I have been working in the field of exercise physiology and nutrition since 1998, beginning with a clinical focus in cardiac and pulmonary rehabilitation and later working in clinical intervention research. For the subsequent seven years, while completing graduate school, I transitioned to community-based research and public health dissemination projects. I have a deep passion and commitment to this field and to working with underserved populations; part of this work has involved training and supporting more than 2,500 leaders nationally to implement community physical activity and nutrition programs targeted to midlife and older rural women. Currently, I am a staff scientist and project director at the Fred Hutchinson Cancer Research Center and a postdoctoral fellow in women's health and aging at the Group Health Research Institute. For this career development award, I am fortunate to have support of leading experts from top-tier research institutions- serving as mentor, co-mentor, and advisors. The main components of my training will include gaining expertise in spatial analysis, GIS, and built environment assessment; community-based participatory research; advanced quantitative methods; and conduct of responsible research. The training activities are directly related to my research plan, which aims to gain understanding about long-term health behavior maintenance. We know that maintenance of physical activity and healthy eating is essential to maintain weight loss and reduce risk for cardiovascular disease (CVD), yet there are limited data identifying key factors that support the behaviors long-term. Research also shows that the food and physical activity environments in which people live affect health behaviors related to CVD. StrongWomen Healthy Hearts (SWHH) is a 12-week community-based program targeted to midlife and older rural women that has demonstrated effectiveness in increasing physical activity, improving diet quality, and decreasing body weight. The SWHH Program has funding from the CDC to evaluate its dissemination nationally. For my research, I will conduct a follow-up survey with SWHH participants and leaders examining factors related to behavior maintenance one year following implementation. I will also develop, implement, and evaluate built environment assessment tools with SWHH community partners. Collectively, these data will inform a comprehensive model of personal, social, and built environment factors related to long-term maintenance of healthy eating and physical activity. I plan to submit a subsequent R01 to follow this cohort over time as part of my ongoing research program. My long-term objectives are to establish myself as an independent investigator and a leader in the field, focusing on theory-driven, community-based physical activity and nutrition research targeting the prevention of CVD and other chronic diseases in underserved populations, and strategies to advance practice and policy related to the effects of food access, built environment, and socioeconomic factors on health. I will share this knowledge through excellence in mentorship, translational and participatory research, and engaged service. The training, mentorship, and research for this award will greatly advance my path to achieve these objectives.
Heart disease is the leading cause of death among women in the U.S., with increased risk among rural, low-income, and minority populations - yet it is largely preventable with adherence to healthy lifestyle behaviors. This work establishes the StrongWomen Healthy Hearts (SWHH) follow-up study to gain understanding about key factors that are related to the long-term maintenance of healthy eating and physical activity behaviors among midlife and older rural women, which will help identify evidence-based intervention strategies to support sustainable lifestyle changes. Additionally, this project will develop, implement, and evaluate physical activity and nutrition built environment assessment tools that community members and scientific investigators can utilize to advance this work with other high-risk populations in the future.
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