The Center for Health Promotion and Disease Prevention (HPDP) at the University of North Carolina at Chapel Hill has received a five-year competitive renewal grant from the Centers for Disease Control and Prevention (CDC). The grant will strengthen HPDP’s infrastructure supporting a broad range of community engaged prevention research addressing health disparities. The Center’s core research project will address the challenge of scaling up Diabetes Self-Management Education and Support (DSMES) programs more equitably to those at highest risk, including people of color, people with lower incomes, and those living in rural areas. With this grant, HPDP will maintain its standing as a CDC Prevention Research Center (PRC), the only center in the country to have been continuously funded since 1986.
“As the CDC funded state health department agency for diabetes education, management and prevention, the Community and Clinical Connections for Prevention and Health (CCCPH) Branch is excited that HPDP will continue to be the CDC Prevention Research Center in NC,” said Tish Singletary, head of the CCCPH branch at the North Carolina Department of Health and Human Services. “We are looking forward to the continued partnership and collaboration necessary to reduce the physical, emotional and financial burden of those living with diabetes; particularly those at highest risk.”
Diabetes affects more than 37 million people in the United States. North Carolina and other states in the southeastern U.S. are located within the “Diabetes Belt”—a geographic region where the risk of diabetes, as well as other health conditions such as stroke and heart disease, is much higher. Within this area, American Indian, African American, and Hispanic/Latino subgroups, as well as residents of rural areas and people making lower incomes, face the greatest burden from diabetes. The total cost of diagnosed diabetes continues to rise, including indirect costs due to increased absenteeism, reduced job productivity, and inability to work due to diabetes-related disability. Moreover, rural counties in NC have limited access to many resources and services that show promise in managing diabetes.
DSMES programs have resulted in positive outcomes related to diabetes. However, these programs often fail to reach those who are most burdened by this disease. Over the next five years, HPDP will conduct research to understand how to implement DSMES more equitably working with those at highest risk. This research will be led by co-principal investigators, Dr. Carmen Samuel-Hodge, associate professor of nutrition, and Dr. Adam Zolotor, professor of family medicine. Among our targeted population at high risk of diabetes, recruitment of participants who identify as American Indians will be led by co-investigator, Dr. Ronny Bell, professor of pharmacy. Dr. Bell is a member of the Lumbee tribe and has prior experience conducting diabetes research in this population; he will work in collaboration with staff from the UNC American Indian Center to assist with recruitment efforts.
Systems science methods will be used to identify and understand barriers to DSMES uptake among populations most impacted by diabetes. Additionally, the team will use implementation science models to identify efficient methods to broadly implement DSMES programs to improve dissemination and address health disparities. Drs. Kristen Hassmiller Lich, associate professor of health policy and management, and Meghan O’Leary, post-doctoral research associate of health policy and management, will lead the systems mapping team. Drs. Chris Shea, co-investigator and professor of health policy and management, and Jennifer Leeman, PRC scientific expert and associate dean for research and professor of nursing, will lead the implementation science team.
“I am excited to bring my past expertise with intervention research to promote healthy lifestyle behaviors among African American, rural, and low-income populations to this core research project,” said Samuel-Hodge, who also served as co-principal investigator for HPDP’s 2019–2024 core research project, the Med-South Lifestyle Program. “I believe our team is well positioned to work closely with community partners to culturally adapt DSMES materials and improve communities’ access to diabetes management and support.”
In addition to funding this core research project to expand DSMES, this grant renews HPDP’s status as a CDC Prevention Research Center. As a Prevention Research Center, HPDP offers a wide range of services to researchers and national, state, and local partners. An interdisciplinary group of HPDP faculty and staff lead the Center’s core services, which include:
- Training & Technical Assistance Core: Led by Dr. Jessica Soldavini, assistant professor of nutrition, this Core trains students, faculty, community members, and health practitioners to create and implement innovative ways to overcome public health challenges.
- Community Engagement & Partnerships Core: Co-led by Dr. Alexandra Lightfoot, associate professor of health behavior, and Melvin Jackson, longtime community partner, this Core helps to build, foster, strengthen, and sustain partnerships between researchers and communities.
- Evaluation Core: Samuel-Hodge leads the Evaluation Core, which develops and tracks performance indicators and uses evaluation results to help the Center refine its research, communication/dissemination, and training activities. This core also assists national, state, and local partners with evaluation projects.
- Dissemination & Translation Core: Dr. Tracy Wesley and Lindy Draeger co-lead the Dissemination & Translation Core which helps HPDP researchers and collaborators share evidence-based interventions and best practices with clinical, public health, and community-based partners in North Carolina and nationwide.
Continued CDC funding provides resources that HPDP leverages to support a wide range of prevention research including cardiovascular health, cancer prevention and control, health equity, and children’s health.
“HPDP supports more than 25 projects that advance a broad base of prevention research,” said Dr. Alice Ammerman, Mildred Kaufman Distinguished Professor of nutrition, who will continue as director of HPDP. “We are honored to serve North Carolinians by working with our community partners to prevent chronic disease, especially among historically underrepresented communities. Our continued status as a CDC Prevention Research Center allows us to advance, scale up, and learn from this work for another five years.”