Presley Visits Primary Care Practices in the Black Belt

Caroline Presley, M.D., MPH, Forge AHEAD project principal investigator, along with Macie Craft, RN, MSN, program manager in the Division of Preventive Medicine at UAB, recently visited primary care practices in the Black Belt area as part of Presley’s project on remotely-delivered Mindfulness-Based Diabetes Education for rural adults with uncontrolled diabetes and elevated distress.

Marion Health Center

Whatley Health Services Staff in Eutaw, AL

Whatley Health Services, Inc. in Eutaw, AL

Edmund Pettus Bridge in Selma, AL

Macie Craft, RN, and Caroline Presley, M.D.

Mural in Eutaw, AL

Presley’s Research on Emotional Distress and Diabetes Management Highlighted at the ADA Scientific Sessions

At the 84th Scientific Session of the American Diabetes Association (ADA), Caroline Presley, M.D., project principal investigator at Forge AHEAD and assistant professor in Preventive Medicine at the University of Alabama at Birmingham, delivered a presentation titled “Emotional Distress and Insulin Initiation in the GRADE Trial.” Her presentation showcased findings from the Emotional Distress Substudy (EDS) of the GRADE (Glycemia Reduction Approaches in Diabetes) trial.

Key Findings from Presley’s GRADE EDS analyses:

Long-Term Study: Researchers followed 1,739 participants with Type 2 Diabetes (T2DM) over three years, checking in with them every six months. During the three-year follow-up, 525 participants were expected to start long-acting insulin and 325 participants were expected to start rapid-acting insulin after reaching Hemoglobin A1c levels of higher than 7.5%.
Insulin initiation was lower than expected: One-third of participants did not start long-acting insulin and two-thirds of participants did not start rapid-acting insulin.
Emotional Distress was not associated with insulin initiation: The study found that emotional distress, including feelings of depression and specific worries about diabetes, was not related to a person’s decision about whether to start insulin.
Support is Key: Other strategies are needed to support individuals who need to start insulin to achieve better blood glucose control; these may include demonstrations and examples about insulin use, discussion about benefits of insulin therapy, and collaborative decision-making.

Presley’s research is a collaborative effort that includes contributions from Forge AHEAD MPI Andrea L. Cherrington, M.D., MPH, a renowned expert in diabetes care. Their joint work showcases the collaborative nature of the Forge AHEAD Center, bringing together diverse expertise to tackle complex health issues.

Richard R. Rubin Lecture and Award

Presley’s presentation was part of the prestigious Richard R. Rubin Lecture. During the ADA conference, Paula M. Trief, Ph.D., received the 2024 Richard R. Rubin Award for her outstanding contributions to understanding the behavioral aspects of diabetes.

Presley’s Work at Forge AHEAD

In addition to her impactful presentation at the ADA Scientific Sessions, Presley is leading a core FAC project. Her project, “Remotely-delivered Mindfulness-Based Diabetes Education for Rural Adults with Uncontrolled Diabetes and Elevated Distress,” aims to test the feasibility and acceptability of an integrated Mindfulness-Based Stress Reduction (MBSR) and Diabetes Self-Management Education (DSME) program.

MBSR has been adapted to focus conditions, including hypertension and prediabetes, with a focus on relating mindfulness to specific behaviors or behavior change activities. However, few research studies have focused on rural populations with limited access to DSME. By combining MBSR and DSME, the project aims to help participants manage both their diabetes and their stress, improving their overall health and well-being.

Caroline Presley, M.D., MPH

Assistant Professor, Division of Preventive Medicine, UAB Heersink School of Medicine

Learn more about Presley.

Type 2 Diabetes and Emotional Distress

Adults living with type 2 diabetes who are experiencing emotional distress, including feelings of depression and specific worries about diabetes, may experience poor health outcomes compared to those not experiencing emotional distress.
Source

Presley presenting at the ADA Scientific Sessions.

Project Highlights:

Primary Aim: To evaluate how well this new approach works for rural Black adults with Type 2 Diabetes who also experience high levels of distress.
Study Locations: The program is being tested at Federally Qualified Health Centers in Alabama’s Black Belt region.
Participants: The study will enroll 80 Black adults with Type 2 Diabetes, high blood sugar levels (hemoglobin A1c of 8.0% or higher), and high levels of stress related to diabetes.
Community Partners: The Alabama Primary Health Care Association is helping to support and implement the study.
Outcome Measures: Researchers are looking at how practical and acceptable the program is, with evaluations at the beginning and six months into the study.

The Forge AHEAD Center is at the forefront of advancing health equity through innovative research and community engagement. Presley’s work at the ADA Scientific Sessions and her ongoing projects exemplify our commitment to improving health outcomes in underserved communities.

To learn more Presley’s impactful research on remotely-delivered diabetes education and support, and to get involved, visit her project page here. Together, we can forge ahead towards a healthier, more equitable future.

What are MBSR and DSME?

Mindfulness-Based Stress Reduction (MBSR): This program teaches mindfulness meditation, helping people focus on the present moment. It reduces stress by making them more aware of their thoughts and feelings without getting overwhelmed. Source
Diabetes Self-Management Education (DSME): This ongoing program helps people with diabetes learn how to take care of themselves. It teaches important skills like checking blood sugar, eating healthy, staying active, taking medicine the right way, and avoiding problems. Source

Ellison presented with George Bray Obesity Research Student Award at Nutrition 2024 Conference

Katie M. Ellison, MS, a doctoral student at UAB and mentee of FAC Core Project PI Drew Sayer, Ph.D., has received the prestigious George Bray Obesity Research Student Award at the Nutrition 2024 Conference in Chicago, where she presented her research on behavioral interventions in obesity treatment. Join us in congratulating Katie on this remarkable achievement. Read more about her achievement here.

Katie Ellison pictured in front of her project poster at Nutrition2024 conference

Katie Ellison speaking during Nutrition2024 conference

Katie Ellison with FAC project PI Drew Sayer, Ph.D., at Nutrition2024 conference

Katie Ellison with colleagues Chelsi Reynolds and Kiu Chui, along with FAC project PI Drew Sayer, Ph.D., at Nutrition2024 conference

Katie Ellison with colleagues Leandra Durham and Kiu Chui at Nutrition2024 conference

From WNBA Dreams to Changing Lives: On A Mission to Promote Physical Activity

As a child, Amber W. Kinsey, Ph.D., dreamed of playing professional basketball in the Women’s National Basketball Association (WNBA). While her path led her elsewhere, her passion for sports ignited a lifelong mission to transform lives through physical activity and exercise.

Kinsey at a Las Vegas Aces WNBA game.

Now an assistant professor in the Division of Preventive Medicine at the University of Alabama at Birmingham (UAB), Kinsey focuses her research on optimizing lifestyle interventions for cardiometabolic health among priority populations. Kinsey defines priority populations as “groups that are experiencing health disparities, underrepresented in research, and/or experiencing worse outcomes in response to interventions.”

At a recent UAB Preventive Medicine Grand Rounds presentation, Kinsey shared strategies for promoting physical activity among these populations. Her mission: To use physical activity and exercise as tools to empower others.

Amber W. Kinsey, Ph.D.

Assistant Professor, Division of Preventive Medicine, UAB Heersink School of Medicine

Learn more about Kinsey.

What are Priority Populations?

Kinsey defines priority populations as “groups that are experiencing health disparities, underrepresented in research, and/or experiencing worse outcomes in response to interventions”.

“Not everyone has access to physical activity opportunities. We must consider the broader context – where people live, work, play, and other factors beyond one’s control – to understand what contributes to an active lifestyle.”

Understanding the Bigger Picture

“Not everyone has access to physical activity opportunities,” Kinsey said. “We must consider the broader context – where people live, work, play, and other factors beyond one’s control – to understand what contributes to an active lifestyle.”

While acknowledging the importance of addressing root causes of inactivity, Kinsey emphasizes that “to truly change health statistics, we need to focus on changing behaviors.”

Learning from Success Models

“In every community, there are some individuals who manage to maintain good health practices despite challenging circumstances,” Kinsey said. “Learning more about their strategies for success and using that information to develop programs may allow us to better help others facing similar challenges.” Some of her work on this topic can be found here.

Exercise Snacks

One of Kinsey’s creative strategies involves “exercise snacks” – brief bursts of activity lasting up to five minutes. These can include taking the stairs, doing jumping jacks, or performing bodyweight squats.

“Finding opportunities to move throughout the day is a great way to be more active,” Kinsey said. “While this concept isn’t new, framing it as ‘exercise snacks’ makes it fun and digestible – pun intended!”

A Gateway to Accessible Exercise

Kinsey is also reimagining traditional approaches to physical activity promotion. “For some health outcomes, consistent resistance training twice a week can be as effective as three to five days of aerobic exercise,” she noted. She goes on to say that “resistance training may be a good first step to getting people active”. “Some data suggests that priority populations prefer resistance training over cardio and may even experience better outcomes with resistance training for some health measures”, said Kinsey.

Her two Forge AHEAD Center projects aim to make resistance training more accessible for priority populations.

Meeting People Where They Are

Kinsey’s work spans exercise science, behavioral medicine, and public health research. “We know physical activity and exercise are effective for improving health and wellbeing,” she said. “We need to figure out effective ways to help people stay active in ways that fit their unique lifestyle and circumstances.”

While she may not be competing in the WNBA, Kinsey is undoubtedly making significant strides towards improving public health, one exercise snack at a time.

Learn more about both of Kinsey’s Forge AHEAD Projects, OVERCOME-IT and an integrated cardiometabolic intervention, as well as her other research at UAB.

Kinsey’s Forge AHEAD Projects:

“For some health outcomes, consistent resistance training twice a week can be as effective as three to five days of aerobic exercise,”

What are Exercise Snacks?

Kinsey defines exercise snacks as brief bursts of physical activity lasting up to five minutes that can be incorporated throughout the day.

Kinsey putting up some shots after completing her resistance training workout at the gym.

Xie Aims to Bridge Gap Between Science and Community Health

In a region grappling with persistent health disparities, Rongbing Xie, DrPH, MPH, a scholar at the Forge AHEAD Center, is working to bring academic studies closer to the communities they aim to serve. Xie recently participated in the 2024 Community Engaged Research Summer Institute, hosted by the Mississippi Center for Clinical and Translational Research (MCCTR) at the University of Southern Mississippi, designed to enhance community engagement in health research.

The institute provided Xie with new perspectives on conducting impactful research.

From Academia to Action

Xie anticipates her experience and skills gained through the Summer Institute will significantly influence her current research. Specifically, she will be able to “develop more effective strategies for recruiting and retaining participants, particularly among underserved populations.”

At the institute, Xie and her fellow scholars engaged in hands-on community research practices. She plans to incorporate these strategies into her future work, including focus groups and community advisory boards.

“I plan to adopt the comprehensive community engagement strategies learned during the institute to ensure that community voices are heard and incorporated at every stage of my research projects,” she explained. “This includes conducting focus groups, community advisory boards and regular feedback sessions.”

The Power of Mentorship

Xie’s experience was enriched by mentorship from experts like Forge AHEAD Community Engagement Core lead Caroline Compretta, Ph.D.

“Working with Dr. Caroline Compretta during the MCCTR Summer Institute has been an eye-opening experience,” Xie said. “Her expertise in community engagement and outreach has significantly influenced my approach to involving communities in my research.”

This mentorship reinforced for Xie the importance of community partnerships in research.

Rongbing Xie, DrPh, MPH

Assistant Professor, Department of Surgery, UAB Heersink School of Medicine

Learn more about Xie.

“The most valuable lesson I took away from the institute is the critical importance of integrating community perspectives into every phase of the research process.”

A Lesson for Life

As the institute drew to a close, Xie carried with her a profound realization: the community isn’t just the subject of research – they’re partners in the journey to better health.

“The most valuable lesson I took away from the institute is the critical importance of integrating community perspectives into every phase of the research process,” she explains. “This approach not only enhances the relevance and impact of the research but also fosters trust and cooperation between researchers and community members.”

Why This Matters

Xie’s experience at the Summer Institute has implications far beyond her individual research. The health challenges she’s addressing – obesity, diabetes, and high blood pressure – affect communities across America, with some groups disproportionately impacted.

By fostering stronger connections between researchers and communities, initiatives like the MCCTR Summer Institute aim to create more effective, culturally sensitive interventions. This approach could lead to improved health outcomes and a reduction in long-standing health inequities.

A Call to Action

Xie’s journey highlights the need for collaboration between researchers, community leaders, and citizens in tackling public health challenges. As she returns to her work with her Forge AHEAD projects, her experience serves as a reminder of the potential for academic research to drive meaningful change when rooted in community engagement.

Xie’s Forge AHEAD Projects:

What is Community-Based Participatory Research?

Community-Based Participatory Research (CBPR) is a collaborative approach that combines knowledge and action to improve community health and reduce disparities.

Key Features:

Equal Partnership: Community members and researchers share power and responsibility throughout the research process.
Cultural Relevance: Methods and interventions are tailored to fit the cultural context of the community.
Community Focused: Research addresses issues important to the community.
Empowerment: Builds on community strengths and resources.
Action and Change: Uses results to promote social change and improve health.
Sustainability: Aims for long-term benefits and lasting relationships.

CBPR makes research more ethical, relevant, and beneficial by actively involving communities and addressing their specific needs.

For more information, refer to the article “Community-based Participatory Research (CBPR): Towards Equitable Involvement of Community in Psychology Research” published in American Psychologist.

2024 Community Engaged Research Summer Institute Participants

Xie presenting one of her Forge AHEAD projects at the Summer Institute