The objectives are to (1) provide a definitive test of activity space versus residential neighborhood environmental explanations for diet/physical activity (PA) variations during mid-life, (2) employ cutting-edge geographically-explicit ecological momentary assessment to address environmental mis-measurement ubiquitous in prior research, and (3) for the first time, provide evidence on activity space environmental contributions to within-person daily/momentary variations in diet/PA, and how they interact with personal trait and state factors.
This R21’s innovative approach to these outstanding questions involves performing an integrated analysis of breast cancer survivors’ serum and fecal metabolome and microbiome before and after an acupuncture intervention. The goal is to understand the effect and mechanism of acupuncture in treating the PN symptom cluster among breast cancer survivors. The specific aims are: (1) to evaluate whether a 5-week acupuncture intervention decreases the severity of the PN symptom cluster (a composite score of pain, fatigue, sleep disturbance, depression, and anxiety) among breast cancer survivors; (2) to determine whether the hypothesized decrease in the severity of the PN symptom cluster following acupuncture is associated with changes in targeted Trp-Kyn pathway metabolites; and (3) to explore associations between changes in untargeted biomarkers in the serum and fecal metabolome and gut microbiome and the changes in the PN symptom cluster.
National Institute on Minority Health and Health Disparities
Project Duration
2021-08-20 — 2026-04-30
African American population is projected to increase up to 18% by 2060 in the US and as the population increases, the deleterious effects of maternal hyperglycemia will also. Sleep disparities exist in African American pregnant women and can lead to disparities in maternal hyperglycemia and related maternal and fetal complications of pregnancy. This innovative study using individually tailored, culturally adapted intervention has the potential to advance science, reduce hyperglycemia, improve glucose metabolism, and improve maternal-fetal well-being by demonstrating the effectiveness of sleep BETTER intervention.
After a 30-year decline, heart disease is projected to increase up to 18% by 2030. Participation rates in cardiac rehabilitation remain extremely low and hopeless individuals are less likely to participate. This innovative study has the potential to advance science, improve patient care, and improve patient outcomes by demonstrating the effectiveness of the Heart Up! program to increase physical activity and reduce hopelessness in patients with heart disease.
The specific aims of the project are: AIM 1: Use a community-based participatory approach to co-design the Y-ACT implementation Toolkit to support community ownership and the training of youth facilitators, and to develop an implementation blueprint. AIM 2: Determine feasibility and acceptability of Y-ACT when carried out by youth facilitators with community members.
National Institute of Diabetes, Digestive & Kidney Disorders
Project Duration
2022-05-01 — 2027-04-30
Older adults with chronic kidney disease (CKD) present on the spectrum of Alzheimer’s Disease and Related Dementias (ADRD) approximately 10 years earlier than age and sex matched controls. The prevalence of accelerated age-related cognitive decline and dementia is remarkably high in older adults with CKD, affecting as many as 20-50%. there is a pressing need to develop non-pharmacological therapies to prevent or forestall cognitive decline in older adults with CKD at risk for ADRD. The objective of this study is to test the hypothesis that a 6-month home-based walking exercise program in 116 older adults with CKD and MCI will improve executive function, cognitive subdomains, brain white matter integrity, structure, and functional connectivity compared to attention control.
The Yurok Tribe, the largest surviving federally recognized Tribe in California, continues to endure the sequelae of a colonial invasion that perpetrated massacres and assaulted the surviving children through abductions and forcing children into indentured slavery and boarding schools. These traumas disrupted culture-based protective factors, community systems, and parenting knowledge, which increased psychosocial risk and health disparities. Today Native Americans die at higher rates than other Americans in many categories, including liver disease, diabetes, injuries, homicide, self-harm, and chronic respiratory diseases. The suicide rate for Native/Indigenous adolescents is more than double that of non-Hispanic Whites.
Our goal is to examine whether Melanated Group Midwifery Care (MGMC), a culturally-adapted, patient-centered maternity care model, attenuates the impact of structural racism on Black pregnant and postpartum women by assessing whether increased health system trust leads to enhanced patient engagement. MGMC packages four evidence-based interventions that specifically address care gaps that disproportionately impact Black women. MGMC maintains patient-provider racial concordance in a group prenatal setting with an extensive nurse case management system that actively coordinates medical referrals and wrap-around services, including in-home postpartum support. We compare MGMC to individualized prenatal and postpartum care. We hypothesize Black women assigned to MGMC will have higher health system trust that will lead to more engagement and positively affect a range of outcomes through 12 months postpartum compared to Black women receiving individualized care.
There is an urgent need for innovative approaches that support the use of Preexposure Prophylaxis (PrEP), a daily pill preventing HIV that is empowering and user-controlled. Using a participatory implementation science framework, I will test whether an adapted and community empowered group healthcare model, Centering PrEP+, is a feasible and acceptable health system intervention to improve the health of sex workers and their clients by increasing PrEP adherence.
Recurrent spontaneous preterm birth is a major public health problem. It is not known why women who have delivered prematurely are at an increased risk of another preterm birth; however, early changes in the cervix have been detected in women who deliver preterm. The process of cervical healing after delivery is poorly understood; therefore, this research will evaluate cervical changes in the postpartum period so that more can be learned about the cervix in the year after birth.
Our long-term goal is to determine why women with EDS have a higher rate of vulvodynia; and to characterize vulvodynia and EDS pain to improve and develop new treatment methods for pain reduction in these chronic illnesses. Our study aims are to 1) characterize and compare general pain (location, intensity, quality, and pattern) in all study groups and 2) characterize and compare vulvar pain (location, intensity, quality, and pattern) in all study groups.
The purpose of our study is to characterize EDS/HSD pain and vulvodynia pain; and to identify patterns in pain presentation, for example, achy, intermittently, and mild pain vs. sharp, constant, and severe pain. Our study will also examine comorbid conditions (occurring together) in EDS/HSD and vulvodynia and identify if there is a relationship between the presence of comorbid conditions and pain presentation.
The purpose of our study is to characterize EDS/HSD pain and vulvodynia pain; and to identify patterns in pain presentation, for example, achy, intermittently, and mild pain vs. sharp, constant, and severe pain. Our study will also examine comorbid conditions (occurring together) in EDS/HSD and vulvodynia and identify if there is a relationship between the presence of comorbid conditions and pain presentation.
The objective of this project is the continuation of a well-established wound care program within a Chicago-based syringe exchange. Funding is being sought to promote access to healthcare services for PWID through dispensing of basic wound care supplies and care. Approximately 20% of all clients served within our mobile and fixed clinic sites have the presence of an acute or chronic wound related.
Low health literacy (HL) negatively impacts the performance of heart failure (HF) self-care. Existing HF interventions aimed at people with low HL follow the core principle of HL universal precautions, which is to decrease the HL demand of all healthcare services (written and verbal) to minimize the risk of misunderstanding when it is unknown which patients may have low HL. While this is an important step in addressing health disparities due to low HL, it does not fully address the problem of low HL. The universal precautions approach overlooks the two-sided nature of HL by solely focusing on the health information provider. The proposed project will address this critical gap in HF self-care – HL research through the development and pilot testing of an innovative intervention designed to improve the individual’s HL while presenting essential HF self-care information following the HL universal precautions guidelines. In addition, improving HL can also increase self-efficacy, which facilitates the adoption of recommended HF self-care behaviors.
This IRSP pilot study will determine whether or not a newly developed game-based intervention has the potential to improve communication, negotiation skills, emotional regulation, and dating violence behaviors among LGBTQ+ youth and young adults. Reducing Adverse Dating Outcomes (RADOS!) is a social media simulation game focused on addressing
identity-based stress, emotional regulation, and equipping youth with skills to maintain healthy relationships.We will 1) build and translate evidence-based content into a 30-minute digital simulation game prototype. 2) the team will conduct iterative usability and feasibility testing of a 30-minute simulation prototype.
National Institute of Child Health and Human Development
Project Duration
2017-09-01 — 2024-05-31
Our goal is to demonstrate the effects of acupuncture for the pain of vulvodynia by performing the first double-blind randomized controlled trial of acupuncture as a treatment method. Evidence from this study will aid in assessing the duration of the treatment effect of acupuncture thus providing insights about need of maintenance treatment to control pain and dyspareunia. Findings will inform future studies for a pragmatic trial and translation to practice.
Patients with advanced cancer experience high levels of anxiety and depression and other barriers that affect their advance care planning discussions with their family caregivers. There have been few clinical trials focusing on resilience-building interventions for empowering patients with advanced cancer and their family caregivers to initiate advance care planning discussions and sustain engagement. This research will provide new insights into the barriers and facilitators associated with advance care planning while developing and evaluating a resilience-building intervention to improve knowledge, self-efficacy, resilience, anxiety, and depression for patients with advanced cancer and their family caregivers.
The objective of this R34 study is to examine the feasibility, acceptability, and preliminary effects of the TELL Tool intervention in a pilot randomized-controlled feasibility trial to determine intervention viability and inform a larger, efficacy trial.
National Center for Complementary and Integrative Health
Project Duration
2022-08-23 — 2025-05-31
People attending federally qualified health centers (FQHCs) typically have limited access to acupuncture, an evidence-based symptom management intervention. This study will assess the feasibility of implementing acupuncture at an FQHC to alleviate multiple symptoms experienced by breast cancer survivors during endocrine therapy. Long-term, this study is the first step toward ensuring equal access to this evidence-based intervention. Results will provide the foundation for rigorous studies to test the effectiveness of integrating acupuncture into FQHC oncology clinic to support medically underserved breast cancer survivors.