Project Type: Complete Project

Your Road to Health

Title:Your Road to Health
Status:Completed
Topic:Health Promotion & Wellness;Nutrition / Diet;Program or Product Development;School-based
Funding Source:Centers for Disease Control and Prevention (CDC), with supplemental funding from Griffin Hospital
Funding Period:2013-2017
Study Design:Pre/post combined with program opinion surveys.
Purpose: This study was a subset of the Valley Initiative to Advance Health & Learning in Schools (VITAHLS). The purpose was to develop, pilot test, evaluate, and revise a nutrition education program for use in middle and/or high schools. The goals were to motivate, teach, and help students develop skills to make healthful food choices and adopt an active lifestyle.
Further Study Details:This project focused on developing and offering a pilot version of the program, and evaluating its feasibility and effectiveness when taught by health teachers in 3 middle schools and 1 high school in two VITAHLS districts (Shelton and Seymour). The pilot program included a lesson plan, PowerPoint, and 2 hands-on activities.  A total of 237 students and 4 health teachers took part in the evaluation.We used the pilot study findings to guide revisions, and implement and evaluate a refined version of the program participating VITAHLS school districts. We replaced the PowerPoint with a Prezi presentation (using cloud-based software that is more interactive and engaging), and edited the content to reduce the potential for misconceptions about nutrition. The revised program also includes a lesson plan and 7 hands-on activities.  
Findings:After exposure to the pilot program, students’ mean nutrition knowledge scores (maximum possible score of 100%) increased from 52% at baseline to 78% on the post quiz (p<0.0001). Students’ responses to additional open-ended questions provided insight regarding potential misconceptions about nutrition concepts. Students’ suggestions to improve the program included: eliminating repetition of content; making the presentation more entertaining; and adding more facts, activities, and tips. Teachers’ suggestions included: shortening the PowerPoint and/or replacing it with a smart board or Prezi presentation; and adding more activities.
Eligibility: Students and teachers in participating health classes in two middle schools and one high school
Changed at:11/30/2017 8:12 AMChanged by:Lisa Seaberg
Created at:3/1/2017 4:54 AMCreated by:Lisa Seaberg

Worksite Smoking Cessation Program: Creating Healthy and Nicotine-free Griffin Employees (CHANGE)

Title:Worksite Smoking Cessation Program: Creating Healthy and Nicotine-free Griffin Employees (CHANGE)
Status:Completed
Topic:Program or Product Development;Smoking Cessation;Worksite Wellness
Funding Source:Centers for Disease Control and Prevention and Griffin Hospital
Funding Period:2/02-2/03
Study Design:Intervention Study
Purpose:To create a work-site smoking cessation program utilizing the impediment profile approach developed and tested in prior studies conducted by the PRC.
Further Study Details:This program was based on a successful smoking cessation pilot study (TISC; see below) developed by the PRC in 1999. As in the TISC study, participants completed an impediment profile questionnaire, were provided with their individual results, and were offered as many as 7 different “interventions” or programs to assist in their attempt to quit smoking. The CHANGE program used a personalized approach for its participants – tailoring the treatment to each person based on their needs. All therapies were offered at the worksite, during regular work hours, at no cost to employees and included medications and nicotine replacement, group counseling, dietary counseling, acupuncture, stress management and others.
Findings:At the end of the one-year program, 45% of participants were smoke free; those who were still smoking reported having cut down considerably on the number of cigarettes smoked daily. The success of the CHANGE program has led to incorporation of the program as a permanent benefit to hospital employees and family members.
Eligibility:Employees of Griffin Hospital, Derby, CT
Changed at:3/1/2017 11:04 AMChanged by:Lisa Seaberg
Created at:8/31/2010 12:03 PMCreated by:Griffin Hospital

Wellness Initiatives For Improved Tomorrows (WINFIT)

Title:Wellness Initiatives For Improved Tomorrows (WINFIT)
Status:Completed
Topic:Health Promotion & Wellness;Program or Product Development;Worksite Wellness
Funding Source:Griffin Hospital / CDC
Funding Period:2005-2016
Study Design:N/A
Purpose:To assist Griffin Hospital in developing a comprehensive employee wellness program with a core focus on nutrition, physical activity and chronic disease management.
Further Study Details:Griffin Hospital is committed to promoting the health and well-being of its employees and their families. The WINFIT initiative fostered a workplace environment to encourage environmental and social support for a healthy lifestyle and a mind/body/spirit approach to health. WINFIT was designed to be a comprehensive employee wellness program with a core focus on nutrition, physical activity, and chronic disease management. Components included: on-site weight loss/management programs; a carpeted stairwell with motivational signs; exercise classes; pedometers; monthly nutrition talks; nutrition information for cafeteria selections; depression screening; and financial management classes. In 2009, the PRC designed a Health Makeover Program for Griffin employees at greatest risk for developing chronic diseases. It offered an intensive 3-month intervention followed by 3 to 9 months of ongoing support to help participants adopt healthier lifestyle habits, including physical activity, nutrition, and weight management. Participants received web-based and group support, nutrition counseling, opportunities for physical activity at the worksite, and tools to set goals and track progress. In 2010, the PRC partnered with the hospital on a Healthy Dining program to encourage employees to make healthful food choices. In 2016, the WINFIT program was transformed into the AgeLess Program, which also aims to promote personal well-being and a healthy workplace through education and program offerings.
Eligibility:Griffin Hospital employees and their families.
Changed at:3/2/2017 7:51 AMChanged by:Lisa Seaberg
Created at:8/31/2010 11:12 AMCreated by:Griffin Hospital

Walnut Ingestion in Adults at Risk for Diabetes: Effects on Diet Quality, Body Composition, and Cardiac Risk Measures

Title:Walnut Ingestion in Adults at Risk for Diabetes: Effects on Diet Quality, Body Composition, and Cardiac Risk Measures
Status:Completed
Topic:Nutrition / Diet
Funding Source:California Walnut Commission
Funding Period:2012-2014
Study Design:Randomized controlled parallel design with two treatment arms
Purpose:We examined the effects of 6 months of daily walnut intake on diet quality, body composition, and markers of cardiovascular risk in a group of adults at risk for diabetes. Many people who are at risk for diabetes are also at risk for developing cardiovascular disease. Prior research has confirmed the health benefits of consuming walnuts, which are a rich source of omega-3 fats, other healthful nutrients, and antioxidants. Although walnuts are high in calories, they have not been found to contribute to weight gain in short-term studies, perhaps because they contribute to a feeling of satiety. We wanted to see if the effects would hold true over a longer time, and to compare the effects of adjusting, vs. not adjusting, for calories in the walnuts.
Further Study Details:The study included a 6-month walnut phase (2 oz walnuts/day), 3-month washout phase, and 6-month control phase (no walnuts). During the walnut phase, each adult was randomly assigned to either a calorie-adjusted or ad libitum diet.  We expected to find that a walnut-included diet (with or without advice to adjust for calories from the walnuts), when compared to a walnut-excluded diet, would significantly improve diet quality, body weight, percent body fat, and other measures of risk for diabetes (fasting glucose, hemoglobin A1C) and/or cardiovascular disease (blood lipids, vascular function). We also expected to find that keeping calorie levels constant while adding walnuts to the diet would enhance the beneficial effects of walnuts on diet quality, body composition, and vascular function.
Findings:Our data suggest that 6 months of a diet including 2 oz. of walnuts per day (whether calorie-adjusted or not) improved diet quality in adults at risk for diabetes. The effects of this diet (whether calorie-adjusted or not) on vascular function, waist circumference, total and LDL cholesterol were inconclusive. Neither version of the diet improved fasting blood glucose, HDL cholesterol, blood pressure, body mass index, percent body fat, percent body water, or visceral fat. Controlling calorie intake did not seem to enhance the beneficial effects of walnuts on diet quality, body composition, or vascular function. More research is needed to clarify the effects of walnuts in adults at risk for diabetes.
Eligibility:Men and women age 25 to 75 years, who were non-smokers, and at high risk for diabetes based on their weight, fasting blood glucose, and/or other risk factors
Changed at:3/2/2017 9:54 AMChanged by:Lisa Seaberg
Created at:3/2/2017 9:54 AMCreated by:Lisa Seaberg

VITAHLS School Breakfast Focus Groups

Title:VITAHLS School Breakfast Focus Groups
Status:Completed
Topic:Nutrition / Diet;School-based
Funding Source:Centers for Disease Control and Prevention
Funding Period:2017-2018
Study Design:Qualitative research (focus groups)
Purpose:Evidence suggests that eating breakfast regularly may improve academic performance and school attendance among children. Serving breakfast in the classroom is associated with improved diet quality. Despite these benefits, less than half of Connecticut students who qualify for free or reduced-price school meals, and who participate in school lunch, also take part in the school breakfast program. We conducted this study to identify the drivers of, and barriers to, school breakfast participation among students in two school districts in the Lower Naugatuck Valley of CT that are part of the Valley Initiative to Advance Health and Learning in Schools (VITAHLS).
Further Study Details:The PRC conducted 13 focus groups with elementary, middle, and high school students. Each focus group included 5 to 11 students with parental consent. We asked questions regarding breakfast consumption in general, and in the home and school settings. We also elicited suggestions to improve breakfast served at school. We used a software program to identify emerging themes from the transcripts and group them into categories based on how they related to our research questions.
Findings:Below is a brief summary of our findings relative to our research questions.Why do students choose to eat breakfast?  The major factors in deciding whether to eat it on school days were parental influence, hunger or desire to avoid physical symptoms, and inadequate time. Many elementary school students said their parents stressed the importance of breakfast, and took steps to ensure that they ate it each morning. Children in grades K-6 tended to report feeling hungry in the morning, while those in grades 7-12 more often mentioned a lack of hunger. Some students said they found it hard to pay attention if they skipped breakfast. However, many students skipped breakfast due to a lack of hunger or desire to eat early in the morning. For some, the importance of eating breakfast varied based on their plans for the day. Many middle and high school students who skipped breakfast said they felt rushed in the morning and had too little time to eat it during the school week. Some said they only ate breakfast on the weekends when they had more time.Why do students eat breakfast at home?  Most felt it was a more appealing option than eating it at school. The top reason was distaste for school food. Many said that school foods are unhealthy or “junk” or “fake.” School breakfast was commonly perceived as a waste of money because better, less expensive food was available at home. Lack of time was also a perceived barrier. Students reported feeling too rushed at school and having other priorities – including socializing with friends.Why do students eat breakfast at school?  While some mentioned eating breakfast at school when preferred foods – such as breakfast sandwiches or “brownie bars” – were served, most students said they ate breakfast at school if hungry and lacking other options due to time constraints at home.How could school breakfasts be improved?  Students expressed a desire for:more food choices, particularly a larger variety of fruits;more opportunities to customize their meals;fresh made-to-order “real” foods, rather than “fake” processed foods; andmore healthful options. 
Eligibility:Elementary, middle, and high school students in a school district in which 22% of students qualified for free or reduced-priced meals. Middle school schools in another district that offered universal free breakfast because 69% of students qualified for these meals.
Changed at:11/27/2018 9:44 AMChanged by:Lisa Seaberg
Created at:11/27/2018 9:44 AMCreated by:Lisa Seaberg

Vascular Reactivity Assessment by a Novel Diagnostic Device, AngioDefender™, compared to using Brachial Artery Ultrasound Imaging

Title:Vascular Reactivity Assessment by a Novel Diagnostic Device, AngioDefender™, compared to using Brachial Artery Ultrasound Imaging
Status:Completed
Topic:Cardiovascular Health / Endothelial Function*
Funding Source:Everist Health
Funding Period:2015 to 2017
Study Design:Non-invasive, randomized, crossover, multicenter investigational device study, blinded (to results only)
Purpose:Cardiovascular diseases (CVDs) are disorders of the heart and blood vessels. Since symptoms often remain silent until a major health event occurs, it is important to detect and prevent CVDs at an early stage before symptoms occur.  One non-invasive means measures the function of endothelial cells that line the inside of blood vessels and help them dilate properly as blood flows through them.  Endothelial function is usually measured by a non-invasive ultrasound procedure that checks how well the brachial artery in the arm dilates as blood flows through it. This procedure works well, but requires highly skilled technicians and expensive equipment. This study compared a new automated machine (AngioDefenderTM) to brachial artery ultrasound imaging (BAUI) in measuring blood vessel function.  
Further Study Details: Other sites participating in this study included the Boston University School of Medicine, the Medical College of Wisconsin, and the University of Colorado.
Findings: Data obtained from these studies will be used to refine the automated technology.
Eligibility:Adults at least 18 years of age who might qualify to take part based on their overall health status, body mass index (BMI), arm circumference, blood pressure, blood cholesterol and glucose levels, absence of certain CVD clinical signs, absence of viral or bacterial infections, and ability to comply with study procedures.  
Changed at:11/30/2017 7:48 AMChanged by:Lisa Seaberg
Created at:3/1/2017 6:10 AMCreated by:Lisa Seaberg

Valley Initiative to Advance Health and Learning in Schools (VITAHLS)

Title:Valley Initiative to Advance Health and Learning in Schools (VITAHLS)
Status:Completed
Topic:Nutrition / Diet;Physical Activity;School-based
Funding Source:Centers for Disease Control and Prevention (CDC) has been the primary funding source, with supplemental funding in 2013-2014 from Griffin Hospital and the Jones Family Farm.
Funding Period:2011-2019
Study Design:N/A
Purpose:VITAHLS was founded in 2011 to promote healthy lifestyles (focusing on nutrition and physical activity) to PreK-12 students, students’ families, and school staff in the Lower Naugatuck Valley. VITAHLS has been a combined effort of the Yale-Griffin PRC, Griffin Hospital, school districts (Ansonia, Derby, Naugatuck, Seymour, and Shelton), a partner from the CT State Department of Education, and community partners (the Naugatuck Valley Health District, Ansonia Chargers Club, Massaro Community Farm, ShopRite Supermarket, Boys & Girls Club, Valley Early Child Regional Council, and Valley YMCA). The PRC played an active leadership role in VITAHLS during its first 8 years. After 2019, leadership will be transitioned to school district representatives.
Further Study Details:The PRC employed a VITAHLS coordinator from 2013-2019 to develop health promotion materials, plan meetings and events, oversee data collection, and serve as a resource for schools. Representatives of the PRC, school districts, and community partners attended monthly working group meetings. Health promotion efforts evolved and expanded over time and included: nutrition and classroom-based physical activity programs for elementary schools; a middle school nutrition program; an annual healthy cooking competition; a cookbook; school gardens; farm field trips; a nutritional scoring system in school cafeterias; a “Smarter Lunchroom” in one cafeteria; physical activity videos featuring local high school students; and weekly “Valley Health Challenge” messages. The PRC provided mini-grant funding to support staff-driven health promotion projects.
Findings:Student BMI: BMI z-scores generally did not change from the 2011-2012 to 2017-2018 school years, except in one district that had declines in both measures. The number of students, grade levels assessed, and timing of assessments varied from year to year and among districts, making comparisons between districts or over time somewhat challenging.Student fitness: Fitness test scores, reported by districts to the state of CT, improved in VITAHLS districts from 2011-2012 to 2017-2018, whereas scores for the state overall remained flat. Because these were aggregate data reported by grade, it was not possible to determine whether these differences were statistically significant.Student academic performance: There were no notable changes in performance measures in any of the districts.Program inventory survey: More than 50 nutrition and physical activity programs, activities, and policies were implemented during this project period. Partnership/staff survey: Among the 125 staff from the school districts who responded, 25% were “very familiar” with the VITAHLS initiative, 57% has some awareness of it, and 18% had never heard of it.Perceived impact of VITAHLS: Benefits included: access to information; professional development opportunities; networking; inter-district collaborations; links to community organizations; student wellness emphasis; ideas for staff wellness; mini-grant funding; other grant opportunities; leveraging the partnership to obtain funding from other sources; support in setting up school gardens; and an enhanced ability to address issues through shared efforts. Challenges included: inability of some staff to attend working group meetings without substitute coverage; lack of authority among some staff to make decisions on behalf of their schools or districts; and lack of awareness of VITAHLS among students’ families or other school staff.
Eligibility:Students in participating grades in participating schools in each district, and staff involved in any VITAHLS-related wellness programs available within their districts.
Evaluation:During the 2014-2019 funding period, VITAHLS served as the school-based “epicenter” of our Community Health Opportunities Organized with Schools at the Epicenter (CHOOSE) core research project. We evaluated the impact of the initiative on changes in students’ body mass index (BMI), fitness levels, and academic performance in repeated cross sections of students over time. We also assessed: awareness of VITAHLS among school staff; uptake of VITAHLS-related programs in schools; and the perceived impact of VITAHLS among school partners.
Changed at:3/27/2020 3:55 PMChanged by:
Created at:3/1/2017 4:38 AMCreated by:Lisa Seaberg

Valley CARES (Community Assessment, Research, and Education for Solutions)

Title:Valley CARES (Community Assessment, Research, and Education for Solutions)
Status:Completed
Topic:Community
Funding Source:Valley Council for Health and Human Services
Funding Period:Not defined
Purpose:To track the well-being of Lower Naugatuck Valley residents on a regular basis, and use this information to mobilize community action to address residents’ needs. ValleyCares was sponsored by the Valley Council for Health and Human Services, a network of non-profit community health and human service organizations. Task force members represented the Naugatuck Valley Health Department, the Valley Council, the Workplace, the Birmingham Group, Griffin Hospital, and the Yale-Griffin PRC.  The PRC also performed data gathering and analysis for the project. 
Further Study Details:The task force identified  a comprehensive set of quality-of-life indicators based on community health, community safety, behavioral health & social services, education & training, natural environment, and community engagement. To fill in gaps in existing data, the task force engaged the Center for Research & Public Policy to conduct a community assessment survey by phone with 400 residents of Ansonia, Beacon Falls, Derby, Oxford, Seymour and Shelton. Residents were asked to comment on their needs, perceived quality of life, and access and barriers to community services and programs. Findings were shared with Valley health and human service providers, community leaders, and residents. The task force offered Community Dialogues to determine priorities for community action, and helped to develop programs/interventions to address those issues.
Eligibility:N/A
Changed at:3/2/2017 7:49 AMChanged by:Lisa Seaberg
Created at:8/31/2010 9:42 AMCreated by:Griffin Hospital

United Way Obesity Prevention Program

Title:United Way Obesity Prevention Program
Status:Completed
Topic:Obesity / Weight Management
Funding Source:Valley United Way
Funding Period:2005-2006
Study Design:Controlled Study with a Delayed Intervention
Purpose:To evaluate the impact of a physical activity intervention at the Ansonia Connecticut YMCA and a cognitive-behavioral intervention at the Boys and Girls Club on fitness levels, BMI, physical activity levels, nutrition education and self-efficacy, and diet.
Further Study Details:This study evaluates the impact a physical activity intervention at the Ansonia YMCA and a cognitive-behavioral intervention at the Boys and Girls Club on fitness levels, BMI, physical activity levels, nutrition education and self-efficacy, and diet. All program participants took part in the evaluation.
Findings:Sixteen children were enrolled in this pilot study: 7 in the Intervention group and 9 in the Control group. Overall, participants were very overweight, with the mean baseline BMI of 28 for boys and 27 for girls. At the end of the program, no significant and meaningful improvements were observed for BMI, percent body fat, or heart rate after a 3-minute step test. Energy expenditure for the after-school-hours activities significantly decreased from baseline to the end of the study for the intervention group, while the reverse was true for the control group. Although the improvements did not reach statistical significance, both groups reported a decrease in their daily caloric intake; an increase in consumption of “heart-healthy” foods and in dietary selfconfidence to choose such foods. This abnormal finding can be explained if children in the control group participated in other programs or activities that increased their physical activities after school.There were limitations to this evaluation. The small sample size affected the ability to detect significant improvements in the outcomes. Also, the length of the intervention program might not have been sufficient to observe changes in the outcomes. Notwithstanding the limitations, this obesity prevention program has a potential to produce desirable changes in the participants over a longer period of time. Therefore, this evaluation can be viewed as an evaluation of a pilot program which warrants further investigation into its efficacy with a larger sample size and longer program duration.
Eligibility:Children of both genders attending the YMCA and Boys and Girls Club
Changed at:1/18/2011 9:52 AMChanged by:Judy Treu
Created at:8/31/2010 11:42 AMCreated by:Griffin Hospital

Understanding the Determinants of and Barriers to Fruit and Vegetable Consumption in Multi-Ethnic, Adult Populations

Title:Understanding the Determinants of and Barriers to Fruit and Vegetable Consumption in Multi-Ethnic, Adult Populations
Status:Completed
Topic:Nutrition / Diet
Funding Source:Centers for Disease Control and Prevention
Funding Period:10/01- 9/04
Study Design:Survey Development and Validity Testing
Purpose:To develop and test survey instruments for use in assessing the determinants of, and barriers to, fruit and vegetable consumption in multi-ethnic, adult populations.
Further Study Details:This study was designed to help understand the reasons why people tend to eat less than the recommended amounts of fruits and vegetables, and to use these findings to develop a survey to gather this information. Study teams from the Yale Prevention Research Center and University of North Carolina Prevention Research Center assessed fruit and vegetable intake through methods that included a systematic search of the literature, focus groups, intercept interviews in supermarket and restaurant settings, and cognitive testing. Information gathered during Phase 1 was used to create a new survey which was validated during Phase 2 of the project.
Findings:Supermarket interviews with 27 adults indicated the top three factors that influenced the purchase of fruits were price, freshness, and taste, whereas the top three factors that influenced their purchase of vegetables were special sales, price, and taste. Restaurant interviews with 17 adults provided similar responses. Focus groups conducted with 66 adults revealed a general lack of knowledge regarding the definition of serving sizes and the term “5 a day” used to promote fruit and vegetable consumption. Perceived barriers to fruit and vegetable consumption were time, price, perishability, presentation, lack of freshness, and lack of variety. Perceived facilitators to fruit and vegetable consumption were taste, presentation, availability, preparation, convenience, variety, and advice from a physician.
Eligibility:African-American, Hispanic, and White adult men and women
Changed at:1/18/2011 9:48 AMChanged by:Judy Treu
Created at:8/31/2010 11:34 AMCreated by:Griffin Hospital