Risk factors for cardiovascular disease (CVD) disproportionately affect low income and minority populations. Lenoir County, North Carolina is among the poorest in the state and situated in the """"""""stroke belt"""""""" with significantly elevated heart disease, stroke, and obesity rates relative to state levels already well above the national average. At the same time, this county is home to many clinical and public health efforts on which to build. We propose an integrated set of three interdisciplinary studies in Lenoir County to: 1) determine genetic factors associated with CVD risk;2) understand the multilevel determinants of poor health outcomes and the potential social and community capital that can support sustainable change;3) work with community leaders, health professionals, and citizens to apply these understandings to improved practice-based management of hypertension and community-centered lifestyle management, and test the impact on improving outcomes and reducing disparities in cardiovascular health among 700 participants. This will include an innovative partnership with a nonprofit call center, Connect Inc, adding a lifestyle and medication adherence coaching component to their current focus on jobs, employment, and benefits counseling;4) test the impact, reach, adoption, and sustainability of clinical, community-level, and policy interventions , including economic development potential;and 5) develop and implement strategies for translation and dissemination of the clinic-based and community-level interventions to other underserved regions. This work will be supported by an administrative core housed in the Center for Health Promotion and Disease Prevention (a CDC funded Prevention Research Center with a focus on community-based participatory research). Additional cores include: 1) a Genomic Bioinformatics Core available to this project and other PSO programs to analyze genetic/genomic data and other pathways of interest;and 2) a Social Determinants/Economic Development/Dissemination Core to understand the interface between poverty and health, and explore strategies with the potential to create jobs while promoting health. Additional core support for data collection, community engagement, and economic development will be leveraged through the UNC CTSA (NC TraCS) and the Community-Campus Partnership for Tomorrow, which is the result of a statewide assessment led to the President of the UNC (16 campus) system to """"""""to produce a more proactively responsive University focused on meeting the challenges of the state over the next 20 years.""""""""

Public Health Relevance

Comprehensive approaches are needed to create healthier environments and stronger health care delivery systems so that individuals of all backgrounds and life situations are able to achieve and maintain cardiovascular health.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Specialized Center (P50)
Project #
5P50HL105184-04
Application #
8467031
Study Section
Special Emphasis Panel (ZCA1-SRLB-3 (J1))
Program Officer
Kaufmann, Peter G
Project Start
2010-08-15
Project End
2015-04-30
Budget Start
2013-05-01
Budget End
2014-04-30
Support Year
4
Fiscal Year
2013
Total Cost
$2,133,909
Indirect Cost
$645,575
Name
University of North Carolina Chapel Hill
Department
Nutrition
Type
Schools of Public Health
DUNS #
608195277
City
Chapel Hill
State
NC
Country
United States
Zip Code
27599
Jilcott Pitts, Stephanie B; Keyserling, Thomas C; Johnston, Larry F et al. (2017) Examining the Association between Intervention-Related Changes in Diet, Physical Activity, and Weight as Moderated by the Food and Physical Activity Environments among Rural, Southern Adults. J Acad Nutr Diet 117:1618-1627
Halladay, Jacqueline R; Donahue, Katrina E; Cené, Crystal W et al. (2017) The association of health literacy and blood pressure reduction in a cohort of patients with hypertension: The heart healthy lenoir trial. Patient Educ Couns 100:542-549
Thayer, Linden M; Pimentel, Daniela C; Smith, Janice C et al. (2017) Eating Well While Dining Out: Collaborating with Local Restaurants to Promote Heart Healthy Menu Items. Am J Health Educ 48:11-21
Cené, Crystal W; Halladay, Jacqueline R; Gizlice, Ziya et al. (2017) A multicomponent quality improvement intervention to improve blood pressure and reduce racial disparities in rural primary care practices. J Clin Hypertens (Greenwich) 19:351-360
Keyserling, Thomas C; Samuel-Hodge, Carmen D; Pitts, Stephanie Jilcott et al. (2016) A community-based lifestyle and weight loss intervention promoting a Mediterranean-style diet pattern evaluated in the stroke belt of North Carolina: the Heart Healthy Lenoir Project. BMC Public Health 16:732
Chatterjee, Avik; Daftary, Genevieve; Gatison, Lenward et al. (2016) Lessons Learned From a Partnership to Evaluate a School Food Program. Prog Community Health Partnersh 10:577-584
Cummings, Doyle M; Wu, Jia-Rong; Cene, Crystal et al. (2016) Perceived Social Standing, Medication Nonadherence, and Systolic Blood Pressure in the Rural South. J Rural Health 32:156-63
Hohl, Sarah D; Thompson, Beti; Krok-Schoen, Jessica L et al. (2016) Characterizing Community Health Workers on Research Teams: Results From the Centers for Population Health and Health Disparities. Am J Public Health 106:664-70
Thornton, Rachel L J; Glover, Crystal M; Cené, Crystal W et al. (2016) Evaluating Strategies For Reducing Health Disparities By Addressing The Social Determinants Of Health. Health Aff (Millwood) 35:1416-23
Smith, Caren E; Fullerton, Stephanie M; Dookeran, Keith A et al. (2016) Using Genetic Technologies To Reduce, Rather Than Widen, Health Disparities. Health Aff (Millwood) 35:1367-73

Showing the most recent 10 out of 20 publications