Completed Projects
Active for Life®
(2001–2009)
Active for Life® was an RWJF-sponsored National Program Office (NPO) to examine the applicability of two research-based physical activity programs to community settings. The primary purpose was to learn how to translate research to practice with an emphasis on how research-based programs need to be altered to be responsive to community needs and structures. In addition to providing scientific leadership, the NPO, in coordination with an external evaluation team, provided technical assistance to nine grantee sites to examine processes and outcomes for more than 8,000 adults, age 50 and older. This study provided substantial experience in identifying essential intervention elements and learning how to make programs more culturally and population relevant so that they could be widely disseminated and sustained over time. It serves as the namesake for our Active for Life® program, a compilation of evidence-based and evidence-driven programs and interventions to improve the health and wellbeing of older Texans.
After Cancer Care Ends-Survivorship Starts for Adolescents and Young Adults (Access-AYA)
(2011–2014)
This Cancer Prevention Research Institute of Texas (CPRIT) grant was designed to (1) develop and deliver professional education to Central Texas medical professionals including family and internal medicine doctors, nurses and nurse practitioners, social workers, and physical therapists; (2) engage with AYA survivors and their families to help them use resources to develop survivorship plans and to learn more about ways to reduce risk and improve their health and well-being; and (3) create networks, information and communication systems to improve access to survivorship services and resources.
ARRA Communities Putting Prevention to Work: Chronic Disease Self-Management Program
(2010–2012)
The National Council on Aging served as the Technical Resource Center for this Administration on Aging Initiative which sought to enroll over 50,000 older adults throughout the Nation in chronic disease self-management programs. The evaluation team at the School of Public Health was responsible for the analytical aspects of the national evaluation. In collaboration with Stanford University, lead evaluators assessed the impact of the Chronic Disease Self-Management Program on self-reported health status, behaviors, and health care utilization among 1,000 seniors.
Assessing the Built Environment in Colonias to Influence Policy Promoting Physical Activity in Mexican American Children and Families
(2009–2011)
Funded by the Robert Wood Johnson Foundation Program in Salud America!, this study addressed how environmental and policy factors affected physical activity in economically disadvantaged, understudied, Mexican American children and families in the Rio Grande Valley. Study objectives included obtaining and evaluating key stakeholder feedback. It involved conducting environmental assessments of different neighborhoods and presenting findings to key community stakeholders for action.
Assessing Existing Screening Guidelines for Physical Activity for Older Adults
(2002–2005)
Goals for this Robert Wood Johnson funded project included: (1) reviewing existing literature regarding exercise guidelines and the extent of adverse events associated with exercise interventions and different screening approaches for older adults; (2) surveying the trans-NIH Behavior Change Consortium to provide the latest empirical data on screening criteria utilized in these premier behaviorally-based physical activity interventions; and (3) conducting focus groups and organize informal working group sessions at selected national professional meetings. A screening round table of key stakeholders was organized to discuss strategies for disseminating best practices and tracking any adverse events associated with new recommendations. A major product was the development of the EasyForYou Screening tool.
Cancer Prevention and Control Research Network
(2009–2005)
Funded as a Special Initiative Project of the CDC Prevention Research Centers, the Communities of Texas: Cancer-Activity-Education-Research-Support (CTxCARES) was a member center of this CDC-funded thematic network. Our network was a catalyst for the adoption of evidence-based cancer prevention and control interventions in Central Texas. CTxCARES, as part of The Texas A&M School of Public Health Center for Community Health Development, partnered with Texas AgriLife Extension, Scott & White Healthcare, the Brazos Valley Area Agency on Aging, and other community and state-wide agencies to foster research on cancer prevention and control. The initial project focused on examining strategies for improving the quality of life in cancer survivors.
Changing Mobility Patterns of the Senior Generation
(2016)
Funded by the Institute for Mobility Research (Germany), this multi-disciplinary research project was designed to develop new knowledge about seniors’ mobility. Combining experts across disciplines including sociology, psychology, transport studies, econometric modeling, urban planning, and travel survey methods, researchers employed descriptive and multivariate statistical analyses of travel survey data from five countries (China, Germany, Japan, United Kingdom, and the US) and five decades. Objectives included: (1) an analysis of historic and current travel behavior of people 65+ years; (2) identification of factors possibly changing mobility patterns of people 65+ ; (3) quantitative estimation of future travel behavior of people 65+; and (4) implications of future travel behaviors for the transport system and BMW group.
Community Research Center for Senior Health
(2010–2013)
This NIA-funded project was designed to develop, implement, evaluate and disseminate evidence-based interventions that address multiple social and behavioral determinants of senior health. Specific Center aims were to: (1) create a sustainable infrastructure that promotes an interdisciplinary and multi-contextual approach to Senior health intervention research; (2) develop community-academic health center relationships which foster community participation in research planning, study participation, and dissemination of findings; and (3) provide guidance and support to investigators and community leaders in research design, evaluation, and data analytic techniques that balance the need for rigorous science and the practical realities of conducting health research in community settings. The School of Public Health serves as the academic partner of this activity, a major project of which was the development of a tool kit to identify and select evidence-based programs. ( https://www.evidencetoprograms.com/).
Developing Partnerships for Delivering Evidence-based Self-Management Programs
(2012–2013)
Chronic Disease Self-Management Program and Diabetes Self-Management Program workshops have been disseminated in the Brazos Valley and other regions in East Texas with the support of the Texas Department of Aging and Disability Services. A grant from WellCare Health Plans, Inc. provided the opportunity to partner with several organizations in the Houston/Galveston area to build a private-public partnership for creating a sustainable system for delivering evidence-based self-management programs. This partnership enabled program delivery and training, technical assistance in program recruitment and selection, and evaluation of the program by documenting reach, adoption, and fidelity processes and outcomes.
Diabetes Prevention & Management
(2004–2009)
Funded as a core research program of the Prevention Research Center, the Diabetes Prevention and Management Project aimed to improve the health of rural and under-served populations through better implementation, dissemination, and sustainability of clinical and community disease prevention and management guidelines. The research project has focused on advancing dissemination research and attention to determinants and intervention research. The project’s primary goal was to examine gaps in real-world utilization of disease prevention and control guidelines and develop strategies for closing these gaps. Data from various assessments supported the need for diabetes and chronic disease self-management research in the Brazos Valley.
Dissemination of Fit & Strong! in the Brazos Valley
(2012–2013)
Combining mini-grant funding from Scott & White Healthcare’s Community Resource Center for Senior Health (CRC-Senior Health) and St. Joseph’s Healthy Communities, Fit & Strong! is an evidence-based physical activity program for older adults. In conjunction with the Brazos Valley Area Agency on Aging (BVAAA), the program, originally designed for older adults with osteoarthritis, is eight weeks long and combines flexibility, strength training, and aerobic walking with health education to reduce arthritis.
Doctor-Patient Encounters: Communications about Lifestyle Recommendations and Other Geriatric Conditions
(2002–2004)
This was a small grant supported by The Texas A&M Health Science Center School of Public Health and Baylor Scott and White Health Services Research Program. The purpose was to examine how doctors communicate to their older patients regarding lifestyle recommendations and the influence of patient, physician, and setting factors. Additionally, we examined the amount of time spent in different lifestyle discussions. The study concluded that precious little time was spent on provider-patient discussions about lifestyle behaviors.
Enhanced Breast and Cervical Cancer Prevention for Low Income and Underserved Using Transdisciplinary Collaboration in a Family Medicine Setting
(2013–2016)
This grant tested innovative ways of increasing breast and cervical cancer screening and prevention activities in the Brazos Valley using nursing students and community health workers. The overall goal was to improve family medicine, nursing, and public health practice related to evidence-based, culturally appropriate care in women’s cancer services. This proved to be a successful model to expand breast and cervical cancer services in rural and underserved areas.
Enhanced Colorectal Cancer Screening in a Family Medicine Residency Program
(2011–2015)
This Cancer Prevention Research Institute of Texas (CPRIT) grant addressed a critical unmet need for colon cancer screenings in the Brazos Valley by increasing the number of low-income underserved Texans, 50 years and older, who are referred to the Texas A&M Family Medicine Residency Clinic for CRC screenings. This project improved access to cancer screenings and follow-up care through culturally relevant case management from Promotoras/Community Health Workers (P/CHW), while simultaneously increasing the pool of family medicine residents and practicing family physicians trained in colonoscopy screenings in Texas. The evaluation team tracked the availability, accessibility, and appropriateness of cancer screenings.
Enhancing Self-Care Activities of Patients with Diabetes Using a PDA: A Pilot Study
(2005–2006)
The specific aims of this Baylor Scott and White Health Services Research Program project were to: (1) assess the feasibility of PDA use in diabetes self-care by patients aged ≥18 years with type 2 diabetes; (2) identify which patients would benefit most from the use of a PDA; and (3) explore whether the use of a PDA as an adjunctive diabetes self-care device leads to better or improved patient adherence to diabetes self-care activities. This work was foundational in our development of self-assessment tools and related mobile health applications.
ÉPICO: Education to Promote Improved Cancer Outcomes
(2011–2013)
(PI: Julie St. John). The program was designed to increase delivery of comprehensive cancer services through the development of a replicable, sustainable tailored training program for promotores on prevention, treatment, and healthy survivorship for colorectal, breast, and cervical cancers among at-risk residents in the Lower Rio Grande Valley (LRGV) on the Texas-Mexico border. Specific aims were to: (1) equip promotores to educate residents on prevention, treatment, and survivorship issues related to colorectal, breast, and cervical cancers; (2) enable promotores to use tailoring strategies to improve their outreach efforts; and (3) increase residents’ prevention, treatment, and healthy survivorship behaviors. A critical role was advisement on translation and dissemination efforts.
Establish Self-Management Programs and Wellness Using Evidence-Based Designs
(2011–2019)
The Texas Health and Human Services Commission received federal funding through the Centers for Medicaid and Medicare to implement an 1115 Transformation Waiver project to provide quality care for low-income Texans. The Center for Population Health and Aging provides a centralized resource for training, implementing, and evaluating evidence-based self-management and wellness programs. In conjunction with the Texas Active for Life® Coalition, the Center seeks to facilitate health care providers’ and agencies’ capacity to select and implement evidence-based health promotion/disease prevention to reduce the burden of illness in our nine-county Regional HealthCare Partnership (RHP) 17 region. Current activities are centered on disseminating Making Moves With Diabetes, a program that has the potential to improve clinical outcomes and result in substantial health care cost savings.
Examining Disparities in Hospital Treatment Leading to Lower Extremity Amputation (LEA) among Residents Living Along the Texas-Mexico Border
(2007–2008)
Specific aims of this pilot study were to examine differences in race/ethnicity, age, gender, or insurance status among those who undergo LEA, exploring geographic and SES differences in total charges for care and particular treatments and therapeutic interventions. The high incidence of lower extremity amputations at the border was documented
Falls Reduction Education and Empowerment (FREE)
(2015–2017)
The United Way of Tarrant County (UWTC), in partnership with eight Area Agencies on Aging (AAAs), the Texas Falls Prevention Coalition (TFPC), and other organizations, collectively known as “Falls Reduction Education and Empowerment (FREE) Partners,” was awarded funds by the Administration on Active Living, to reduce falls and falls risk in Texas. The School of Public Health oversaw the Texas Falls Free Coalition and evaluated the effectiveness of implementing A Matter of Balance (AMOB) among participating Area Agencies on Aging. The goal of graduating at least 4,000 participants in AMOB in Dallas/Fort Worth, Austin, San Antonio, Corpus Christi, and El Paso metropolitan areas was met. Through the TFPC, FREE provided training for FPPs to master trainers, physical therapists, emergency medical professionals, and community health workers. FREE’s key sustainability partners, Texas Healthy at Home and WellMed, were consulted on the best strategies to generate funding for program delivery and sustainability.
Health Maintenance Consortium Resource Center (HMCRC)
(2004–2011)
The Health Maintenance Consortium represented twenty-one funded NIH grants examining factors associated with long-term behavioral maintenance. The Resource Center created an infrastructure to (1) foster ongoing cross-site communications among the funded projects; (2) provide technical assistance to identify common questions, methods, and measures related to maintenance and sustainability and to address cross-cutting issues that add synergy to the individual projects; (3) establish a central clearinghouse for behavioral change concepts, assessment instruments, intervention protocols, methods, and data that can be beneficial for other researchers and practitioners; and (4) disseminate research findings to both researchers and practitioners. Nearly 50,000 individuals from adolescence to adulthood to old age were involved in this HMC-supported research, making this one of the largest groups of studies of behavior change strategies.
ICANFIT
(2011–2014)
Funded as a small grant through Baylor Scott and White HealthCare, ICANFIT was a web and mobile technology-based solution for older cancer survivors to promote physical activity and increase their quality of life. Specific study aims were to (1) gain an in-depth understanding of cancer survivors’ needs and preferences for health PA promotion programs; (2) develop a state-of-the-art, web and mobile device accessible program “ICANFIT” using a user-centered design approach; and (3) assess the feasibility and initial efficacy of ICANFIT by pilot testing it among 100 older cancer survivors (post-treatment) recruited from clinics and communities. A major accomplishment was the creation of an ICANFIT website ( icanfit.org).
Impact, Sustainability & Scalability of Multi-Component Falls Prevention Programs
(2011–2015)
Working collaboratively with the Centers for Disease Control and Prevention (CDC) and the three funded State Health Department Injury Programs, the goal was to facilitate the evaluation of the processes and impacts of state-driven fall prevention programs for older adults. The two primary aims during the initial three years of the states’ five-year, multi-component fall prevention program implementation were to: (1) determine the impact of the designated multi-component fall prevention interventions on health, health care utilization, and costs using quantitative and qualitative methods; and (2) build states’ capacity for ensuring program successes by providing technical assistance on strategies for enhancing and monitoring the reach, fidelity, sustainability, and scalability of evidence-based fall prevention programming. This work resulted in a lessons learned report shared with CDC staff and grantees.
It Takes a Village – A Multi-Disciplinary, Multi-Level Evaluation of Learning Network
(2014–2016)
Affiliated with the Active for Life® program, the Learning Network was designed to create a mechanism for sharing resources about successful approaches to active aging. Partnering with the National Blueprint, this project created an interactive Learning Network for the Building Healthy Communities Recognition Program which promotes the pairing of smart growth principles with activity programming for older adults.
Learning Network
(2006–2009)
The Learning Network was affiliated with the Active for Life program and built community capacity for translating research to practice. The Learning Network was designed to create a mechanism for sharing resources about successful approaches to active aging. By partnering with the National Blueprint, this project created an interactive Learning Network for the Building Healthy Communities Recognition Program which promoted the pairing of smart growth principles with activity programming for older adults.
Medication Use, Dietary Intake, and Functional Outcomes among Homebound Elders
(2003–2004)
This was a small grant supported by The Texas A&M University System School of Public Health and Baylor Scott and White Health Services Research Program. This project examined medication use, dietary intake, and functional outcomes among a large and diverse sample of frail elders in the community. The project delineated drug-use patterns that may influence dietary intake and nutritional status, physical performance, and disability, and it identified appropriate targets for tailored interventions.
Nationwide Evaluation of Evidence-Based Programs (EBPs) for Seniors
(2008–2011)
Working collaboratively with the Administration on Aging, the following objectives were addressed in a three-year cooperative agreement: (1) assess the current state of knowledge about EBP practice and evaluation; (2) identify strengths and gaps in reaching aging populations, delivering EBP services, and building training and evaluation capacity; (3) recommend a nationwide evaluation plan, specifying design, measurement, desired outcomes, and other critical elements; and (4) indicate key players/areas of expertise needed to conduct the proposed evaluation plan. This activity was coordinated with the Healthy Aging Research Network.
National Study of Evidence-Based Chronic Disease Management Programs
(2008–2011)
The National Council on Aging serves as the Technical Resource Center for this Administration on Aging Initiative which seeks to enroll over 50,000 older adults throughout the Nation in chronic disease self-management programs. Working collaboratively with the NCOA and the Stanford Patient Education Research Center at Stanford University, The Program on Healthy Aging will conduct a national study of 1,000 older adults to document individual outcomes of the Stanford Chronic Disease Self-Management Program, such as self-reported health status, quality of life, health behaviors, and health care utilization. Data will come from approximately 30 delivery sites across the Nation, with an emphasis on getting a diverse population of participants from both urban and rural areas. This collaboration provides a synergy that will help bridge the research-to-practice gap and further our knowledge about the outcomes of widely disseminated evidence-based programs.
A New Tool Applies Research to Assisted Living Design
(2004–2008)
This Phase I and II SBIR grant was funded by the National Institute on Aging to improve outdoor access for residents of long-term care facilities. In Phase I, an educational tool was developed that made it easier for decision-makers to apply evidence-based research to the design of new or existing facilities, leading to potential benefits for residents. The specific aims were to (1) develop the relevant behavioral design principles; (2) create an interactive multimedia instructional format on CD/ DVD; (3) evaluate the prototype for usability and effectiveness with representative target users in the design and provider industries.
Patient-Reported Outcomes in Patient-Centered Medical Homes
(2012–2014)
With supplemental funding from the National Cancer Institute, Texas A&M participated in a cluster-randomized pragmatic trial comprised of nine pairs of diverse primary care practices randomized to adopt and field My Own Health Report (MOHR). This study evaluated an electronic or paper-based, publicly available health behavior and mental health assessment paired with a counseling and goal setting tool, versus no systematic assessment. This pragmatic research study examined how intervention practices independently integrated MOHR into their workflow, adapted their integration over time, and affected the patient experience.
Pilot Evaluation of the Chronic Disease Self-Management Program
(2011–2013)
This Centers for Medicare and Medicaid Services (CMS) funded project was responsive to the requirements of Section 4202 subsection (b) of the Affordable Care Act (ACA) directing the Secretary of the Department of Health and Human Services to “conduct an evaluation of community-based prevention and wellness programs and develop a plan for promoting healthy lifestyles and chronic disease self-management for Medicare beneficiaries.” This study examined the impact of the Chronic Disease Self-Management Program (CDSMP) on health outcomes, utilization, and costs in an existing sample of participating beneficiaries by linking CDSMP records to Medicare administrative data. Working collaboratively with Stanford University, the Texas A&M Health Science Center Evaluation team was responsible for data linkage, analysis, and report writing. This study demonstrated that the CDSMP met the triple health care aims of better health, better health care, and better value.
Policies, Programs, and Partners for Fall Prevention (PPPFP)
(2012–2015)
Funded as a Special Initiative Project of the CDC Prevention Research Centers, PPPFP addressed the urgent need to identify more effective public health strategies for reducing falls, fall-related injuries, and fall-related rates of emergency room visits among the growing population of seniors. This unique partnership between Texas A&M Health Science Center and the University of North Carolina School of Medicine and Public Health examined falls-related policies in over 40 state fall prevention coalitions. Another aspect of PPPFP was the evaluation of a training program for physical therapists to implement evidence-based fall prevention programs to be integrated with state and national fall prevention policies. The project developed fall prevention strategies and trained community health workers to help raise awareness about falls prevention and refer older adults to evidence-based programs.
Program for Rural & Minority Health Disparities Research
(2007–2012)
The Disparities Program is a collaborative initiative between the Center for Community Health Development at SPH and the Center for the Study of Health Disparities at TAMU. Funded by the National Center on Minority Health and Health Disparities at NIH, this program focuses on the intersection of setting and population characteristics and how they impact health-with specific attention to nutrition, physical activity, obesity, and diabetes. The program’s core research project, Employing Diabetes Self-Management Models to Reduce Health Disparities in (central) Texas, is addressing many aims of relevance including 1) documenting the nature and magnitude of health disparities among patients with type 2 diabetes; 2) evaluating different diabetes self-management intervention approaches on patient behavioral and clinical outcomes; 3) assessing the cost-effectiveness of these different approaches to diabetes self-management education; and 4) exploring the reach of our intervention efforts and the broader organizational impacts of diabetes self-management education, examining how self-management interventions get linked back into clinical practice. Program on Healthy Aging faculty co-direct the research and translation core and participate in research to investigate behavioral and social strategies for diabetes management.
Promoting Walking and Other Physical Activity among Obese and Diabetic Patients in Integrated Healthcare Plans
(2007–2009)
Funded through the Baylor Scott and White Health Services Research Foundation, this pilot study examined both physician and environmental influences on patient activity levels by: (1) assessing if, and how, healthcare providers encourage walking and engagement in other physical activity to their obese and diabetic patients; and (2) identifying specific built environmental facilitators of, and barriers to, walking and engagement in other physical activity in the neighborhood. Factors influencing doctor-patient interactions and the doctor’s understanding and application of environment-behavior-health linkages were examined. A major product was the development of a community resource guide for use by health care providers and patients to identify accessible places for physical activity.
Reinventing Public Transportation Programs to Fight Obesity Epidemic: A Pilot Study in El Paso, Texas
(2016–2017)
Little is known about the causal impact of a rapid bus transit system on nearby residents’ physical activity. There are many methodological challenges to overcome in designing a rigorous longitudinal case-control study to understand how new transportation options affect obesity risk factors among a predominantly lower-income Hispanic population. With internal Texas A&M University funding (PESCA), a multidisciplinary team with expertise in architecture, urban design, transportation sciences, and public health conducted pilot work to develop valid, reliable, and culturally sensitive recruitment strategies and data collection protocols needed to submit a competitive NIH grant proposal in 2017. The R01 submission was reviewed successfully and Fighting Obesity by Reinventing Public Transportation: A Natural Experiment was funded in 2018.
Research Core Project for the Texas A&M University System CDC-funded Prevention Research Center
(2004–2008)
The purpose of this research core was to improve the health of rural and underserved populations through better implementation, dissemination, and sustainability of clinical and community prevention and disease management guidelines. Two primary questions were addressed: (1) why community and clinical practice guidelines, which are designed to improve health, were not better utilized? and (2) what strategies for better guideline implementation, adherence, and dissemination in especially vulnerable populations (including poor rural populations) were most effective? This activity served as the foundation for our later diabetes prevention and management research and practice efforts.
Research and Translational Research Core Program for Rural and Minority Health Disparities
(2007–2012)
This NIH-funded program (PI: Kenneth McLeroy) addressed rural and minority health issues by (1) providing critical information on how population and setting characteristics to impact food choice, dietary patterns, and the risk of obesity in minority and rural populations; (2) developing interventions to reduce the risk of obesity, particularly among rural, minority, and underserved individuals; (3) testing the differential effectiveness of diabetes self-management models in rural, urban and minority populations; (4) strengthening the ability of the Texas A&M System to support disparities research and the recruitment and training of faculty committed to disparities research; and (5) developing a health disparities institute that will serve the 9 universities and 6 state agencies of the Texas A&M System. Critical roles included serving as Co-Director of the Research and Translational Research Core and Co-Investigator on the Diabetes Intervention Study.
South, West and Central Consortium Geriatric Education Center of Texas (Texas A&M Health Science Center affiliate member)
(2010–2015)
Funded through the Health Resources and Services Administration, the SWAC GEC was based at the University of Texas Health Science Center at San Antonio. The primary purpose was to improve patient care for the aged through interdisciplinary partnerships with faculty and practitioners in the fields of gerontology and geriatrics. This was accomplished by providing culturally appropriate geriatric training to health professionals through both on-site and distance learning mediums. Working with our other member networks, the subcontract to Texas A&M Health Science Center provided the infrastructure to direct activities in the Brazos Valley to focus on advancing the knowledge base about chronic disease management for seniors.
Special Initiative Project, Texas Healthy Aging Network (TxHAN) Center
(2009–2014)
The TxHAN was a member center of a CDC-funded thematic research and practice network promoting healthy aging research. Investigators at each member Center contributed to cross-cutting research initiatives, as well as developing and implementing externally reviewed site-specific research projects which were seeded through this mechanism. The TxHAN advanced key HAN research initiatives in the areas of physical activity and environmental assessment, while also engaging in addressing new research priorities identified by the HAN network in areas including evidence-based programming, depression, nutrition, and Alzheimer’s Disease.
The State Driven Fall Prevention Project
(2011–2016)
Essential elements of effective fall prevention programming at the state level were identified to accelerate and improve the dissemination of these effective models and associated findings to a broader, national audience. CDC funding supported three aims: (1) evaluate the impact of programs as they are scaled statewide; (2) provide technical assistance to bring programs to scale; (3) disseminate findings to key stakeholders. The ultimate impact of this initiative was to improve the health and functioning of the growing population of older Americans at risk for falling.
Statewide Evaluation of Childhood Obesity Prevention Policies in Texas
(2008–2015)
This RWJF-funded project examined the impact of two policy initiatives designed to improve physical activity (PA) and eating behaviors of children at risk for obesity in Texas: (1) the Safe Routes to School (SR2S) program; and (2) the revised WIC food package for children. Submitted jointly by the UT Dell Center (co-lead: Deanna Hoelscher) and Texas A&M (co-lead: Marcia Ory), this project used a mixed-methods approach for evaluation of these policies and included community-level (observations, GIS), organizational (counts of active transport at school, key informant interviews), and interpersonal/intrapersonal (social norms about PA and food, safety perceptions, child PA, purchasing & food consumption) measures. Findings from this study were disseminated through a comprehensive policy outreach educational effort, including a series of high visibility policy forums and related activities coordinated through the Texas Health Institute and the Live Smart Texas coalition website to inform future policy implementation and development.
Health Maintenance Consortium Supplemental Challenge Grants
(2004–2005)
The purpose of this subcontract to an existing NIH grant, Theory-based Interventions for Smoking and Obesity, was to foster cross-site analyses within the NIH-funded Behavioral Change Consortium. This contract supported five challenge grants and related technical assistance, along with resources, for sending common data to the Health Maintenance Consortium Resource Center. Challenge grants involved conceptual, methodological, and analytical work related to nutrition, physical activity, and smoking.
SUSTAIN for Better Health and Health Care for Older Adults
(2016–2019)
Widespread dissemination of evidence-based programs for older adults requires coordinated local and regional efforts. Funded by the Administration for Community Living as one of seven community grants to address the burdens of chronic disease among the aging population, this project will serve as the bridge to embed a suite of Stanford Patient Education Chronic Disease Self-Management Education (CDSME) programs within a 59 county region to strengthen and support Area Agency on Aging (AAA’S) services as a sustainable and reimbursable model. SUSTAIN’s objectives are to (1) create and evaluate a replicable healthcare referral model for linking clinical and community sectors; (2) examine Return on Investments (ROI) for the healthcare sector; (3) strengthen AAA’s by creating a business case for CDSME reimbursement.
Testing a Low-Literacy Diabetes Self-Management Education Kiosk
(2008–2011)
This three-year research study, funded by The Morris L. Lichtenstein, Jr., Medical Research Foundation, evaluated the implementation and dissemination of a computer-assisted touch screen, low-literacy, Diabetes Education Kiosk in five clinics/organizations in the Corpus Christi/Coastal Bend region. After investigating readiness for implementation, the study team focused on translational implementation research questions, using a combination of a focus group, survey, on-site observation, and computer tracking methodologies. After some local pilot testing in the Brazos Valley to test the feasibility and use of the Kiosk, we have redesigned the basic educational module to run off a web-based system so that we can more easily place KIOSKs in different geographical settings.
The Texas A&M University Coalition for Healthy Active Living
(2014–2016)
Rapid advances in sensor technologies, big data analytics and processing, electronic health and medical records, and the realization of the so-called “Internet of Things” have created a world in which devices and data can be harnessed to promote health and well-being in ways unimaginable just a mere decade ago. The Texas A&M University Center for Healthy Active Living (TAMU-CHAL) served as a research, education, outreach, and clinical nucleus within which multi-disciplinary research teams can be empowered to develop, test, and deploy new techniques and strategies which exploit this new ecosystem of data, services, and sensors to improve public and individual health. The core mission of this center was to engineer technologies and techniques for data collection and analyses, facilitate new forms of health research and analyses, and enable novel lines of health interventions, monitoring, and promotion for targeted populations of at-risk individuals.
Texas Cares: Model for Dementia Capable Communities
(2016 –2019)
Funded by the Texas Alzheimer’s Research and Care Consortium, this was a collaborative effort between Texas A&M and Baylor Scott and White Health to provide Persons with Dementia (PWD) and their family caregiver’s access to local services and supports that have been proven to promote the health and well-being of the PWD and their family caregivers. Objectives of this pilot research study were to concept test a comprehensive model of care to (1) promote dementia-friendly communities for Texans; (2) personalize educational and support services through candid interviews with dementia caregivers; and (3) create an online adaptation of an evidence-based intervention to provide tailored resources and coaching. This seed funding has resulted in funded projects to further develop and pilot test behavioral, environmental, and technological approaches to dementia care.
Texercise: Evaluating its Reach and Effectiveness
(2012–2013)
Texercise, a health promotions/disease prevention program of the Texas Department of Aging and Disability Services (TDADS), provides education, motivation, and recognition tools to help older adults and people with disabilities engage in healthy lifestyles. In collaboration with the Community Resource Center for Senior Health centered at Baylor Scott and White Health Care in Temple, Texas, TERE examined the existing Texercise program and its resources to document its evidence base. Major aims were to (1) review past experiences with the implementation and dissemination of Texercise; (2) modify current materials for replication; (3) examine the program reach and effectiveness in at least ten program sites in Texas, and 4) publish findings in peer-reviewed Journals to increase the visibility of Texercise. The major accomplishments were the standardization of a new Texercise Select Program to be further tested.
Texas Falls Prevention Coalition
(2007–2009)
This two-year project, funded through the Department of Aging and Disability Services, examined the implementation and outcome of A Matter of Balance, an evidence-based falls prevention program delivered throughout Texas. Technical assistance on study design, data protocol issues, and evaluation tools to assess major impacts on health and fall-related outcomes were provided. This project was coordinated with the Texas Healthy Lifestyles Program and the A Matter of Balance Program in the Brazos Valley. Established in 2007 to promote, implement, and evaluate evidence-based programs and policies to reduce falls and injuries in older adults, the Texas Falls Prevention Coalition transferred activities to the Texas A&M School of Public Health to reconstitute a Steering Committee of broad-based stakeholders to promote a multi-faceted approach to falls prevention and chronic disease self-management throughout Texas.
Texas Grow! Eat! Go!: Using Family Focused Garden, Nutrition & Physical Activity Programs to Reduce Childhood Obesity
(2016–2011)
The goal of this Integrated Research and Extension project is to assess the efficacy of a coordinated school health (CSH) program enhanced with family-focused, experiential garden, nutrition, and physical activity programs on the prevalence of child overweight and obesity in 3rd-grade students. The home food and physical activity environments will be targeted through two Extension programs designed to build upon CSH. Independent and combined effects of different programmatic approaches will be evaluated.
Texercise Select—Building the Evidence-Based Program
(2015–2017)
Texercise Select is a statewide health promotion created collaboratively between the Texas Department of Aging and Disability Services and Texas A&M School of Public Health Program on Healthy Aging. The program combines (1) education about the importance of physical activity and healthy eating; (2) skill-building sessions for learning how to set and achieve attainable lifestyle goals; and (3) a multi-component exercise program designed to increase strength, endurance, balance, and flexibility. Following up on an earlier study which standardized Texercise Select, the major objectives of this study were to examine: (1) the impact of Texercise Select on increased physical activity and healthy eating, enhanced social interaction, improved perceived quality of life, and better physical functioning; (2) the relationship between intervention dosage and study outcomes; (3) potential differential impacts across participant characteristics; (4) programmatic costs and quality-adjusted life-years attributed to program; and (5) factors affecting (i.e. barriers, facilitators) program implementation, dissemination, and long/short-term sustainability. This research enabled Texercise select to be considered an evidence-based program and eligible for title 3D funding.
Texas Healthy Aging Research Network Collaborating Center
(2009–2014)
Together with the Collaborating Center of the Healthy Aging Research Network (HAN), other HAN sites, and the CDC, TxHAN works to continue the advancement of the translation of prevention research to community-based practice focused on an aging population. Through partnerships with local, county, and state agencies, TxHAN seeks to identify public health, aging services, and related community resources and engage them in collaboration for healthy aging. The TxHAN will advance key HAN research initiatives in the areas of physical activity and environmental assessment, while also engaging in new research priorities including depression, nutrition, and Alzheimer’s disease.
Texas Healthy Lifestyles: Communities Putting Prevention to Work
(2010–2012)
The state of Texas was awarded Recovery Act funding to disseminate the Chronic Disease Self-Management Program to over 3,000 older Texans. The State selected five geographic areas as regional sites for the delivery and dissemination of this program. A critical role was to direct the statewide evaluation effort to track program dissemination, document the adoption by local community agencies, and provide technical assistance on standardized data collection and fidelity processes among partnering communities. This partnership has proven to be an excellent educational opportunity as well as a means to disseminate and sustain the delivery of evidence-based programs throughout the state.
Texas Healthy Lifestyles: Empowering Older People to Take More Control of Their Health Through Evidence-Based Prevention Programs
(2006–2011)
This four-year project created a focal point at the state level for evidence-based health promotion to help seniors take control of their lives and reduce the risk of disease and disability. The centralized evaluation effort examined study impacts in terms of the five Re-AIM elements and assisted in the evaluation of local activities to implement the Chronic Disease Self-Management Program.
Umbrella Partnerships-Be Active in our Towns (UP-BEAT)
(2010–2011)
The Brazos Valley Community Action Agency, Inc. was awarded a contract from the Texas Department of Health and Human Services to build the infrastructure for preventing obesity in Brazos County. The goal was to increase community capacity to address obesity through strategic planning around evidence-based community strategies for obesity prevention and make healthy eating and physical activity easier choices in Texas communities through the implementation of evidence-based community strategies for obesity prevention. The evaluation included assessments of activities to promote environmental and policy strategies for obesity prevention in College Station and Bryan, Texas.
WellCare: Developing Partnerships for Delivering Evidence-Based Self Management Programs
(2012–2013)
While Chronic Disease Self-Management Program and Diabetes Self-Management Program workshops have been disseminated by the Program on Healthy Aging in the Brazos Valley and other regions in East Texas with support of the Texas Department of Aging and Disability Services, a new grant from WellCare Health Plans, Inc. allows a significant opportunity in 2012-2013 to partner with several organizations in the Houston/Galveston area. Such private-public partnerships are essential for building a sustainable delivery system for reaching underserved populations. Our goal in the next year is to empower at least 400 older adults in the Houston/Galveston area to better manage their chronic disease and diabetes. This will be accomplished with the introduction of evidence-based programming in partnership with the collaboration of partners in the Houston Consortium. The Texas A&M Health Science Center Program on Healthy Aging will assist in program delivery and training, provide technical assistance in program recruitment and selection, and evaluate the program by documenting reach, adoption, and fidelity processes and outcomes.
Working on Wellness
(2014 –2018)
In response to the CDC Funding Opportunity on Programs to Reduce Obesity in High Obesity Areas, Working on Wellness (WOW), a community-based program was established to address obesity in Hidalgo County, Texas, where more than 40% of its 800,000 residents were obese. The Texas A&M AgriLife Extension Service and Texas A&M Health Science Center School of Public Health partnered to address the obesity issue in Hidalgo County by combining the skills and expertise of both organizations to improve access to healthier foods and safe places for physical activity. Bringing a wide array of specialists to support project implementation and evaluation, both organizations have a strong presence in Hidalgo County and considerable experience implementing and evaluating community prevention programs in border communities. Utilizing a community-based participatory approach, community assessments were conducted, and proposed strategies for addressing high rates of obesity were vetted with community stakeholders. The School of Public Health was responsible for the process and outcomes evaluation.