University of North Carolina Investigators Awarded New CDC Funding to Study the Economic Burden of Metastatic Breast Cancer

Stephanie Wheeler and Justin Trogdon of the University of North Carolina were awarded CDC funding for SIP 17-004, Assessing the Lifetime Economic Burden in Younger, Midlife, and Older Women with Metastatic Breast Cancer. The economic cost data produced by this study will help decision makers allocate scarce public health resources more effectively for the prevention and treatment of mestastics breast cancer (mBC). For example, the cost projections can highlight cost drivers for women with mBC and motivate population-level prevention, early detection, and timely treatment activities. This study will also identify cost-effective treatment pathways to improve quantity and quality of life among women of all ages with mBC to ensure that women with mBC receive high-quality care while minimizing the economic impact on patients and payers. In addition, findings can be used to support value-based pathway driven treatment decisions and inform policymaking.

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HPDP Research at APHA 2017

HPDP researchers are presenting their work at the American Public Health Association’s 2017 Annual Meeting and Expo. This year’s theme is “Creating the Healthiest Nation: Climate Changes Health”. The meeting is from November 4 to November 8 in Atlanta, Georgia. HPDP research that will be presented includes:

Public Health Experts Celebrate 30 Years of CDC’s Prevention Research Solutions for Communities with Health Disparities

 

UNC HPDP February 16, 2017 – It has been 30 years since the Centers for Disease Control and Prevention (CDC) envisioned the creation of a bridge between academic public health research and public health practice. The result is the Prevention Research Centers (PRC) Program, currently a network of 26 academic institutions across the U.S. dedicated to moving new discoveries into the communities that need them. Marking this milestone, key members of the PRC Network community share their insights and commentaries to provide an insiders’ perspective on the past, present, and future of the PRC Program in a special supplement to the American Journal of Preventive Medicine.

“The 30th anniversary of the founding of the PRC Network is an appropriate time to reflect on our progress as well as look to the future. Applied prevention research with a focus on understanding health disparities and promoting health equity has never been more important than now. The PRC Network has made great strides in developing, testing, and disseminating programs and policies that have had broad and sustained impact,” commented supplement Guest Editor Dr. Mehran S. Massoudi, former PRC Director and currently the Regional Health Administrator, Region VI, Department of Health and Human Services (DHHS).

PRC Program leaders provide a historical look, current assessment, and perspective for the future of the program. The contributions represent continuing efforts to promote health by conducting cutting-edge research and translating research to practice in partnership with communities.

Dr. James S. Marks, former CDC’s National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) Director, and Dr. Jeffrey P. Koplan, former NCCDPHP and CDC Director, review the early years of the PRCs and offer perspectives into the future. They examine the early struggles that led to missed opportunities and how the original goal of PRCs, namely, practical research in challenged communities as a core part of the academic enterprise of scholarship, service, and training, has been accomplished. They observed that “the bridge the PRCs have helped to build between public health academia and practice is broad, heavily traveled, and has brought longer, healthier, more fulfilling lives to all.”

Four former PRC directors look back on some unique challenges faced by the PRC Program and how they ultimately successfully addressed them. Eduardo J. Simoes, MD, MSc, MPH, Director from 2002 until 2011, noted, “Along the way and every day, this partnership of government, academia, and community traveled a bumpy road with improved pavement provided by dedicated federal public health officials motivated by knowledge and a strong sense of duty.”

Leaders from the Association of State and Territorial Health Officials and National Association of County and City Health Officials provide a frame from the practice-based perspective on how the PRC Program serves as a resource to state and local public health departments as they fulfill their public health mission.

Association of Schools and Programs of Public Health and American College of Preventive Medicine representatives provide a perspective of the PRC Program as an integral portfolio of the Schools of Public Health and Medicine to advance population health. The PRCs are pushing academic research to pay more attention to on-the-ground prevention efforts, state and local health departments that benefit from closer ties to the research institutions, and the public, which gains an evidence-based platform for health promotion and disease prevention.

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Caption: 30 years of building healthier communities. An overview of the Prevention Research Centers Program and its contributions to public health and education. Credit: Prevention Research Centers Program, Centers for Disease Control and Prevention

The supplement documents the story of how PRC Programs have impacted the health of African Americans, Hispanics/Latinos, Native Americans, deaf populations, adolescents, older adults, and urban and rural under-resourced populations. Other articles deal with measuring the impact of a national media intervention implemented across the PRC Network, evaluating healthy food incentive programs, assessing fall risk prevention programs, and promoting teen contraception through parental intervention.

Twenty-one peer-reviewed original research articles from the PRC academic and community partners show the depth and scope of their work. These articles cover a wide range of important topics including dissemination and implementation of long-standing evidence-based programs, including formation of thematic research networks in physical activity, healthy aging, cancer prevention and control, and epilepsy management; health surveillance of the deaf community; research to practice in state and local public health settings; collaboration with community partners; use of community health workers or “promotoras;” and training of the public health workforce.

Reaching out to the public health community, Dr. Massoudi noted, “In looking to the future, we must build on the work of the past 30 years, incorporating new knowledge and technology while remaining committed to our mission of working as an interdependent network of community, academic, and public health partners to conduct prevention research and promote the wide use of practices proven to promote good health.”

 

 

 

 

 

 

 

Media contact:

Sonya Sutton

1700 Martin Luther King Jr Blvd #7426, Chapel Hill, NC 27514

919-966-4118

ssutton@unc.edu

Guest Editors:

Alice S. Ammerman, DrPH, Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC

Ross C. Brownson, PhD, Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, MO

Jeffrey R. Harris, MD, MPH, MBA, Prevention Research Center, University of Washington School of Public Health, Seattle, WA

Mehran S. Massoudi, PhD, MPH, Regional Health Administrator, Region VI, Office of the Assistant Secretary for Health, DHHS, Dallas, TX; formerly the Director of the Prevention Research Centers Program, CDC, Atlanta GA

 

This supplement to the American Journal of Preventive Medicine, volume 52, issue 3 (March 2017), published by Elsevier, is openly available at http://www.ajpmonline.org/issue/S0749-3797(17)X0002-0. Please visit the site to view the table of contents and access full text of the contributions.

 

Full text of these articles is also available to credentialed journalists upon request; contact Jillian B. Morgan at +1 734-936-1590 or ajpmmedia@elsevier.com. Journalists wishing to interview the authors should contact Dr. Mehran S. Massoudi, Office of the Assistant Secretary for Health, US Department of Health and Human Services, at +1 214-767-8433, +1 202-853-4235 (mobile) or Mehran.Massoudi@hhs.gov.

 

This publication was made possible through the Centers for Disease Control and Prevention (CDC) and the Association for Prevention Teaching and Research (APTR) Cooperative Agreement No. 1 U36 OE000005. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Department of Health and Human Services, CDC, or the Agency for Toxic Substances and Disease Registry, or APTR.

 

About the American Journal of Preventive Medicine

The American Journal of Preventive Medicine (www.ajpmonline.org) is the official journal of The American College of Preventive Medicine (www.acpm.org) and the Association for Prevention Teaching and Research (http://www.aptrweb.org/). It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health. The journal features papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women’s health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and alcohol and drug abuse. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. The journal also publishes official policy statements from the two co-sponsoring organizations, health services research pertinent to prevention and public health, review articles, media reviews, and editorials.

 

The American Journal of Preventive Medicine, with an Impact Factor of 4.465, is ranked 14th in Public, Environmental, and Occupational Health titles and 16th in General & Internal Medicine titles for total number of citations according to the 2015 Journal Citation Reports® published by Thomson Reuters, 2016.

 

About Elsevier

Elsevier (www.elsevier.com) is a world-leading provider of information solutions that enhance the performance of science, health, and technology professionals, empowering them to make better decisions, deliver better care, and sometimes make groundbreaking discoveries that advance the boundaries of knowledge and human progress. Elsevier provides web-based, digital solutions – among them ScienceDirect (www.sciencedirect.com), Scopus (www.scopus.com), Elsevier Research Intelligence (www.elsevier.com/research-intelligence), and ClinicalKey (www.clinicalkey.com) – and publishes over 2,500 journals, including The Lancet (www.thelancet.com) and Cell (www.cell.com), and more than 35,000 book titles, including a number of iconic reference works. Elsevier is part of RELX Group (www.relx.com), a world-leading provider of information and analytics for professional and business customers across industries. www.elsevier.com

 

About Prevention Research Centers (PRC)

PRC 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. These centers are located at either a school of public health or a medical school that has a preventive medicine residency program. As leaders in translating research results into policy and public health practice, the centers work with communities to develop, evaluate, and implement major community changes that can prevent and control chronic diseases. They identify gaps in research and develop innovative approaches to improving public health that can be shared broadly with public health partners. www.cdc.gov/prc

 

Help from a family member can help adults with type 2 diabetes lose weight and manage their health

Carmen Samuel-Hodge

Carmen D. Samuel-Hodge, RD, PhD

CHAPEL HILL, NC – Working with a family member can help adults with type 2 diabetes lose weight and improve their health, according to a UNC study published in the January 2017 issue of Obesity.

Family-centered weight loss interventions have been shown to be effective in both managing diabetes and preventing the onset of diabetes in family members. Investigators with the Family PArtners in Life Style Support (PALS) study, based at the UNC Center for Health Promotion and Disease Prevention (HPDP), recognized a particular need for interventions adapted to the social, family, and community contexts of African Americans with diabetes. Family PALS aimed to address this need by developing and testing a family-centered behavioral weight loss intervention for African American adults with type 2 diabetes. The research team was led by Carmen D. Samuel-Hodge, RD, PhD, also a research assistant professor of nutrition at the Gillings School of Global Public Health, and also included Ziya Gizlice, Gwendolyn Davis, and Thomas C. Keyserling of HPDP. This research was supported by a grant from the National Institutes of Health.

Adults with type 2 diabetes were paired with a family member who was overweight or obese but not diagnosed with diabetes. The pairs were encouraged to attend weekly group-based sessions together that focused on problem solving and goal setting with regards to weight management. For both diabetes patients and their family partners, weight loss was greater in those who attended more sessions.

“We’ve seen in many behavioral weight loss trials that African American women don’t lose as much weight as other participants. In Family PALS, losing weight with the support of a family member made a difference. Pairs who attended more than 10 sessions together lost about 5.5 pounds more than pairs attending fewer sessions together,” said Samuel-Hodge.

Participants benefited not only from significant weight loss, but also showed greater improvements in other health measures, including hemoglobin A1c, depressive symptoms, family interactions, quality of life, and perceptions of diabetes control.

“These very positive results strongly support the effectiveness of a family-centered approach in African Americans families living with diabetes. We are now much more aware that ‘one size does not fit all’ when it comes to interventions,” said Samuel-Hodge. “What may work better for African American families is pairing family members in lifestyle interventions that target both diabetes prevention and diabetes treatment through modest weight loss.”

To the investigators’ knowledge, Family PALS is the first family-centered weight loss intervention study conducted among African American adults with diabetes. This study establishes the potential that family-centered interventions have to significantly improve weight loss outcomes among African Americans with diabetes.

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

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

New Mediterranean-style diet pattern leads to weight loss and improved blood pressure

A UNC research study recently published in BMC Public Health shows that incorporating a Mediterranean-style diet is likely to facilitate weight loss and reduce risk of cardiovascular disease.

The Heart Healthy Lenoir study was conducted in Lenoir County in eastern North Carolina and

focused on developing healthy dietary, physical activity and weight loss strategies to improve cardiovascular health. Dr. Thomas Keyserling, MD, MPH, in the UNC School of Medicine and research fellow at the UNC Center for Health Promotion and Disease Prevention led the lifestyle and diet portion of the study.

Keyserling and his team encouraged project participants to focus on eating foods with healthy fats regularly instead of focusing on a low fat diet. They asked participants to eat more nuts, vegetable oils and fish as part of a Mediterranean-style diet. In addition, the diet also promoted regularly consumption of fruits and vegetables, whole grain products and beans.

Among study participants who returned for their 6-month follow-up visit, compared to baseline there was a reduction in systolic blood – of 6.4 mmHg and a reduction in diastolic blood pressure was -3.7 mmHg. In addition, though weight loss was not an objective during the first 6 months of this project, average weight loss was 0.7 kg on the fat unrestricted diet.

The Heart Healthy Lenoir diet was well received in the community because it didn’t require participants to give up many of the foods they already enjoyed. For example, the study promoted full fat salad dressing and mayonnaise, as there products are made of heathy vegetable oils as opposed to the low or no fat versions which have higher salt content and high fructose corn syrup, a poor quality carbohydrate. In addition, fried foods were considered acceptable as long as non-trans fat vegetable oil was used for frying.

“A major goal of the research study was to develop an intervention that would be similarly effective among minority and non-minority participants in order to decrease health disparities. As a whole, both lifestyle and physiologic outcomes were similar by race. However, there was a trend showing greater reduction for systolic blood pressure among African American participants.”

“As African Americans typically have higher blood pressure, it was promising to see a greater reduction in blood pressure within this subgroup of study participants.”

The study concludes that a large majority of the participants reported substantial improvement in dietary intake and a meaningful percentage lost weight and maintained weight loss. Equally important were the findings that as lifestyle and physiologic changes were similar for African American and white participants, the culturally tailored intervention has the potential to reduce both CVD risk as well as disparities in CVD rates.

Other members of the research team included Carmen D. Samuel-Hodge, Stephanie Jilcott Pitts, Beverly A. Garcia, Larry F. Johnston, Ziya Gizlice, Cassandra L. Miller, Danielle F. Braxton, Kelly R. Evenson, Janice C. Smith, Gwen B. Davis, Emmanuelle L. Quenum, Nadya T. Majette Elliott, Myron D. Gross, Katrina E. Donahue, Jacqueline R. Halladay and Alice S. Ammerman.

HPDP employee establishes community garden project

A recently established garden project at the UNC Center for Health Promotion and Disease Prevention (HPDP) and other surrounding areas acts as a haven for staff and community members to relax and meditate while exemplifying HPDP’s theme of developing healthy eating habits and sustainability.

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After construction of a new ABC store near the Center’s offices was complete, a group of employees noticed there was a lot of open ground that wasn’t being utilized by the store. Ziya Gizlice, the director of HPDP’s Biostatistical Services Unit, reached out to see if they could use these open grounds for their garden project. The ABC store gave consent, but UNC grounds services advised against it saying that land is not sanctioned UNC land and it could be dangerous considering it is underneath power lines. UNC grounds services also listed several legal issues regarding injury liability on land that isn’t sanctioned by UNC, however, they permitted the use of UNC land to establish a container garden.

Despite the setbacks, Gizlice decided to continue to pursue his original plan for the garden to be a community garden as well as a HPDP garden. He contacted local shops, apartments, and even some places in Raleigh, in order to garner support for the garden. He also spoke to employees from other UNC departments with space at the building at 1700 Martin Luther King Jr. Boulevard so that people on different floors would meet and interact with each other.

Gizlice also touched on the growing division around the world due to hate speech and international conflict. He explained that, “It will be nice to have a place where people can relax and meditate that is inclusive and unifying.”

Gizlice initially had plans of a large garden, but decided to gauge interest by establishing a smaller trial garden first. He stated that, “If you are leading something, you have to feel the pressure behind you.”

A small team of HPDP employees have brought the garden to life. HPDP employees can sign up to contribute to the garden by donating supplies, providing funds for miscellaneous small expenditures, and tending to the garden in their free time. After the produce is harvested, it goes to those who are signed up with the program. If there is leftover produce, it is distributed to other HPDP employees. The garden currently yields tomatoes, watermelon, squash, peppers, and other common fruits and vegetables that would be found in the typical backyard garden.

Gizlice’s background as an agricultural plant geneticist along with his burning passion for gardening and growing food at home motivated him to start the garden project. He claimed that, “the best local food is grown in the backyard with local resources and passion.” He also believes that gardening is a very applicable learning experience. “Appreciation comes from doing” is the mantra that he assigned to gardening as a learning experience for people who are dependent on food from others. According to Gizlice, food independence is important for health and sustainability. He defines sustainability as “stuff you can do over and over again.”

This project ties in with HPDP research areas in  Local Foods and Sustainable Agriculture. HPDP is able to promote healthy eating habits and community engagement through the implementation of community-led gardens. Another major goal of these programs is to reach out to underserved areas where fresh, healthy and cost-effective produce isn’t readily available.

In addition, these HPDP programs tie in with the 2015-2017 university-wide academic theme: Food for All. This theme encompasses many topics regarding food such as sustainable development, community health and nutrition among many others. The Food for All initiative is also comprised by many projects on campus and in the community that focus on educating people about local foods and agriculture in order to promote healthier lifestyles to people of all socioeconomic backgrounds. HPDP’s director, Dr. Alice Ammerman, co-chairs on the steering committee of the Food for All initiative. HPDP works alongside the university in the name of facilitating access to healthy produce for people in the community.

Go NAP SACC program revamps their website

The Nutrition and Physical Activity Self-Assessment for Child Care program, currently known as Go NAP SACC, recently revamped their website. Besides the updated look, the new renovations to the website also make it more compatible with mobile devices. Success stories accompanied by videos of actual program participants on the front page of the website highlight the triumphs of NAP SACC.

NAP SACC was created in 2002 as a joint effort between childhood obesity researchers at UNC-Chapel Hill and employees of the Nutrition Services branch at the North Carolina Division of Public Health. In 2005, the team received funding for a Special Interest Project through the CDC Prevention Research Center fund. Read more about the CDC grant here.

The program is rooted in perspectives of early care and education providers, families, and experts in child health and education. The NAP SACC team consolidated these perspectives into a set of best practices with current research and national standards in mind. The goal of these practices is to help early care providers make improvements in their nutrition and physical activity with the idea that healthier child-care providers leads to healthier children.