Dr. Dana Carthron — When you know better, you do better: Diabetes self-management among African American adults

Among ethnic groups in the United States, African Americans continue to be among those with notably low life expectancy and high overall rates of chronic illness, including diabetes. It is well documented that diabetes self-management decreases the severity of symptoms, slows the progression of disease trajectory and increases quality of life. However, socio-economic factors and the stress of structural racism continue to strongly influence health equity and disease disparities which, in turn, may interfere with self-management. While interventions focused on clinical targets have reduced overall disease burden, they have failed to eliminate racial and geographic disparities in diabetes. To that end, there is an urgent need for sustainable interventions devoted to increasing health equity and the self-management of diabetes in African Americans. Today’s webinar will highlight the successes and challenges of a program of research dedicated to the self-management of diabetes among African Americans — including recruitment and retention — as well as discuss next steps in practice and research.

What can implementation research tell us about equitable interventions for diabetes and related chronic disease prevention in community settings? A Review of Lessons Learned

The limited success in the prevention of diabetes and other chronic diseases and the related efforts to achieve health equity reflects a lack of knowledge about which programs and policies can effectively reach underserved racial/ethnic minority and low-resource populations. Implementation of programs and policies outside of health care settings (i.e., in community settings such as schools and childcare centers, worksites, social service organizations, and religious organizations) has high potential in this respect. However, unique challenges arise from the fact that primary missions, capacity, cultures, and values in such settings are not centered on physical health or health services delivery. This webinar will present a review of implementation research in community settings and highlight lessons learned to guide future research and practice in diverse settings and geographies.

Multilevel Contexts of Weight Gain During the Childbearing Window: Exploring the Multidimensional Role of Neighborhood Environment on Intervention Effectiveness

Racial disparities in weight status during the childbearing window have long-lasting implications for racial disparities in obesity over the life course. Neighborhood context is a key multilevel determinant of maternal weight status during and after childbearing. However, the multidimensional nature of neighborhood contexts is often not captured in a comprehensive way. Doing so would facilitate a more complex understanding of how neighborhoods impact on health beyond simple additive accumulations of individual factors across the social, physical, and built environment. It can also improve insight into how neighborhoods can be leveraged to enhance the effectiveness of interventions targeting maternal weight status. This talk will explore insights from my research using composite measures of neighborhood opportunity access in relation to racial/ethnic disparities in key weight-related maternal health outcomes, including gestational weight gain and postpartum weight retention. The talk will conclude by proposing systems-based methods as a next step in continuing to capture the complex and dynamic aspects of neighborhood context in ways that can facilitate translation of evidence into action to improve Black maternal health.

Bridge to Health/Puente a la Salud: Addressing Diabetes Self-Management and Social Needs among Racial/Ethnic Minority and Low-Income Patients

Racial/ethnic and socioeconomic disparities in diabetes-related outcomes persist. There is a need for effective interventions that facilitate diabetes self-management while also acknowledging the social context in which patients are trying to self-manage. We will present results from our NIDDK-funded two-year randomized pilot trial, Bridge to Health/Puente a la Salud, as well as lessons learned.

Will Telehealth Lessen or Widen the Gap in Black-White Disparities: New questions for translational research in diabetes control

The COVID-19 pandemic has rapidly expanded the use of telemedicine, remote diagnosis and treatment of patients using telecommunication technology, for care delivery. Telemedicine has appeared especially promising in the management of chronic diseases, such as type II diabetes mellitus (T2DM), which require consistent monitoring and adjustment to be optimally controlled. This webinar will provide a review of the current state of knowledge regarding the impact of telemedicine on diabetes outcomes and on disparities in diabetes care, identify the current gaps in knowledge with regard to delivery of diabetes care via telemedicine, and discuss barriers to telemedicine that can exacerbate known disparities in diabetes outcomes. Dr. Batch will conclude by discussing opportunities for future research that can inform clinical care and reduce disparities in diabetes.

Dr. Rebecca Hasson — Successful translation of a school-based physical activity program before and during COVID-19 pandemic

Despite increased funding allocated for health and physical education (PE) programs through Every Student Succeeds Act, disparities in school-based physical activity programming persist with low-resource schools less likely to offer recess, have a certified PE teacher, or provide after-school sports programming, compared to higher-resource schools. Classroom-based physical activity interventions hold great potential for reducing physical activity disparities at school by providing children with 19 minutes of in-class activity every day (approximately two-thirds of the school-based recommendation of 30 minutes). Yet, low rates of treatment fidelity (the extent to which an intervention is delivered as conceived and planned) have been observed in low-resource schools, resulting in children accumulating less than 5 minutes of daily in-class activity. There is a critical need to develop classroom-based physical activity interventions that are tailored to context, to maximize fidelity and motivate behavior change in students toward increased activity levels. In the absence of such tailored programs, classroom-based interventions have the potential to perpetuate existing disparities in physical activity participation among low-income children. This webinar highlights the successes of a school-based physical activity program tailored for implementation in low-resource settings and how this same program was adapted for dissemination in the home environment during the COVID-19 pandemic.

Dr. Cotwright — It’s a Family Affair: Promoting Healthy Beverage Consumption among Black Youth in Early Childhood

One major contributor to excess weight gain is the high intake of sugar-sweetened beverages (SSBs). Increasing access to water and other healthy beverages is one viable strategy to reduce excess weight gain. Nationally, in 2012, 26% of adults reported consuming sugar-sweetened beverages (e.g., regular soda, fruit drinks, or both) ≥1 times daily. In 2014, consumption of SSBs at least once per day was highest among Black American adults aged 20-39 (77%), those of parenting age. Black youth have significantly higher total beverage consumption from soft drinks (30%) as compared with other children (as low as 9%). For all of these reasons, promoting healthy beverages throughout childhood and adolescence is a public health concern. This webinar aims to describe the national recommendations and resources for healthy beverage consumption among Black youth. Participants will: understand the effects on sugar-sweetened beverages on the health of Black youth, identify best practice recommendations to promote healthy beverages to Black youth, identify credible sources of information to promote healthy beverage consumption, and assess alternatives to sugar-sweetened beverages to consume healthy beverages.

Dr. Alhassan — Teacher-led physical activity intervention in low income preschool-age children: Lessons learned

Preschool-age children from low socioeconomic environments tend to have low physical activity levels. In the US, approximately 61% of preschool-age children spend most of their day in non-parental childcare settings such as preschool centers, making this an ideal setting to intervene on their physical activity levels. A significant proportion of physical activity interventions targeting preschool centers have been stand-alone programs and have been implemented by trained external staff, which is not a viable model. For a physical activity program to be viable and sustainable, the program must be integrated into the preschool day and implemented by preschool teachers. This presentation will describe the characteristics of successful preschool-based physical activity interventions. The majority of the presentation will focus on lessons learned from implementing teacher-led physical activity interventions in preschool-age children from low socioeconomic environments.

Dr. Barr-Anderson — The Potential of Yoga to Impact the Health of Black Women

African-American women are disproportionately affected with a sedentary lifestyle, high body weight, and increased risk for stress-related chronic diseases. Yoga can be an effective strategy to address adverse health outcomes by decreasing sedentary behavior and stress; however little research has been conducted to explore its effect in African-American women. This presentation will review the existing literature on the benefits of yoga and explore the potential of yoga to address health outcomes in African-American women.

Dr. Singleton — Expanding Healthy Food Retail in Black Communities

Dr. Singleton will present current evidence on the feasibility and acceptability of several local and national strategies to expand healthy food retail in low-income black communities. Furthermore, she will discuss findings from studies that evaluated the impact of these strategies on healthy food availability, food purchasing behavior, diet, and health. Dr. Singleton is an assistant professor of community health at the University of Illinois at Urbana-Champaign. Her research examines relationships between healthy food retail, food purchasing, and dietary intake in low-income communities.

Dr. Haire-Joshu — Addressing Weight Gain in Women of Childbearing Age

Young adulthood is a period of high risk for excessive weight gain and development of obesity due to pregnancy and postpartum weight retention. Women often face multiple responsibilities which prevent their participation in lifestyle interventions, increasing health inequities among women of color that contribute to obesity disparities. This presentation will describe lessons learned from a longstanding academic research partnership with a national home visiting organization that offers a model for reaching women and achieving real world lifestyle change.