Yale-Griffin Prevention Research Center| Title: | A Prescription for Health Equity: A Healthcare Provider-based Produce Prescription Program for People with Prediabetes and Type 2 Diabetes |
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| Status: | Current |
| Topic: | Cooking/Culinary Arts;Diabetes / Insulin Resistance |
| Published Article: | Nutrition Education Content for E-Blasts and Websites full.pdf |
| Eligibility: | To qualify for this study, you must: |
| Changed at: | 7/28/2023 3:53 PM | Changed by: | Christian Meagher |
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| Created at: | 7/28/2023 3:48 PM | Created by: | Christian Meagher |
| Title: | Effects of Daily Inclusion of Eggs in a Heart-Healthful Dietary Pattern on Endothelial Function, Cardio-Metabolic Risk Factors and Diet Quality |
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| Status: | Current |
| Topic: | Cardiovascular Health / Endothelial Function*;Diabetes / Insulin Resistance;Nutrition / Diet |
| Funding Source: | The Egg Nutrition Center |
| Funding Period: | July 2022 – December 2023 |
| Study Design: | Randomized controlled trial with a crossover design. All participants will be assigned to both an intervention and a control phase. The sequence of the phases will be randomly assigned. |
| Purpose: | This study will examine the effects of including eggs in the context of the Dietary Approach to Stop Hypertension (DASH) diet.The DASH diet features vegetables, fruits, whole grains, low-fat dairy products, fish, poultry, beans, nuts, seeds, and vegetable oils. It includes eggs, but limits egg yolks to 4 per week due to their cholesterol content, and the long-standing belief that foods high in dietary cholesterol raise blood cholesterol level. Yet recent studies haven’t supported a link between dietary and blood cholesterol levels and cardiovascular risk.Because eggs are rich in protein, vitamins, and minerals, and contribute to satiety, it is important to study their consumption in the context of health-promoting diets. |
| Further Study Details: | This study will examine the effects of a DASH diet with and without eggs on cardio-metabolic risk measures and diet quality when consumed by 45 overweight adults with high blood cholesterol. Participants will be randomly assigned to Group A or B. Both groups will receive dietary guidance from the study dietitian.During an initial 4-week run-in period, both groups will consume a DASH diet without eggs.After the first 4 weeks:Group A will consume a DASH diet plus 2 eggs daily for 8 weeks (Phase 1), then a DASH diet without eggs during an 8-week washout, then a DASH diet without eggs for 8 weeks (Phase 2).Group B will consume a DASH diet without eggs for 8 weeks (Phase 1), then a DASH diet without eggs during an 8-week washout, then a DASH diet plus 2 eggs daily for 8-weeks (Phase 2). |
| Eligibility: | Inclusion criteria:Men greater than 18 years of agePost-menopausal women not on hormone replacement therapyNon-smokersOverweight or obeseTotal cholesterol of 240-300 mg/dl and /or LDL cholesterol of 130-190 mg/dl, and/or a total cholesterol to HDL ratio of >5.7 |
| Evaluation: | Assessments will be done at the start and end of each phase. Each of the 4 study assessments will include these measures: 1. Ultrasound of the brachial artery in the right arm to assess blood flow (endothelial function) 2. Review of 3-day diet intake, medications, and physical activity 3. Blood pressure 4. Height, weight, body composition and waist circumference 5. Blood cholesterol, glucose, and insulin |
| Changed at: | 4/12/2023 4:14 PM | Changed by: | Christian Meagher |
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| Created at: | 4/12/2023 4:14 PM | Created by: | Christian Meagher |
| Title: | A Prescription for Health Equity: A Healthcare Provider-based Produce Prescription Program for People with Prediabetes and Type 2 Diabetes |
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| Status: | Current |
| Topic: | Community;Diabetes / Insulin Resistance;Nutrition / Diet |
| Funding Source: | Gus Schumacher Nutrition Incentive Program (GusNIP) Produce Prescription Program, administered by the National Institute of Food and Agriculture at the U.S. Department of Agriculture |
| Funding Period: | 2022-2026 |
| Study Design: | This project will be conducted in 3 phases: 1. Sept. 2022-Feb. 2023: Formative research and program co-design with community partners and potential program participants 2. March 2023-Feb. 2025: Randomized controlled trial of a healthcare provider-based produce prescription program (PPR) 3. March 2025-Aug. 2026: Data analyses and dissemination of findings |
| Purpose: | Griffin Hospital and the Yale-Griffin PRC are partnering to offer a healthcare provider-based produce prescription program (PPR) (co-designed with community partners and residents) to low-income residents of Connecticut’s Lower Naugatuck Valley (LNV) who receive care from Griffin Hospital and/or the Griffin Faculty Physicians practice, and who have prediabetes or type 2 diabetes. The goal is to improve their food security, diet quality, cardio-metabolic health outcomes, and healthcare costs.Disparities in access to healthy foods can lead to disparities in obesity, diabetes, overall health, and quality of life. Produce prescription programs with incentives to buy fruits and vegetables can help improve participants’ food security and nutritional status, which can help reduce health disparities resulting from differential access to healthy foods. |
| Further Study Details: | The project team will recruit 134 adults with pre-diabetes or type 2 diabetes. We will randomly assign 67 to a PPR intervention and 67 to a delayed intervention control group.The 6-month PPR will include vouchers to buy fresh fruits and vegetables, along with nutrition education. The vouchers’ monthly value will be $40 per household, with an extra $5 per additional household member. The specific nutrition education and the voucher redemption sites will be determined based on the formative research. |
| Eligibility: | To qualify for this study, you must be:Age 18 years or olderResident of the Lower Naugatuck ValleyPatient at Griffin Hospital and/or Griffin Faculty Physicians practiceEligible for Medicaid and/or the Supplemental Nutrition Assistance ProgramDiagnosis of prediabetes or type 2 diabetesAble to communicate in English or Spanish |
| Evaluation: | The project team will evaluate the co-design process, PPR implementation, and the PPR’s impact on participants’ food security status, diet quality, hemoglobin A1C, blood lipids, blood pressure, weight, and body mass index. Outcome measures will be assessed at baseline, after the 6-month intervention, and 3 months later. We will also assess the PPR’s impact on healthcare costs. |
| Changed at: | 4/12/2023 1:19 PM | Changed by: | Christian Meagher |
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| Created at: | 4/12/2023 1:19 PM | Created by: | Christian Meagher |
| Title: | REALIST REVIEW: What Does it Take for Type 2 Diabetes Prevention/Lifestyle Management Virtual Interventions to Work among Low-Income Communities? |
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| Status: | Current |
| Topic: | Community;Diabetes / Insulin Resistance;Health Promotion & Wellness;Nutrition / Diet;Physical Activity |
| Funding Source: | Centers for Disease Control and Prevention (CDC) |
| Funding Period: | 2020-2023 |
| Study Design: | Realist review of published literature |
| Purpose: | Concurrent with our core research project, a team led by Associate Research Scientist Amber Hromi-Fielder, PhD, MPH is conducting a realist review of published research articles on Type 2 diabetes prevention/ lifestyle management interventions in low-income communities. The purpose of this review is to determine how, why and in what circumstances diabetes prevention programs (DPPs) delivered virtually can effectively improve diabetes risk factors among adults with lower incomes. The team will search for articles on: (1) diabetes prevention and lifestyle management programs, (2) virtual services, and (3) community health workers (CHWs), and will then look for areas of overlap between these topics to help address these questions. Adults with lower incomes are at increased risk for Type 2 diabetes, but face barriers to participating in programs to help reduce this risk. Virtual services have been proposed as a way to reduce these barriers. Although they’ve been found effective in improving diabetes self-management among adults in general, less is known about their effectiveness in preventing diabetes in adults with lower incomes.CHWs can serve as a critical link to providing health services to these adults. Research has been published on virtual delivery of DPPs, and the roles of CHWs in diabetes prevention. However, there is a gap in knowledge concerning the role of CHWS in the virtual delivery of DPPs. The realist review is intended to help fill in this gap. |
| Further Study Details: | Realist reviews, unlike traditional systemic reviews, are not intended to locate every published paper. Rather, searches become refined as the conceptual framework guiding the search is continually improved. |
| Eligibility: | Journal articles that meet criteria for selection as established by the Realist Review team. |
| Evaluation: | The team will search for published articles on three research topics and look for areas of overlap between these topics to help address our research questions. See “Purpose” for more details. |
| Changed at: | 4/12/2023 4:17 PM | Changed by: | Christian Meagher |
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| Created at: | 1/5/2021 9:07 AM | Created by: |