s work is the ultimate example of engaged research,” said Alice Ammerman, DrPH, professor of nutrition and HPDP director. “She has a multitude of community partners who seek her collaboration, and she never fails to include input from these partners in her efforts. She is a master at balancing rigorous research principles with meaningful community engagement.”

De Marco, who came to UNC eight years ago for a post-doctoral appointment in community-based participatory research, said she was humbled by the award. “I stand on the shoulders of so many amazing mentors, including Alice Ammerman, Alexandra Lightfoot, Eugenia Eng, Rev. William Kearney, Melvin Jackson, Naeema Muhammad, David Caldwell and Tony Locklear.”

Locklear, a HPDP community partner and current Access to Recovery Services Coordinator and Lumbee Tribal Liaison for the American Indian Center and North Carolina Tribal Nations, received the Partnership Award in the ceremony.

Chancellor Carol L. Folt, who presented the awards, said she was proud to recognize the awardees’ innovativeness, scholarship and dedication.

“The University’s three-part mission to research, educate and serve our local communities, state, nation and world is truly enhanced by our unwavering commitment to public service,” Folt said. “The recipients of this year’s Public Service Awards prove that public service and engaged scholarship enhance the research conducted, lessons taught and knowledge used to serve the public good at this University.”

Other winners include Rhonda Lanning, clinical assistant professor in the School of Nursing, and the American Indian Center and N.C. Tribal Nations (Office of the Provost Engaged Scholarship Awards); Beverly Foster, clinical associate professor and director of undergraduate education in the School of Nursing (Ned Brooks Award for Public Service); undergraduate student Gayatri Rathod, graduate students Catherine Schricker and Korry Tauber, staff member Christopher Wallace, clinical assistant professor of social work Josh Hinson, MSW, and campus organization Student Health Action Coalition (Robert E. Bryan Public Service Awards).

Read more about the awardees on the Carolina Center for Public Service website.

Women’s Health Month Highlight: COMPARE-UF seeks to understand treatment options for uterine fibroids

COMPARE-UF small logo

By Jake Ford, 2016 Communications Intern

In recognition of Women’s History Month, we at the UNC Center for Health Promotion and Disease Prevention will be posting a weekly tribute to the work done by and for women as part of the Women in Science Wednesday initiative by UNC Research. Our activities will include featuring projects that focus on benefitting the lives of women in our community as well as featuring the accomplished women researchers here at HPDP that lead efforts in promoting community health.

COMPARE-UF_ProblemUterine Fibroids affect ¾ women, and disproportionately affect African-American women, but not much is known about what causes fibroids or the best way to manage fibroids.

COMPARE-UF is a study to determine the effectiveness of different surgical and medical management options for uterine fibroids in women across the lifespan (ages 18-54). To help achieve this objective, researchers will create a multi-center (9 US centers) registry of geographically, racially, ethnically, and clinically diverse group of women with uterine fibroids. The University of North Carolina at Chapel Hill is one of these 9 clinical sites participating in this landmark study. Our goal is to reach women throughout the state of North Carolina that have been affected by uterine fibroids.

The UNC study is led by principal investigator Wanda Nicholson.  Aditi Sundaresan, a COMPARE-UF Research Assistant, has been focusing on recruitment of participants in the study.  “After spending hours and hours on the phone with these women and surveying them about their feelings and experiences surrounding fibroids, it’s so clear that this is a major problem and truly affects a woman’s quality of life,” Sundaresen said.

The study is purely observational and will collect information from women before and after treatment about how the treatment affected their uterine fibroid symptoms. This information will be compared nationally, used to provide answers to women’s questions about treatment options, and lead to improved care for patients with uterine fibroids now and in the future.

Participant Laura Maddux spoke on her motivations to work with COMPARE-UF, “I’m participating in this study because I want to help find answers to the problems that have been so troubling to me,” Maddux said. “It’s been frustrating that so little is known about what causes uterine fibroids, yet they are so common. I also want to encourage other women to talk about what is often an unspoken problem.”

The study has enrolled 24 women for COMPARE-UF so far. Women who may qualify are:

  • Women with symptomatic fibroids
  • Between the ages of 18-54
  • Primarily English speaking
  • Scheduled for a surgical procedure (myomectomies, endometrial ablations, uterine artery embolizations, and MRI focused ultrasounds)

Sundaresan commented, “Fibroids cross all disciplines of women’s health and the doctors I work with are excited to see the results of the study as well. It’ll definitely affect what treatment options they recommend to patients in the future.”


Students in Orange County Schools rate new healthy menu options at Try-Day Friday


Click here to see a news story on this project from WRAL.com

HILLSBOROUGH- The childhood obesity epidemic has brought many different ideas and approaches to helping children learn to eat more healthy foods, and making

Spring Dawson-McClure, an investigator on the Kohl's Fav5 Club project, serves samples to students at Try-Day Friday

Spring Dawson-McClure, an investigator on the Kohl’s Fav5 Club project, serves samples to students at Grady Brown Elementary.

those changes can be especially difficult when it comes to school lunch. A partnership between UNC Children’s and  the UNC Center for Health Promotion and Disease Prevention—funded through a $59,956 donation  from Kohl’s —is enabling cafeteria staff in Orange County to develop healthier menu options and solicit feedback from the most important stakeholders: students themselves.

“The goal of the project is to get kids to try new foods and build enthusiasm around the school lunch program in Orange County Schools,” said Larissa Calancie, who is helping to lead the project from the Center for Health Promotion and Disease Prevention.

The initiative brought professional chef Ryan McGuire of the Chefs Academy in Morrisville, N.C., in consultation with the school nutrition staff in Orange County elementary schools to develop new menu options that were healthy, tasty, and met with federal nutritional guidelines for schools. The study culminated in a taste testing event called Try-Day Friday in each of the seven elementary schools in Orange County.

Students tried three new dishes: super Caesar salad; crispy fish wraps; and French toast casserole with apples. After sampling the items, students completed a short survey indicating whether they liked each and if they would try the items again.

“I really liked the fish,” said Tia Hilber, a fourth grade student at Hillsborough Elementary School. Her classmates agreed, and some even asked for second helpings.

“I loved the salad, especially the dressing,” said Isabel Sutton, also a fourth grader at Hillsborough Elementary. “The only thing is I wish it had more vegetables than just the cabbage and carrots.”

The recipe development and taste testings are part of the Kohl’s FAV5 Club. The program and its website offer practical, evidence-based strategies for encouraging healthy eating and physical activity among children and adults.

The program launched at the start of the academic year with information sessions for parents, teachers, administrators, and cafeteria staff, establishing the powerful influence that healthy eating and exercise habits have on brain development, academic success and overall well-being. Students received water bottles to stress the importance of hydration and pedometers to help them track their activity.

Eliana Perrin, MD, MPH, a professor of pediatrics at the UNC School of Medicine who is involved with phase two of the program’s development which will take place in the Chapel Hill-Carborro Schools says it is important for children and parents to understand the health consequences of childhood obesity.

“In North Carolina, 19 percent of children are classified as obese and less than one-third of elementary school children consume recommended daily servings of fruits and vegetables,” said Dr. Perrin. “Obese children and adolescents may experience immediate health consequences and may be at risk for weight-related health problems in adulthood.”

The project also provided an opportunity for UNC students to learn about nutrition research in public schools by volunteering to help prepare and serve the samples. Will Chapman, a master’s student in Nutrition at the UNC Gillings School of Global Public Health, said he wanted to volunteer because he enjoys working with kids and the project compliments some research he is working on as part of his degree.

“I’m working on a proposal for work similar to this, so I’ve learned a lot about what’s involved and found some missing pieces in my proposed work,” he said. “I learned a lot about what it takes to conduct something like this. It’s very scientific, but there are also realities about working in this kind of environment.”


Teachers at Hilsborough Elementary dressed up as vegetables to get students excited about the event.

The Child Nutrition Services staff plan to add some of these menu items to the school lunch menu beginning in the Spring.  They also plan to partner with No Kid Hungry NC to  capitalize on the enthusiasm generated in the Kohl’s  project to increase children’s participation in school breakfast, as part of ongoing efforts to increase access to healthy food in support children’s health and school success.

Lisa Sales, the child nutrition manager at Hillsborough Elementary, said she was very excited to be a part of the project.

“It gives me joy to see them eating healthy foods, and fresh foods,” said Sales. “I’m a trained chef and this is part of the reason I went to school. These children are our future, and seeing them eat healthy foods is why we are here.”

HPDP researchers present their work at American Public Health Association Annual Meeting

Researchers at the UNC Center for Health Promotion and Disease Prevention presented their work at 16 sessions of the 2015 American Public Health Association Meeting held in Chicago, IL this week. See the full list of presentations and poster sessions below:

Name/Type of Session


Authors (HBEH* faculty, student, postdoc, or graduate)


 1009.0 Using ‘Putting Public Health Evidence in Action’: Interactive training guides and resources Leeman, J., Escoffery, C., Carvalho, M., Norton, W., Shannon, J. Saturday, October 31, 2015: 9:00 a.m. – 5:00 p.m.
329152 Community-academic grants administration translation (CAGAT): Enhancing the capacities of community-academic partnerships in grants management Lori Carter-Edwards, PhD, MPH, Zoe Enga, MPH, Chanetta Washington, MPH, Kimberlee Hyman, MS, C. Madeline Mitchell, Elizabeth Millar, Melvin DuBose, DD, Melissa A. Green, MPH, Al Richmond, MSW, Giselle Corbie-Smith, MD, MSc Monday, November 2, 2015
328842 Cheryl Emanuel, MS, Marcus Plescia, MD MPH, Camina Davis, MS, Lori Carter-Edwards, Mark J. DeHaven, PhD Tuesday, November 3, 2015
328865 Creating and implementing a community-engaged evaluation framework to understand and promote health equity Lori Carter-Edwards, PhD, MPH, Jill Rushing, MS, Ceola Ross Baber, PhD,Abby Lowe-Wilson, MPH, Mary Sherwyn Mouw, MD, Monique Bethell, PhD, MA, Monday, November 2, 2015 : 8:30 a.m. – 8:50 a.m.
3209.0 Poster session: Disparities in patient care A Systematic Review to Understand What we Know about Implicit Racial/Ethnic Bias and Healthcare Outcomes William Hall, Mimi Chapman, Robert Colby, Tamera Coyne-Beasley, Steve Day, Eugenia Eng*, Kent Lee, Alexandra Lightfoot*, John McGowan, Yesenia Merino*, Keith Payne, Florence Simán*, Kari Thatcher*, Tainayah Thomas* Monday, November 212:30 p.m. – 1:30 p.m.
4065.0 Roundtable Community-Based and Community-Engaged Research Photovoice: A method to understand perceptions of cardiovascular health in the “stroke belt” Sarah Kowitt*, Briana Woods-Jaeger*, Jesse Lomas, Tamara Taggart*, Linden Thayer, Sussie Sutton, Alexandra Lightfoot* Tuesday, November 38:30 a.m. – 10:00 a.m.
4115.0 Oral Using CBPR to Eliminate Health Disparities Equity in managing pain and side effects from cancer treatment: Findings from photovoice and focus group interviews with breast cancer survivors Cleo Samuel, Nora Jones, Kristin Black, Carol Cothern, Samuel Cykert, Eugenia Eng*, Alexandra Lightfoot*, Omar Rasul, Linda Robertson, Jennifer Schaal, Christina Hardy Tuesday, November 310:50 a.m. – 11:10 a.m.
4198.0 Student poster session: the links between social justice & public health Theatre arts for health promotion: Using performance art for sex education and HIV prevention for North Carolina youth Niranjani Radhakrishnan*, Arianna Taboada, Alexandra Lightfoot*, Amy Burtaine Tuesday, November 3 12:30 p.m. – 1:30 p.m.
4325.0 Roundtable Innovations in HIV Screening, Prevention, and Treatment AMP!: A Pilot Evaluation of a Theater-based HIV Prevention Intervention for High School Students Tamara Taggart*, Arianna Taboada, Judith Stein, Norweeta Milburn, David Gere, Alexandra Lightfoot* Tuesday, November 32:30 p.m. – 4:00 p.m.
4357.0, Oral Session,  Public Health Nursing Research  Testing the Effects of the Chronic Disease Self-Management Program (CDSMP) on Employment Outcomes for Lower-Wage Workers Shawn M. Kneipp, PhD, Laura Linnan, ScD, CHES, Justin Trogdon, PhD, Ziya Gizlice, PhD, Mary Grace Flaherty, PhD, Matthew Lee Smith, PhD, MPH, CHES, Cecilia Gonzales and Lindsey Horrell, RN, BSN
Tuesday, November 3, 2015: 3:15 p.m. – 3:30 p.m.
4404.0 Youth Roundtable: Youth leading the way to healthier communities Co-Creating Change through PhotoVoice: Latino/a Teens and Physicians-in-Training Combat Inequity Together Kari Thatcher*, Alejandra Mendez, Ruben Suarez, Mimi Chapman, Robert Colby, Tamera Coyne-Beasley, Eugenia Eng*, William Hall, Kent Lee, Alexandra Lightfoot, John McGowan, Yesenia Merino*, Keith Payne, Florence Simán*, Tainayah Thomas* Tuesday, November 34:30 p.m. – 6:00 p.m.
4404.0 Youth Roundtable: Youth leading the way to healthier communities “I’ve done all that I can, and I still cannot get what I deserve”: Using Photovoice to Explore Latino youths’ experiences of Deferred Action for Childhood Arrivals (DACA) Cruz Nunez, Kari Thatcher*, Kashika Sahay, Alexandra Lightfoot* Tuesday, November 34:30 p.m. – 6:00 p.m.
321981 Electronic Cigarette Sales to Minors via the Internet  Rebecca Williams, MHS, PhD, Jason Derrick, MSW, Kurt Ribisl, PhD,
Tuesday, November 3, 2015 : 5:10 p.m. – 5:30 p.m.
5035.0 Roundtable Policy and Community-Based Participatory Research Healthcare Equity Education Training: Informing diversity and inclusion policy at cancer centers Eugenia Eng*, Christina Hardy, Barbara Akins, Kristin Z. Black, Carol Cothern, Samuel Cykert, Steven Evans, Karen Foley, Deena Hayes-Greene, Dwight Heron, Skip Hislop, Nora Jones, Kalsoom Khan, Alexandra Lightfoot*, Lilli Mann*, Matthew Manning*, Lyn B. Robertson, Jennifer Schaal, Beth Smith Wednesday, November 48:30 a.m. – 10:00 a.m.
322559 Standardized Tobacco Assessment for Retail Settings (STARS): Comparative data for US stores  Kurt Ribisl, PhD, Shelley Golden, Katie Byerly, BSPH, Heather D’Angelo, MPH, Douglas Luke, PhD, Lisa Henriksen, PhD
Wednesday, November 4, 2015 : 8:50 a.m. – 9:10 a.m.
328747 CHWs Linking Primary Care and Public Health Services: A Community-Engaged Process for Developing the CHW Role  Leeman, J., Cykert, S., Moore, A., & Rosemond, C.  Wednesday, November 4, 2015 : 9:06 a.m. – 9:18 a.m.


Community shows psychological, spiritual and social components of heart health through photo research project

Heart Healthy LenoirCHAPEL HILL-People in at-risk communities see heart health as more than just physical health and include psychological, spiritual and social health as well, according to research from UNC-Chapel Hill published today in Preventing Chronic Disease.

Researchers with the Heart Healthy Lenoir study worked with two groups of African-American residents of Lenoir County, in eastern NC, adults and youth, to explore barriers to heart health. They used the photovoice method, a research process that provides cameras to participants to take photographs of the environment to illustrate and understand the factors influencing health issues. The participants selected topics for each session, took photographs to show their perspectives, and then came together to discuss causes and potential solutions to improve health in their community.

The photos and discussions showed that participants thought of heart health as an issue affected by many factors, especially food availability (both healthy and unhealthy) and stress. Participants also talked about personal responsibility for heart health, related to making healthy choices, and the importance of social support from friends and family to make those healthy changes. See a slideshow of selected study photographs here.

Heart Healthy Lenoir Photovoice Project

“The project really illustrated how community members feel about cardiovascular health,” said Sarah Kowitt, a doctoral student in health behavior at the UNC Gillings School of Global Public Health who led the analysis of the photovoice results. “People clearly recognized heart disease was a problem and were actively trying to improve their health, but they also reported facing a number of structural barriers, such as unhealthy food environments. The great thing about photovoice is that, in addition to barriers, the approach identifies assets in communities that can be harnessed for health promotion.”

The group included 9 adolescents and 6 adults who live in and around Lenoir County, which has some of the highest rates of death from heart disease in the country, particularly among low income and minority individuals. The adults in the study talked about being good role models for youth, and the adolescents looked to family members when talking about good role models for healthy lifestyle choices. The adults also discussed faith as integral to helping themselves and adolescents find a purpose for prioritizing their health.

The photovoice project was part of formative research establishing a community partnership with Lenoir County residents as part of the Heart Healthy Lenoir study,  a 5-year study designed to develop and test better ways to reduce heart disease in Lenoir County. Heart Healthy Lenoir was based at the UNC Center for Health Promotion and Disease Prevention (HPDP) and funded by the National Heart, Lung and Blood and Institute and led by Alice Ammerman, director of HPDP and professor of nutrition at the School of Public Health.

The photovoice study research team was led by Alexandra Lightfoot, director of HPDP’s community engagement core and research assistant professor in the department of health behavior. The team also included co-investigators in the study, postdoc and graduate students, and community partners who live in Lenoir County.

“This formative work using photovoice provided a critical basis for the design of clinical and community-based programs to reduce the risk of heart disease,” Lightfoot said. “By tailoring programs like this to the specific concerns and needs of the community, the chances of success are much greater. ”

UNC News Contact:

MC VanGraafeiland

UNC-Chapel Hill, Office of Communications and Public Affairs


UNC Center for Health Promotion and Disease Prevention Contact:

Sonya Sutton



Five states selected to pilot GO NAP SACC and improve health habits in young children

NAPSACC logoCHAPEL HILL, N.C. Go NAP SACC is a North Carolina child care initiative that is expanding into five new states. Go NAP SACC is an online tool that helps child care programs foster healthy eating and physical activity habits in young children. The University of North Carolina at Chapel Hill’s Center for Health Promotion and Disease Prevention (HPDP), which runs Go NAP SACC, has selected Louisiana, Maine, Massachusetts, Oklahoma and Virginia to pilot the program over the next six months.

Many young children attend child care programs, and these programs become their “home away from home.” As partners with families, child care programs have a big role to play by helping children develop healthy habits that can serve them throughout their lives. Enjoyable mealtimes where fruits, vegetables, and other healthy foods are served help children learn to like these foods. Indoor and outdoor playtime not only let children burn energy, but also help fuel brain development and learning.

Go NAP SACC helps programs set and reach goals to improve their menus and mealtimes, increase opportunities for enriching active play, and make other healthy changes. Technical assistance professionals in each of the selected states will be working with child care programs to help them set and reach goals that will help them become healthier places for children to learn and grow.

Go NAP SACC is the online version of NAP SACC (Nutrition and Physical Activity Self-Assessment for Child Care), an evidence-based program created in 2002 by a team of child obesity researchers at UNC Chapel Hill. It has been used successfully by child care programs in dozens of states throughout the country over the past decade.

This pilot project is made possible with support from the Centers for Disease Control and Prevention and The Blue Cross and Blue Shield of North Carolina Foundation.

For more information, visit the Go NAP SACC website at www.gonapsacc.org.

“BEAUTY is a Balancing Act” to test new venue to deliver health awareness messages and falls prevention education

Falls Prevention Awareness Week in North Carolina runs September 21 through 26

(Chapel Hill, N.C.—September 21, 2015) – The Injury Prevention Research Center at the University of North Carolina at Chapel Hill is recruiting beauty salons for a special opportunity—to participate in a randomized trial study to test the impact of different health messages, including information about falls prevention.

According to the North Carolina Injury and Violence Prevention Branch of the North Carolina Division of Public Health, falls are the leading cause of injury among North Carolinians age 65 and older, and resulted in 17,861 hospitalizations and 820 deaths in 2013. Moreover, many people do not realize that falls are the leading cause of emergency room visits for people of nearly all ages. Preventing falls across the lifespan is critically important.

The “BEAUTY is a Balancing Act” randomized test was developed by a research team led by Dr. Laura Linnan, professor of health behavior and Health Promotion and Disease Prevention research fellow at UNC-Chapel Hill, and the BEAUTY and Barbershop Advisory Board, which has guided the planning and delivery of more than 10 health-related studies over the past 16 years.

The idea around the study is to test the effectiveness of delivering falls prevention messaging in a nontraditional environment – the beauty salon. The relationship a woman has with her hair stylist is unique. Hair stylists serve as confidantes for their clients, and a strong bond is created between the two that often lasts many years. Salons also provide a safe atmosphere for open and honest conversation, making them the perfect locations for discussions about health topics. This is the first study in the nation to focus on falls prevention awareness in the beauty salon environment.

BEAUTY seeks to remedy this largely preventable community health issue by identify individuals who are at high risk of falling, and referring them to evidence-based falls prevention programs in the community. In addition, BEAUTY will interject meaningful, potentially life-saving information into the salon environment through everyday exchanges between customers and licensed hair stylists. The goal of BEAUTY is to take steps to protect those who are at risk of falling, including seniors who at high risk of falling, caregivers of older adults and individuals of all ages who can benefit from this information.

The randomized trial study will recruit 22 beauty salons in North Carolina. Half of the salons will receive the falls prevention program (Healthy Balance) and the other half will receive a financial health program (Healthy Finances) over the six-month period of the study. The Healthy Finances program will help salon clients improve their personal finances. All participating salon owners will benefit from training about how to improve the financial health of their small businesses. Training topics will range from using social media to promote awareness and creating a business plan to information about arranging for new credit/business loans to expand a business.

The BEAUTY is a Balancing Act research team will host a kickoff celebration with participating salon owners and stylists on Monday, September 21, 2015, at the UNC Friday Center from 4:00 – 6:30 p.m. The meeting will include a lite dinner and an up-close demonstration of the health and balance screenings that will be offered to customers who join the study through the participating salons.

The timing of the event is perfect: North Carolina Governor Pat McCrory has declared the first week of fall, September 21-26, Falls Prevention Awareness Week.

For additional details and to learn more about the study, visit the BEAUTY is a Balancing Act project at http://beautybalanceproject.com/


Project manager contact: Carrissa Dixon, (919) 966-6887, cdixon08@email.unc.edu


Communications and Public Affairs contact: Michael John, (919) 445-8555, michael.john@unc.edu