Beyond the Holiday Table: Four Community-Informed Projects Advancing HIV Research and Wellness in the Deep South

December is a time to pause, reflect, and renew our commitment to one another. As HIV/AIDS Awareness Month, it calls attention to the progress made in HIV research while underscoring the work still needed to support individuals and communities across the Deep South. This season reminds us that caring for our communities extends beyond the holiday table. It means working toward health, hope, and connection for everyone.

As families gather and reflect, it’s important to remember that many people in our communities still face serious health challenges. For many families, HIV exists alongside other ongoing health and social challenges, including diabetes, heart disease, and limited access to stable housing or care. These overlapping barriers shape everyday experiences and require solutions that are grounded in community realities, not isolated conditions. By working together, we can begin to close these gaps and build healthier, stronger communities.

The Forge AHEAD Center supports early-stage investigators (ESIs) whose research reimagines HIV care by integrating community partnerships, behavioral health, and system-level interventions to address real-world needs.

Together, these four featured projects show what it looks like to care boldly, listen deeply, and build lasting systems of health, not just during the holidays, but all year long.

Four Paths to Better Health and Connection

Peer MODELS: Supporting HIV, Diabetes, and Pain Management Through Peer Mentorship

HIV has become a chronic condition often accompanied by other challenges such as diabetes and chronic pain. Studies estimate that 10%-15% of people living with HIV in the U.S. also have diabetes, and up to 85% report living with chronic pain, depending on the population studied. Yet few interventions consider the lived experience of managing these overlapping conditions and how treatment, symptoms, and daily life overlap.

Dr. Kristen Allen-Watts’ Peer MODELS project—short for “Managing a COmmunity-based HIV, Diabetes, and pain intervention that Encourages healthy Living and provides Support”—aims to fill this gap. Grounded in social cognitive theory, the project explores participants’ confidence in managing all three conditions, the strategies they develop over time, their sources of motivation, and barriers to care. It also examines experiences with peer support and invites participants to envision what an ideal program would look like and identify the resources and services that would make managing complex health needs more achievable.

“Peer support offers encouragement, resources, and tips that help people living with HIV and diabetes stay on track with their health goals. It fosters a sense of belonging and reduces isolation, which is especially meaningful during the holiday season when connection matters most,” Dr. Allen-Watts said.

Conducted in collaboration with the UAB 1917 Clinic and UAB RISC, the project uses in-depth interviews to capture how people manage overlapping conditions and what support they need most. As the holiday season brings both joy and stress, Peer MODELS highlights how care delivered through connection can be a powerful tool for healing.

Kristen Allen-Watts, Ph.D.

Assistant Professor, Division of General Internal Medicine and Population Science, UAB Heersink School of Medicine

Learn more about Allen-Watts.

— Kristen Allen-Watts, Ph.D.

Stable Housing as a Foundation for HIV and Cardiometabolic Health

A safe, stable home is essential for health—but for many people living with HIV, housing instability remains a barrier to consistent care. Dr. Donny Gerke’s project investigates how participation in housing programs, particularly the Housing Opportunities for Persons with AIDS (HOPWA) program at AIDS Alabama, affects both HIV outcomes and cardiometabolic health.

Despite major treatment advances, people living with HIV remain at high risk for conditions like hypertension and diabetes—risks that worsen with unstable housing. Dr. Gerke’s study combines electronic health record (EHR) data with in-depth interviews to evaluate how HOPWA-supported housing influences outcomes such as viral suppression, medication adherence, and engagement in care.

Conducted in collaboration with AIDS Alabama and the UAB 1917 Clinic, the project explores how housing interventions also offer consistent support and help build trust between individuals and service providers.

During a season when home and stability take on deeper meaning, this research reminds us that meeting basic needs must come first—and that sustainable health starts with a place to live.

“Access to stable, affordable, safe housing provides a necessary foundation for healthcare access and engagement in health-promoting behaviors. It is difficult to remember to take your medication or get to your doctor’s appointments if you are constantly worried about where you will sleep…,” Dr. Gerke said.

Donny Gerke, Ph.D.

Assistant Professor, Department of Social Work, UAB College of Arts and Sciences

Learn more about Gerke.

— Donny Gerke, Ph.D.

Urgent Care as a Gateway for HIV Prevention

Pre-exposure prophylaxis (PrEP) is a powerful HIV prevention tool—yet far too many people in the Deep South, especially Black and Hispanic individuals, still face high rates of new HIV diagnoses and low rates of access to PrEP. That’s the gap Dr. Matt Gravett’s work seeks to close through urgent care clinics (UCCs) that could serve as trusted, approachable, and accessible settings for PrEP delivery.

Dr. Gravett’s project centers on a key question: What if urgent care clinics—where many people already go for STI testing or acute needs—also became reliable access points for PrEP? While primary care providers may be stretched thin and HIV specialty clinics may not be geographically or easily accessible for many, UCCs may offer an overlooked opportunity to meet people where they are, without judgment or delay.

“Our efforts to expand PrEP access… Putting PrEP in more convenient spaces can improve access without extra burden on community members. Our partners at UAB Urgent Care and Cooper Green Health Services Urgent Care have been especially rewarding.” Gravett said.

During the holidays—when schedules shift and routines break down—this model offers a promising way to reach people with prevention services when and where they need them most.

Ronnie "Matt" Gravett, M.D.

Assistant Professor, Division of Infectious Diseases, UAB Heersink School of Medicine

Learn more about Gravett.

“Putting PrEP in more convenient spaces can improve access without extra burden on community members. Our partners at UAB Urgent Care and Cooper Green Health Services Urgent Care have been especially rewarding.”

— Matt Gravett, M.D.

Engaging Black Women with HIV in Research for Cardiometabolic Wellness

Black women living with HIV face layered health challenges, including higher risks of cardiometabolic and cardiovascular diseases such as hypertension, diabetes, obesity, heart failure, and stroke. Despite the well-documented benefits of physical activity—including high-intensity interval training (HIIT)—most Black women with HIV are not meeting recommended exercise levels.

Using the theoretical domains framework (TDF), Xie’s team is conducting focus groups at UAB and UMMC to explore how caregiving demands, transportation access, and experiences of judgment affect participation in wellness research.

“For people living with HIV, social determinants… These factors often impact dietary quality significantly,” Xie said.

This research offers more than an intervention—it offers a roadmap for making cardiometabolic health promotion more accessible and grounded in lived experience. As holiday routines grow more complex, the project reinforces that achieving health means co-designing solutions and conducting research that meets people where they are.

Rongbing "Bing" Xie, DrPH

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

Learn more about Xie.

“For people living with HIV, social determinants… These factors often impact dietary quality significantly.”

— Rongbing Xie, DrPH

These four projects reflect a shared vision: that health isn’t just a matter of medicine—it is trust, support, and understanding the everyday challenges people face. Whether through peer mentorship, housing stability, exercise programs, or accessible PrEP pathways, these investigators are expanding the definition of HIV care to include the whole person and the whole community.

Their work models the next generation of HIV research: rooted in lived experience, strengthened by community, and designed for long-term impact. Each project reminds us that healing begins with listening.

This Holiday Season, Join Us in Honoring HIV/AIDS Awareness Month

Support local programs. Connect with organizations offering HIV prevention, testing, housing, or peer support. Visit HIV.gov – Find Services.

Give back. Volunteer, donate to HIV service organizations, or share educational resources. Small actions reduce stigma and spread awareness.

Start the conversation. Talk with loved ones about screenings, testing, and prevention tools such as PrEP.

Stay informed. Learn how the Forge AHEAD Center is partnering across Alabama, Mississippi, and Louisiana to expand access to care.

Written by: April Agne, MPH

Staying Healthy Through the Holidays: Alabama Researchers Lead Community-Driven Diabetes Solutions

The holiday season is a time of celebration, filled with food, family, travel and traditions. But for many people, it can also mean disrupted routines, more time sitting, and eating habits that vary from usual.

Even for those who don’t have a chronic condition like diabetes, this time of year can make it harder to stay healthy. And for those who do, it becomes even more important to keep track of medications, maintain physical activity, and make intentional choices about meals.

“For communities already facing higher rates of diabetes and limited access to care, the holiday season can widen existing health gaps,” shares Joshua Lee, Ph.D., a Forge AHEAD scholar and researcher at the University of Alabama at Birmingham. “Rich foods, travel, and stress can make blood sugar control more difficult. Maintaining medication routines, thoughtful eating, and regular activity is key to avoiding complications. Supporting these habits during the holidays helps prevent setbacks and reduces the need for urgent care. It’s also a good time to stay connected with community resources, like local clinics or community health workers, who can help bridge gaps and keep patients engaged in their care.”

“For communities already facing higher rates of diabetes and limited access to care, the holiday season can widen existing health gaps,” shares Joshua Lee, Ph.D., a Forge AHEAD scholar and researcher at the University of Alabama at Birmingham. “Rich foods, travel, and stress can make blood sugar control more difficult. Maintaining medication routines, thoughtful eating, and regular activity is key to avoiding complications. Supporting these habits during the holidays helps to stay healthy and reduces the need for urgent care. It’s also a good time to stay connected with community resources, like local clinics or community health workers, who can help bridge gaps and keep patients engaged in their care.”

Across Alabama, Forge AHEAD scholars are exploring approaches that may help communities make small, realistic changes to support better health during the holidays. Their ongoing projects focus on early risk detection, peer-based education, and improved medication systems that could support healthier choices during this time of year.

Healthy routines often slip during the holidays

This time of year brings joy, but also challenges. Regular movement slows down. Meals tend to be heavier and more frequent. Travel or shifting schedules can make it easy to skip a dose of medication or forget to refill a prescription. For some, the season leads to avoidance: “I’ll just start again in January.”

But those small gaps, especially when it comes to blood sugar, blood pressure, or medication use, can grow into larger issues. Many people don’t realize they’re at risk. Others feel overwhelmed or disconnected from resources that could help.

“The holiday season can widen existing health gaps. Rich foods, travel, and stress make blood sugar control more difficult. Staying consistent with medications, food choices, and physical activity helps prevent complications and keeps people out of urgent care.”

— Joshua Lee, Ph.D.

That is where these Alabama-based projects come in. By developing tools that reflect people’s lived experiences and by focusing on support in familiar settings, these researchers aim to offer strategies that may help people maintain healthy habits during the busiest time of year.

Know your risk

Lucia Juarez, Ph.D., a Forge AHEAD scholar and researcher at the University of Alabama at Birmingham, is developing a diabetes risk score to help identify individuals, particularly Hispanic adults, who may be living with undiagnosed diabetes. Her work includes factors beyond the clinic, such as food access, language, and transportation.

This approach is intended to help people better understand their risk early, even before symptoms begin. During the holidays, that awareness can lead to small, meaningful behavior changes.

“The holidays are a joyful time, but they can also be a high-risk period for communities already facing a greater burden of diabetes,” said Juarez. “Supporting nutrition, physical activity, and medication use during this time is critical because even small shifts in behavior can have a long-term impact on health, and for Hispanic communities in Alabama, the holidays are an important moment to stay informed and engaged.”

Make a change

Know Your Numbers: Schedule a screening for blood sugar, blood pressure, and cholesterol before the holiday season.
Start Small: Begin healthy holiday swaps, for example, using whole grains instead of refined carbs or drinking water instead of sugary beverages.

“Culturally informed tools help people see themselves in the information we provide. When individuals feel understood and their culture and language are acknowledged, they’re more likely to recognize their risk and take action.”

— Lucia Juarez, Ph.D.

Build trust

Courtney E. Gamston, PharmD, a Forge AHEAD scholar and professor of experiential practice at Auburn University, is working with community health workers (CHWs), trusted individuals trained to help neighbors make informed health decisions. Her project examines how peer-led support from trusted community health workers may assist individuals facing challenges accessing primary care in managing diabetes.

CHWs offer practical strategies for maintaining healthy behaviors during the holidays, such as modifying traditional recipes, organizing family walks, or simply checking in with reminders and encouragement. They are a trusted resource, especially when the healthcare system can feel difficult to access or disconnected from day-to-day life.

“Community health workers empower people to enjoy the holidays while safeguarding their health. Their support helps families stay connected to healthy choices even when routines shift.”

— Courtney Gamston, PharmD

“During the holidays, people spend more time with friends, family, and community, making it harder to maintain healthy habits,” said Gamston. “Community health workers play a key role in providing education, advocating for healthy choices, and connecting individuals to local resources. Their consistent support for healthy choices empowers people to enjoy the holidays while safeguarding their health.”

She added, “The holiday season brings increased temptation to indulge in unhealthy foods, reduced opportunities for physical activity, and disruptions to daily routines which can impact medication-taking behaviors. By prioritizing healthy behaviors, individuals avoid short-term health setbacks and reinforce long-term management strategies. This is especially important in communities at high risk for diabetes because we know that diabetes onset and its outcomes are highly linked to our everyday health choices.”

Stay connected

Connect With a Community Health Worker: Ask your local clinic or community organization if CHW-led programs are available in your area.
Stay Active Together: Organize or join a community walking group or local dance event during the holidays.

Know your medications

Joshua Lee, Ph.D., a Forge AHEAD scholar, is leading a project at UAB that uses artificial intelligence to identify patients at risk of medication errors after hospital discharge. His system helps health teams intervene early, especially for individuals managing diabetes or taking multiple prescriptions.

During the holidays, when pharmacies may have reduced hours and travel can interrupt routines, managing medications becomes more complex. Lee’s work is exploring ways to support safer medication management during care transitions, and individuals can also take steps to stay prepared.

“The holidays can disrupt our daily routines, especially for people managing chronic conditions like diabetes. Missed doses, duplicate medications, or confusion caused by travel and schedule changes can all lead to medication errors. This risk is even higher when care transitions have occurred recently, for example, after a hospitalization, when treatment plans may have changed.

To reduce their risk, patients should carry an up-to-date medication list, clarify any recent changes with their care team, and use tools like pillboxes or phone reminders to stay on track. During the holidays, it’s especially important for caregivers and providers to stay in sync—whether it’s confirming medication lists before traveling or checking in after recent care changes—to help patients avoid gaps or duplications.”

Plan ahead

Keep a Medication List: Write down all medications and bring the list to holiday travel or family events.
Ask Questions: Talk with your pharmacist about refill options if you’ll be traveling or adjusting your schedule.

You don’t have to be perfect. You just have to start.

Whether you’re managing a condition like diabetes, supporting a loved one who is, or just looking to feel better through the holidays, small actions make a difference. The work of these Alabama researchers highlights how health is shaped by more than personal willpower. It is also supported by tools, information, and systems that can make better choices easier.

If you’re ready to take the first step, whether that’s getting screened, walking with a neighbor, or asking your pharmacist a question, you’re already moving in the right direction.

Want to learn more about these projects?

Small Steps for a Healthier Holiday Season

Know Your Health

Schedule a screening for blood sugar, blood pressure, and cholesterol before the holidays (Source: CDC Diabetes Management)
Keep an up-to-date medication list and bring it with you when traveling or attending family events (Source: FDA Medication Tips)

Make Simple Swaps

Choose whole grains instead of refined carbs
Drink water instead of sugary beverages (Source: USDA MyPlate – Diabetes)

Stay Active and Connected

Join or start a walking group or a community holiday dance event (Source: NIDDK – Diabetes and Exercise)
Connect with a community health worker through a local clinic or organization for support

Be Prepared

Talk with your pharmacist ahead of travel to ensure you have needed refills (Source: NIA – Questions About Medications)

Written by: Chris Campos

CMG Spotlight: Food Is Medicine – Edwards Street Fellowship Center Brings Fresh Solutions to Diabetes Care in Hattiesburg

Community Micro-Grant Spotlight: Food is Medicine – Edwards Street Fellowship Center Brings Fresh Solutions to Diabetes Care in Hattiesburg

In Hattiesburg, Mississippi, Edwards Street Fellowship Center has long been a place where compassion meets action. Through its Fellowship Health Clinic, the Center provides free medical, dental, and pharmaceutical care for uninsured and underinsured adults in Forrest and Lamar counties. Every service, every interaction, shines with the Center’s mission to extend a helping hand to those who need it most and to reflect the light of faith.

The Forge AHEAD Center is proud to support this mission through a Community Micro-Grant awarded to Edwards Street Fellowship Center for their project, “FOOD IS MEDICINE: Health Outcomes Based on Consistent Access to Fresh Produce for Diabetic, Obese, and/or Hypertensive Patients of a Free Clinic.” This initiative puts fresh fruits and vegetables directly into the hands of patients who need them most and tracks how that access supports their health.

A Fresh Approach to Managing Chronic Conditions

For many of the Fellowship Health Clinic’s patients, barriers to health are not just medical; they are practical. Every patient in the program qualifies as low-income, and consistent access to fresh, quality food is a daily challenge. This reality makes managing conditions like diabetes and hypertension especially difficult.

That is where the Food Is Medicine project comes in. As the start of the project, ten patients diagnosed with diabetes and/or hypertension are receiving produce vouchers to redeem at a local grocery store. In addition to their free medications and supplies, participants meet regularly with registered nurse educators, including volunteer professionals, instructors, and nursing students from the University of Southern Mississippi, for personalized chronic condition education.

Through these one-on-one sessions, patients learn how diet, exercise, and daily habits directly influence their health. Graduate students from the University’s nutrition program have also joined in, providing individualized nutrition consultations, diabetic cookbooks, and “My Plate” portion control tools to help patients put new habits into practice.

Tracking Health, Building Hope

This project is about more than providing resources; it is about measuring real change. Over a twelve-month period, the team is tracking each participant’s weight, A1C levels, and blood pressure to assess how consistent access to fresh produce impacts their overall health. So far, results are promising, and the enthusiasm is contagious.

“Our patients are delighted to receive their fresh produce vouchers,” said Ann McCullen, Executive Director of Edwards Street Fellowship Center. “The grocery store we partner with provides detailed receipts for every voucher, so we know patients are buying fruits and vegetables and enjoying them.”

Monthly check-ins for weight and blood pressure, along with quarterly A1C tracking, are painting a clear picture of how nutritional support translates into improved outcomes. The team has also shared the project’s progress with community groups, donors, and board members, sparking broader conversations around food access in Hattiesburg.

Nourishing Bodies and Communities

While the data collection continues, the project has already achieved something powerful: it has connected the dots between food security, education, and long-term health. It has also shown how collaborative community partnerships between local organizations and universities can drive meaningful change at the local level.

As National Diabetes Month shines a spotlight on prevention and management, Edwards Street Fellowship Center’s work is a timely reminder that health starts with access to care, to knowledge, and to nutritious food.

“We are grateful for the opportunity for improved health that this Forge AHEAD micro-grant provides for our patients,” McCullen said. “It’s opening doors to better health, one grocery basket at a time.”

The Forge AHEAD Center is honored to partner with community organizations like Edwards Street Fellowship Center to advance health across the Deep South. To learn more about Edwards Street Fellowship Center, visit their website.

Written by: Carol Agomo, Ph.D.

Forge AHEAD Center Announces Fifth and Sixth Cohort of Scholars Focused on Advancing Cardiometabolic Health

The Forge AHEAD Center (FAC) is pleased to introduce the recipients of its pilot funding for the fifth and sixth cohorts – early-stage investigators dedicated to advancing evidence-based solutions that address cardiometabolic health challenges and differences in health outcomes across the Deep South.

These scholars are translating research into action to improve access to care and health outcomes for communities with limited healthcare resources. Join us to become part of a vibrant community not only focused on providing funding but dedicated to making a real difference together.

Fifth Cohort Scholars

Seven outstanding early-stage investigators were selected for innovative projects targeting cardiovascular disease, diabetes, and related conditions.

Keri Barron, Ph.D., MSN, BSN

Assistant Professor, University of Alabama

Project: Evaluating the Utilization of the Heart Truth Program® among Young Black Women in the Deep South

Focus: This project evaluates the reach and outcomes of a national educational campaign addressing cardiovascular health awareness and prevention for young Black women, tailoring efforts to meet the unique health needs of the region.

Kaylee Crockett, Ph.D.

Assistant Professor, University of Alabama at Birmingham (UAB)

Project: Pilot Testing of a Primary Care-Based Dyadic Cardiovascular Risk Reduction Intervention: “Heart Care Pairs”

Focus: Pilots an innovative dyadic intervention that engages primary care patients and their care partners, “Heart Care Pairs”, in shared health behaviors to reduce cardiovascular risks and improve long-term outcomes.

Deborah Ejem, Ph.D., RN

Associate Professor, University of Alabama at Birmingham (UAB)

Project: Enhancing Patient-Centered Care for Older African American Patients with Cardiovascular Comorbidities: Piloting the Patient Priorities Care Model at Cooper Green Mercy Health Service Authorities (PPC-HEART)

Focus: Explores precision, patient-centered approaches to improve co-occurring condition management among older Black patients at a safety-net primary care clinic.

Abbey Gregg, Ph.D., MPH

Assistant Professor, University of Alabama

Project: Challenges and Enabling Factors to Implementing Remote Patient Monitoring for Hypertensive Conditions of Pregnancy

Focus: This research examines how remote patient monitoring technology can support management of hypertensive disorders in pregnancy, particularly for Medicaid-insured populations, addressing logistical obstacles to improve maternal health outcomes.

Lucia Juarez, Ph.D.

Assistant Professor, University of Alabama at Birmingham (UAB)

Project: Development and Validation of a Diabetes Risk Score for Undiagnosed Hispanics Living in the United States

Focus: Develops and validates a diabetes risk score developed with community input to improve relevance and uptake to enhance early diabetes detection and prevention for Hispanic populations.

Seung-Yup “Joshua” Lee, Ph.D.

Assistant Professor, University of Alabama at Birmingham (UAB)

Project: AI-Guided Risk Stratification for Medication Reconciliation for Patients with Diabetes

Focus: Uses artificial intelligence to strengthen medication reconciliation and reduce medication adherence-related risks for patients living with diabetes.

Chin-Yen Lin, Ph.D., RN

Assistant Professor, Auburn University

Project: Feasibility and Acceptability of a Yoga Intervention in Heart Failure Patients with Mild Cognitive Impairment

Focus: Evaluates the feasibility and benefits of a yoga intervention developed with community input to enhance cognitive and cardiovascular health in rural areas.

Sixth Cohort Scholars

Six early-stage investigators join with projects addressing hypertension, diabetes, food insecurity, and cardiovascular health through innovative approaches developed with input from community partners.

Osayande Agbonlahor, M.D., Ph.D., MPH

Assistant Professor, University of Mississippi Medical Center

Project: Using a Physician-Patient and Community Advisory Board to Address Health Care Discrimination and Improve Cardiovascular Outcomes for Black Adults

Focus: Examines how approaches developed with input from community partners and stakeholders can build trust and improve cardiovascular outcomes among Black adults.

Dashauna M. Ballard, Ph.D., MPH

Assistant Professor, University of Alabama at Birmingham (UAB)

Project: Empowering faith-based communities to provide personalized diabetes self-management education and support (DSMES) in the Magic City: A pilot study

Focus: Implements a faith-based diabetes self-management program combining community health workers and remote monitoring to improve diabetes-related health outcomes in Black and rural communities.

Courtney E. Gamston, ScM, PharmD, BCPS

Assistant Professor, Auburn University

Project: Assessing the Feasibility and Preliminary Efficacy of a Hispanic Community Health Worker Program in a Safety-net Clinic

Focus: Evaluates a community health worker program to improve diabetes care and education among Hispanic populations at a safety-net clinic in Alabama.

Catheryn Orihuela, Ph.D.

Assistant Professor, University of Alabama at Birmingham (UAB)

Project: Impact of a Health Coaching Program to Improve the Health of Food Insecure Adults with Cardiovascular Disease

Focus: Tests a health coaching program designed to enhance nutrition access and improve cardiovascular health outcomes for adults with cardiovascular disease.

Chloe Taub, Ph.D.

Assistant Professor, University of Alabama at Birmingham (UAB)

Project: Pharmacist-Led Remote Patient Monitoring for Diabetes and Hypertension Management in Persistent Poverty Areas

Focus: Tests the feasibility of an AI-supported, pharmacist- and community health worker–led program to improve diabetes and hypertension management in areas with limited healthcare resources.

Gabriel S. Tajeu, DrPH

Assistant Professor, University of Alabama at Birmingham (UAB)

Project: A Clinical Decision Support Questionnaire to Identify Obstacles to Blood Pressure Control

Focus: Develops and tests a clinical decision support questionnaire to identify factors and logistical obstacles influencing blood pressure control and improve hypertension management among patients in a safety-net clinic in Alabama.

Supporting Scholarly Success

The Forge AHEAD Center is dedicated to fostering a collaborative environment that equips these scholars with the resources they need to succeed. Recipients will receive mentorship, strategic guidance, and funding to translate their innovative ideas into measurable health outcomes.

By addressing significant health needs related to cardiometabolic conditions, these projects aim to enhance health outcomes and care for communities experiencing healthcare challenges.

Advancing Health through Innovation

The Forge AHEAD Center remains committed to driving transformative research that improves cardiometabolic health outcomes for all populations across the Deep South. Together, our scholars and partners are forging a healthier future for all.

Stay Connected!

For more details about the scholars and their projects, visit the Forge AHEAD Center’s website. Early-stage investigators interested in applying for upcoming pilot funding cycles are encouraged to review application guidelines and deadlines online.

Community Micro-Grant Spotlight: Pinktopps – Building a Healthier Future after Breast Cancer

October is Breast Cancer Awareness Month, a time to create awareness and honor the millions of lives affected by breast cancer (WHO, 2025). For Alabama’s Pinktopps, this month is also about honoring people who have faced breast cancer and to spotlight programs that help survivors thrive. The Forge AHEAD Center is proud to support Pinktopps Inc. through our Community Micro-Grant Program for their project, “Pinktopps Building a Healthier Future after Breast Cancer”. This community-based wellness initiative focuses on the real work of returning to life as normal as possible, one step at a time.

Pinktopps’ project is exactly the kind of community-first innovation the Forge AHEAD Center aims to lift up. The Center’s efforts place values on programs that are rooted in local culture, led by people with lived experience, and designed to be sustainable beyond the grant period.

Who the program serves and why it matters

Pinktopps targets young survivors and women with limited healthcare access who often face challenges to follow-up care and wellness resources. The program also provides education and support for families and caregivers, so recovery is supported at home. By focusing on younger survivors ages 19 to 45, Pinktopps supports a population that is building families, careers, and community roles while coping with survivorship.

This work matters because the transition from clinic to “life after treatment” is a time requiring increased support. Programs like Pinktopps help survivors move from short-term recovery into long-term wellness through peer-led support, practical skills, and connections to local resources.

A program built from lived experience

Pinktopps was created with the understanding that surviving cancer is not only a clinical journey. It is a life change that touches the body, emotions, relationships, spirit, and daily routines. The program centers lived experience at every level. Facilitators and peer leaders are trained to lead with their own histories in mind. That shared experience creates trust and makes it easier for participants to try new strategies, ask hard questions, and stay engaged. Peer leaders, survivor participants, and family members shape every session and every resource. Their leadership creates programs that are respectful, useful, and ready to be shared across communities.

The program sits on three core principles. First, health promotion that gives survivors practical tools for daily life. Second, community engagement that brings trusted local networks into the work. Third, peer empowerment that values survivor leadership and pushes decision making down to the people the program serves. Together these principles shape a holistic and sustainable model of survivorship care.

The Wellness Wheel: a whole-person curriculum

Pinktopps uses a Wellness Wheel Model that integrates six domains of health. Each domain is taught in ways that are practical, developed with input from community partners to reflect local context, and trauma informed.

Physical Wellness
Strengthening the body through movement adapted from physical therapy principles, good sleep habits, and gentle exercise that meets survivors where they are.

Nutritional Wellness
Practical education on meal planning, cooking on a budget, and ways to use anti-inflammatory foods to support recovery and long-term health.

Emotional Wellness
Group counseling, peer support circles, and journaling workshops that help people process what they have been through and build emotional tools for the future.

Spiritual Wellness
Mindfulness, guided meditation, nature therapy, and gratitude practices that support inner restoration and resilience.

Social Wellness
Safe spaces for social reengagement, relationship building, and reconnecting with family, friends, and community after treatment.

Environmental Wellness
Hands-on activities like growing food, nature-based sessions, and guidance on choosing eco-conscious health products that support a healthier home and neighborhood.

This Breast Cancer Survivor Month, help us spread the word. Share this post with your networks, invite a survivor to a Pinktopps session, or connect a community partner who can help grow the program. When communities and researchers work together, survivors gain both the practical tools and the social support they need to thrive.

Written by: Carol Agomo, Ph.D.

InspireHER Women’s Health Walk: Walking to Wellness

The Forge AHEAD Center is proud to collaborate with community partners to support the InspireHER Women’s Health Walk, taking place on Saturday, October 18, 2025, at Black Creek Park in Fultondale, AL. Registration opens at 8:00 a.m., with the program and walk from 9:00 a.m. to 12:00 p.m.

The InspireHER Walk is more than just a morning in the park. It is a celebration of women’s health and wellness, a chance to connect with others, and an opportunity to take steps toward healthier futures. With the theme “Walking to Wellness,” the event invites women, families, and the broader community to come together for a morning of movement, learning, and encouragement.

Group from 2024 InspireHER Walk

Participants will engage with healthcare providers, access health awareness information, and explore practical ways to take charge of their health. October is recognized as Health Literacy Month, which makes this walk even more timely. Attendees will be able to gather resources, ask questions, and strengthen their ability to make informed choices about their health and well-being.

This year, the walk also highlights October as Domestic Violence Awareness Month, with an emphasis on lifting up survivors and their stories of strength. As Dr. Angela B. Haynes, CEO of InspireHER Global, shares, “October is a month of both awareness and action. By walking together, we honor the journeys of survivors while standing firm in our commitment to build healthier, safer communities for all women.”

As a planning partner, the Forge AHEAD Center is committed to advancing the message of cardiometabolic health. The walk reflects our shared mission: to promote healthier lifestyles, expand access to health screenings, and support policies that give our community the resources they need to thrive.

Walking improves more than just physical health. It strengthens the heart, reduces stress, boosts mental well-being, and reminds us that a community moving forward together is stronger than any individual walking alone.

We invite you to join us at Black Creek Park on October 18. Together, let’s keep Walking to Wellness and building healthier communities, step by step.

To learn more about InspireHER Global, the walk, and to register, please visit inspireherglobal.com.

Written by: Carol Agomo, Ph.D.

Health Literacy Month: Taking Charge of Your Heart and Health

Vicky, or Ms. V. as many in the neighborhood call her, lives in a small town in Alabama, loves her Sunday gumbo, and keeps the family photo albums on the porch for visitors to see. Last winter she started feeling more tired than usual and sometimes felt lightheaded when she stood up too fast. At first, she blamed it on a busy schedule and caring for her grandchildren. Then her niece, who is a nurse, noticed Vivian’s hands were shaky when she opened a pill bottle and encouraged her to get a checkup.

At her checkup, Ms. V. learned that her blood pressure was higher than it should be. She felt scared and overwhelmed by the numbers and the medical terms. Her niece sat with her during the visit, wrote down what the nurse said, and helped Ms. V. set a reminder to take her medications on her phone. Ms. V. also talked with her pastor, who connected her with the church wellness team. Between her niece, her church friends, and a kind nurse at the clinic, Ms. V. started to feel supported instead of alone.

Over a few months Ms. V. began making small changes. She used a simple pill box, set an alarm for medicine time, and started walking with a neighbor three times a week. At the Sunday potlucks she started asking the cook for a smaller portion and often added a side of greens to her plate. She keeps a little notebook with her blood pressure readings and brings it to appointments. These changes did not happen all at once; they happened step by step with people who cared for her.

Health Literacy Month

The Forge AHEAD Center works with community partners, researchers, and healthcare providers in Alabama, Mississippi, and Louisiana to reduce cardiometabolic risk and support healthy living. We are sharing these tips for Health Literacy Month because clear information and small, doable steps help people protect their hearts and reduce risk for chronic diseases. This month we want to spotlight simple tools you can use right away that make it easier to take those next steps.

October is Health Literacy Month, a time when communities nationwide focus on making health information easier to find and easier to use. Health literacy is not about being a doctor. It is about understanding health information and using it to make choices that keep you and your family well. For people in the Deep South, where heart disease, stroke, and type 2 diabetes affect many families, stronger health literacy can help turn fear into action.

Download our one-week Health Literacy Month checklist to help you keep track of blood pressure, medicines, and simple steps you can try this week. [Download the checklist]

What health literacy looks like in real life

Health literacy means you can read a prescription label and know when to take it. It means you can understand what your blood sugar and blood pressure numbers mean. It means you feel comfortable asking your doctor or nurse to explain something again in plain language. It also means knowing how to find trustworthy local resources when you need help.

Good health literacy helps prevent cardiometabolic diseases. The good news is that many of the changes that lower risk are within reach and can be easy shifts to make.

Health Literacy Month Checklist

One week. Small steps. Better health.

Use this checklist during Health Literacy Month to build small habits that help prevent heart disease and diabetes. Pick one or two items to start. Check the box when you do each task. Bring this page to your next clinic visit.

Download the checklist

You do not have to be perfect

Prevention is about progress, not perfection. Remembering to take your medicine twice instead of zero times or walking 10 minutes more each day are all wins. Share what you learn with a neighbor or a community group. That ripple can help families across your town stay healthier.

Ms. V. did not change everything at once. She asked simple questions, leaned on her niece and her church friends, and kept a small notebook of her blood pressure readings. Over time those steps became habits that protect her heart and health.

Download our one-week Health Literacy Month checklist to help you keep track of blood pressure, medicines, and simple steps you can try this week. [Download the checklist]

Written by: Carol Agomo, Ph.D.

Forge AHEAD Center announces 2025 Community Microgrant awardees improving health in the Deep South

BIRMINGHAM, Ala. (Sept. 25, 2025) – The Forge AHEAD Center awarded six community-based organizations through its 2025 Community Microgrant Program. The program, administered in partnership with the University of Alabama at Birmingham’s Center for Clinical and Translational Science (CCTS), provides up to $10,000 in funding to support innovative, community-driven projects that address pressing health challenges in Alabama, Mississippi and Louisiana.

The Community Microgrant Program recognizes that local organizations are often best positioned to identify needs, build trust and lead change. By investing directly in community partners, Forge AHEAD affirms its commitment to supporting organizations that bring deep knowledge, cultural understanding and long-standing relationships to their work.

“We are proud to partner with CCTS to invest in local organizations whose work reflects the needs and priorities of their communities,” said Andrea Cherrington, M.D., MPH, UAB director of the Division of General Internal Medicine and Population Science, and Forge AHEAD multiple principal investigator. “These projects are powerful examples of how grassroots leadership can make a real difference in people’s lives.”

2025 Awardees

El Pueblo (Mississippi): Bilingual hypertension self-management program tailored for limited English proficient adults, with education, goal-setting and weekly support.
Edward Street Fellowship Center (Mississippi): Food Is Medicine initiative integrating monthly produce vouchers and clinical monitoring for patients with diabetes and hypertension.
BirthWell Partners (Alabama): Expansion of postpartum care with free doula and lactation services for low-income families, training a new workforce of doulas and educators.
Pinktopps (Alabama): Survivorship program for young breast cancer survivors, offering wellness education and mental health support.
Metromorphosis (Louisiana): Resident-led community garden project to increase access to healthy food, reduce neighborhood blight, and build local leadership.
Louisiana Organization for Refugees and Immigrants (Louisiana): Development of a maternal health risk assessment tool co-designed with immigrant and refugee women to improve maternal health outcomes.

Throughout the year, the Forge AHEAD Center will provide technical assistance, evaluation tools, and opportunities for peer learning. This ongoing collaboration reflects the center’s belief that lasting solutions emerge when universities and communities work together, with communities leading the way.

“These organizations are at the forefront of improving health in their communities,” said Caroline E. Compretta, Ph.D., University of Mississippi Medical Center assistant vice chancellor for research and Forge AHEAD Community Engagement Core lead. “We look to them as leaders and assets whose vision, creativity and dedication will have a measurable impact on the individuals and families they serve.”

The Community Microgrant Program is part of the Forge AHEAD Center’s broader mission to strengthen partnerships, build community capacity and support innovative approaches to improving health in the Deep South.

For more information about the Forge AHEAD Center and its programs, visit https://www.forgeaheadcenter.com/.

Closing the gap: managing high blood pressure after an ER visit

Leaving the emergency room with dangerously high blood pressure can feel overwhelming. For many patients, the support ends the moment they walk out the door. A new pilot program at the University of Alabama at Birmingham (UAB) is changing that by helping patients take charge of their health from home.

High blood pressure, or hypertension, happens when blood flows through your arteries with too much force, putting stress on your heart and blood vessels. Without timely care, patients discharged from the hospital with high blood pressure can face serious health risks, including strokes or repeated hospital visits.

World Hypertension Day, observed on May 17, highlighted the need for better blood pressure management worldwide. That urgency is at the heart of the “Post-Emergency Department Telehealth Follow-Up Program”, led by Lama Ghazi, M.D., Ph.D., assistant professor of epidemiology at UAB. The project offers personalized, tech-enabled support to help patients safely recover and stay out of the hospital.

Who Is participating?

The study successfully enrolled 40 adults aged 30–75 discharged from UAB’s emergency department (ED) with very high blood pressure (systolic readings of 160 mm Hg or higher). All participants live within 30 miles of the hospital, speak English or Spanish, and use a home blood-pressure monitor, with support available from caregivers as needed.

What does the program involve?

Participants receive home blood-pressure monitors along with comprehensive training. Nurses teach participants and caregivers how to measure and record their blood pressure accurately.

Lama Ghazi, M.D., Ph.D.

Assistant Professor, University of Alabama at Birmingham

Learn more about Ghazi.

Did You Know?

Hypertension, or high blood pressure, significantly increases the risk of heart disease and stroke. Regular monitoring can help control it.

Source: American Diabetes Association

Each week, participants connect virtually with a nurse-pharmacist team through phone or video calls. During these telehealth sessions, the team reviews blood-pressure readings, adjusts medications according to set guidelines, and addresses participants’ health questions.

Automated text reminders twice a week prompt participants to take their blood pressure and submit readings via text or phone calls. Pharmacists also help participants address medication-related challenges, such as affordability, by connecting them to discount programs and local healthcare services.

Early signs of progress

While full evaluation is ongoing, early trends from the pilot phase suggest the program is having a positive impact.

Blood Pressure Improvement (90-day follow-up):

Participants experienced an average systolic drop of 16 points (from 162 to 146 mm Hg).
Diastolic readings fell by an average of 9 points (from 94 to 85 mm Hg).

Reduced Return Visits:

Participants had 22% fewer ED visits within 30 days compared to similar patients who received standard care.

Strong Participation:

Nearly all scheduled telehealth check-ins were completed, with 95% of visits attended.

Positive Experience:

Most participants shared high levels of satisfaction with the support they received.
Many found the reminder texts easy to use and helpful in staying on track.

These preliminary results will help inform the next phase of the program, which continues to assess longer-term outcomes.

Recognizing the importance of digital literacy, the program introduced a 15-minute “tech check” call at the beginning to boost early engagement. Additionally, new Spanish-language tech guides introduced in March 2025 expanded access and helped ensure more participants could comfortably utilize and understand the materials.

What’s next?

The team will complete 180-day blood-pressure and quality-of-life assessments by mid-June 2025. A cost-effectiveness analysis is scheduled to begin in July, and expansion into two UAB community clinics is planned for late 2025. These next steps aim to evaluate long-term impacts on health outcomes and overall cost efficiency.

By combining user-friendly home monitoring, consistent virtual check-ins, and accessible medication support, Ghazi’s pilot demonstrates a practical approach to managing high blood pressure, potentially preventing severe health complications such as stroke.

Learn more about Ghazi’s Forge AHEAD pilot project.

Key Terms to Know

Hypertension: Persistently high blood pressure.
Telehealth: Remote healthcare provided through phone or video calls.
Systolic and Diastolic: Systolic (top number) measures pressure when your heart beats; diastolic (bottom number) measures pressure between beats.

Smarter follow-up and safer care: how AI could support men with diabetes

June is Men’s Health Month, an opportunity to focus on health challenges that often go unnoticed, especially among men living with chronic conditions like diabetes. At the University of Alabama at Birmingham (UAB), Forge AHEAD investigator Seung-Yup Lee, Ph.D., is leading a pilot study that combines artificial intelligence with clinical data to prevent medication mix-ups and help patients get the follow-up they need.

Why men with diabetes need a smarter safety net

Men are more likely to delay routine visits and less likely to follow up after hospital care. both of which can lead to missed medications, dangerous side effects and avoidable complications. For those living with diabetes, these risks are even higher. Managing medications correctly is critical to controlling blood sugar, avoiding hospital readmissions and staying healthy.

But for busy clinics, it’s not always clear who needs the most help. That’s where Lee’s project steps in.

Using AI to spot who needs help first

Lee’s team is developing an AI-powered risk score to help doctors and pharmacists spot patients who are most likely to have medication problems. The system analyzes a wide range of health data, including medical records, prescription refill patterns, and social factors like insurance status or housing instability, to assign a “reconciliation risk score” to each patient with diabetes.

Seung-Yup Lee, Ph.D.

Assistant Professor, University of Alabama at Birmingham

Learn more about Lee.

Did You Know?

Men are more likely than women to skip routine checkups, and more likely to face serious medication-related problems as a result.

Source: Healthline

The goal? Use this score to flag high-risk patients so care teams can follow up directly, either by phone or in person, to double-check medications, fix errors and offer support.

What the tool actually does, and how AI fits in

Artificial intelligence, or AI, refers to computer systems that are trained to notice patterns in large sets of information, kind of like how a person might learn from experience, but much faster. For example, just like a nurse might notice that certain symptoms usually come before a problem, AI can spot those same signs by studying thousands of patient records at once. In this project, AI is used to scan medical records, pharmacy data and provider notes to predict which patients might be most at risk for medication problems.

It’s important to know that AI doesn’t replace doctors, nurses or pharmacists. It doesn’t make decisions on its own or replace face-to-face care. Instead, it helps teams work smarter by pointing out which patients might need extra attention. That gives healthcare providers more time to focus on what people need most, support, questions answered and care that feels personal.

Data-driven prediction: The model looks at over 5,000 patient records and uses natural-language processing (a type of AI that reads doctors’ notes) to detect warning signs.
Real-time alerts: Risk scores are displayed inside a clinician dashboard so that care teams know who needs outreach before the next visit.
Focused follow-up: Patients with high scores receive extra attention, including calls from pharmacists to reconcile prescriptions and catch any problems early.

Measuring what matters: fewer errors, better follow-up

The pilot study includes around 200 patients and is testing whether the tool helps reduce medication discrepancies within 30 days. It’s also tracking whether fewer patients return to the hospital with drug-related issues, and how satisfied doctors and nurses are with using the system.

This type of focused support may be especially helpful for men, who often manage more complicated medication routines and may delay reaching out for help when issues arise.

Key Terms to Know

Medication reconciliation: The process of double-checking all a patient’s medications to make sure they match what was prescribed.
Risk stratification: Grouping patients by risk level to focus care where it’s needed most.
Health-related social factors: Things like income, housing or transportation that can affect someone’s ability to stay healthy.

What is AI?

Artificial intelligence (AI) refers to computer systems that can learn from large sets of data and help identify patterns.

In health care, AI is used to support, not replace, human decision-making by helping teams spot risks earlier and prioritize follow-up care.

Source: National Institutes of Health

What’s next for the project

If successful, Lee’s team plans to expand the tool across partner sites in Alabama, Mississippi and Louisiana. They’re also exploring ways to pull in data from state prescription-monitoring systems and bring the program into more community health clinics, including those that serve men with limited access to care.

How this could help you or someone you know

This project reflects a growing effort to use data to guide follow-up care and reduce preventable health problems. For men with diabetes, it could mean fewer hospital visits, safer medication use and better outcomes over time.

Learn more about Lee’s Forge AHEAD pilot project.