Morehouse School of Medicine/ Tuskegee University/ University of Alabama at Birmingham Comprehensive Cancer Center

Cancer Research Partnership: Community Outreach

Cancer Health Disparities Summit July 14, 2008

Healthy Lifestyles: A Community Based Nutrition and Physical Activity Behavior

Change Intervention Program

Vivian L. Carter, PhD., MHR - Primary Investigator Norma Dawkins, PhD.- Co-Primary Investigator

Barbara Howard, BA - Project Coordinator

Healthy Lifestyles Program:Aims and Goals

The specific aim of the Healthy Lifestyles Program is to develop and evaluate the effectiveness of culturally sensitive programs that will enhance a healthier lifestyle to reduce risk of cancer.

The goal of the program is to engage the community in changes on multiple levels that will be sustained beyond the scope of the MSM/TU/ UAB CCC Cancer Research Partnership Project.

Method: Healthy Lifestyles Program

Community-Based Nutrition and Cancer Awareness Research Program:

A lifestyle behavior change program specifically designed to reduce the risk of cancer among African Americans in rural black belt communities in Alabama.

The program partners with the Macon County Community Health Advisors (CHA) to develop and implement the Healthy Lifestyles Program.

Community-Based ResearchDefinition:

Research that takes place in community settings and involves community members in the design and implementation of research projects. The activities demonstrate respect for the contributions made by community partners as well as respect for the principle of "doing no harm" to the communities involved.

Purpose- To provide the community with the tools and information necessary to enact change.

Research Beneficiaries- Local community and the academic community

Knowledge Input- Community members and academic experts

Determiner of Research Topics: Members of the local community

Rationale for research methodology- Community empowerment and mutual learning

Controller of Research Process- Community members and the researcher

Owner of Research Results- Community members and the researcher

Emphasized aspect of research- Process

Source: Sociological Initiatives Foundation, The University of Washington School of Public Health and Community Medicine

Healthy Lifestyles Program Intervention Dimensions Component

The program takes a three dimensional approach to cancer risk reduction by promoting healthy eating and increased physical activity:

IndividualCommunity systems: Community organizationsAgents of Change: City Council members,

Ministers, and policy makers

Healthy Lifestyles Program Intervention Dimension: Individual

The individual level approach is aimed directly at impacting individual behavior through two areas

DietFood and Nutrition

ExercisePhysical Activity

CurvesFloor AerobicsTai ChiWalkingWater Aerobics

Healthy Lifestyle Program Intervention Dimension: Community Systems

Community systems level: To implement programs, policies, and practices to facilitate access to and utilization of beneficial programs and/or practices, and engagement in a targeted health behavior(s) or decrease engagement in a harmful behavior(s) or environment (e.g., lack of access to affordable healthy foods, creation of places to be physically active); Participants were recruited from the Network which consist of local CHAs and member of the Macon County Cancer Coalition.

Kellogg Conference Center

Healthy Lifestyle Intervention Dimension: Agent of Change

To change the agents’ of change attitudes, knowledge, and practices toward access to and utilization of beneficial programs, engagement in the targeted health behavior(s) or discontinuation of harmful behavior(s) as well as disseminate knowledge and practices among community members. To change the agents’ of change attitudes, knowledge, and practices toward access to and utilization of beneficial programs, engagement in the targeted health behavior(s) or discontinuation of harmful behavior(s) as well as disseminate knowledge and practices among community members.

Healthy Lifestyles Program Brochure

Focus Groups

Five focus groups were held with a total 34 participants from local churches, CHAs, and City of Tuskegee City Employees.

Focus Groups:Demographics

Marital Status:Single 23.8%Divorced/Separated 28.6%Married 47.6%

Education Level High School Diploma or less 33.4%Some College 19.0%College Degree 38.1%Graduate Degree 9.5%

Income bracket$25,000 or less 59.1%

91% have Insurance coverage

Focus Groups: Survey Response

72% tried to lose weight by dieting

43% had used dieting products25% had used a laxative or diuretic 34% had used diet pills

85% felt that they should lose weight

80% indicated that exercise was the best way to lose weight

76% eat fruits, vegetables and other low calorie foods

20% did not drink at least 8 glasses of water a day

36 % rated their health status as Good

Fourteen Team leaders were selected based Fourteen Team leaders were selected based upon: upon: –– their willingness to servetheir willingness to serve–– residency in Macon Countyresidency in Macon County–– no present involvement in any other research projectsno present involvement in any other research projects

August 20, 2007: First Team Leader MeetingAugust 20, 2007: First Team Leader MeetingSeptember 24, 2007: Weekly Site Physical September 24, 2007: Weekly Site Physical Fitness Visits beganFitness Visits beganOctober 18, 2007: 8 week Nutrition Education October 18, 2007: 8 week Nutrition Education Classes Classes

Healthy LifestylesTeam Leader Selections

Nutrition Education8 Week Nutrition Course

Carbohydrate/EnergyFatsFruits Vegetables and Dietary FiberVitaminsFood ChoicesCarbohydrate/EnergyFatsFruits Vegetables and Dietary FiberVitaminsFood Choices

Each nutrition section also contained information on cancer and nutrition

Certificates of completion were issued on December 06, 2008

Healthy Lifestyles Team LeadersNutrition Education

Healthy Lifestyles Program Recruitment

Team Leaders worked with Program Coordinator to recruit Community Members as program participants.

Two Healthy Lifestyles Informational Meetings: Participants were surveyed and provided with an overview of the Healthy Lifestyles Program. In addition, participants were given the Healthy Lifestyles In Tuskegee brochure which was designed for the program. From the informational meeting a list of 40 potential participants in the Healthy Lifestyles Program was constructed, from which 30 were selected.

January 22, 2008: Healthy Lifestyles Program Team Meeting began

Healthy Lifestyles Program Participants: Demographics

Marital Status:Single 19.0%Divorced/Separated 23.8%Married 47.6%Widowed 9.5%

Education LevelSome College 30.0%College Degree 30.0%Graduate Degree 25.0%

Income bracket $25,000 or less 48.1%

All have Insurance coverageMedicare 5%Blue Cross/ Blue Shield 62%Other Private Insurance 14%Combination Insurance 14%None 5%

Healthy Lifestyles Program Participants Survey:

67% tried to lose weight by dieting.

52 % used dieting products to lose weight.43% use a laxative or diuretic52% used diet pills

86% felt they should lose weight

67% indicated that exercise was the best way to lose weight

80% eat fruits, vegetables and other low calorie foods.

20% do not drink at least 8 glasses of water a day.

47% rated their health status as Good

Health Behavior

3-Month Progress Report

0

20

40

60

80

100

120

140

160

180

200 Total Group  Averages

J anuary to February 197.72 141.46 86.19 38.43 41.91 33.41

February to March 182.46 136.81 80.92 38.54 41.77 31.93

March to April 196.45 135.56 83.09 38.93 43.13 33.58

Weight (lbs ) S ys tolic  B lood 

P ressure (mmHg)

 Dias tolic  B lood P ressure (mmHg)

 Wais t Measurement 

(Inches )

 Bust Measurement 

(Inches ) BMI 

Sub-Groups:3-Month Increase/ Decrease

0.78% Increase

1.30% Increase

7.10% Increase

3.39% Increase

3.77% Increase

Water AerobicsWalkingTai Chi

Floor AerobicsCurves

6.00% Decrease

4.87% Decrease

5.82% Decrease

0.51% Decrease

Average Weight (lbs)

1.40% Decrease

3.13% Decrease

0.27% Increase

7.84% Increase

Average Bust Measurement (Inches)

0.19% Decrease

1.43% Decrease

2.28% Decrease

3.2% Increase

Average Waist Measurement (Inches)

8.31% Decrease

1.19% Decrease

8.1% Decrease

3.75% Decrease

Average Diastolic Blood Pressure (mmHg)

7.16% Decrease

6.52% Decrease

6.71% Decrease

4.46% Decrease

Average Systolic Blood Pressure (mmHg)

Community Outreach Events

Health Marathon for Cancer Awareness and Prevention

Relay for Life

Alabama Department of Public Health New Leaf Program

Summer Institute

Healthy Lifestyle Health Marathon 2007 and 2008

The Beginning of A Healthy Lifestyle