NEWS ARCHIVES

CDC FUNDS NEW CENTER FOR HEALTH COMMUNICATION WITHIN CHIP
November 2005

NIH FUNDS NEW CHIP AFFILIATE RAFAEL PEREZ-ESCAMILLA TO CREATE NEW CENTER FOR ELIMINATING HEALTH DISPARITIES AMONG LATINOS
October 2005

CHIP GRADUATE STUDY DESIGNS NUTRITION PROGRAM FOR LATINO DIABETICS
October 2005

CDC FUNDS NEW CENTER FOR HEALTH COMMUNICATION WITHIN CHIP

November 14, 2005
By Beth Krane

Photo by Melissa Arbo

A team of researchers led by communication sciences professor Leslie Snyder has won a $3.8 million federal grant to establish the Center for Health Communication and Health Marketing on the Storrs campus.

The new UConn center is one of the first two agencies in the country funded by the U.S. Centers for Disease Control and Prevention (CDC) to focus on health communication.

“Until now, the only federally-funded centers to focus on health communication have been funded through the National Cancer Institute, and have focused exclusively on cancer-related communication campaigns,” says Snyder, who will be director of the new center. “This is a brand new opportunity in the field of health communication – an opportunity to focus on health communication more broadly.”

The center, which will be housed within UConn’s Center for Health/HIV Intervention and Prevention (CHIP), is funded for three years. During that time, it will develop two communication tools – using what is known as “an educational entertainment approach” – to deliver messages about safe sex and the dangers of using club drugs to hard-to-reach teen and young adult audiences.

The first project will be to create a video game that promotes safe sex for urban 18- to 25-year-olds from low socio-economic backgrounds, Snyder says.

The researchers chose this age group, even though some teens become sexually active much younger, because research has shown that the older teens have the highest incidence of unprotected sex.

The game, which will be designed by the research team in collaboration with a video game company, will target youth who are not in school and not likely to read newspapers or watch television news, and hence not likely to be exposed to health-related messages in other settings, she says.

“We think the interactivity of the video game format will keep them engaged with the safe sex messages longer, and the opportunity for role playing will allow them to learn the appropriate negotiation skills,” Snyder says.

“Video games have been used effectively for diabetes and asthma management, but not for safe sex. This is new.”

Snyder says she expects to have a prototype of the video game ready for testing in Hartford, Willimantic, and Providence next fall, with the ultimate goal of distributing it for use in urban areas nationwide.

The center’s second project will be to develop and host a series of shows at local entertainment venues in Hartford that will appeal to urban youth ages 16 to 20, and include messages about the risks of club drug use, which may lead to other risky behaviors, Snyder says.

The project will be a collaborative effort between UConn researchers and a new partner for the University – the Institute for Community Research in Hartford – that promotes local culture through community events and outreach. Jean Schensul, the organization’s founding director, is the lead investigator for the project with Snyder, who is co-principal investigator.

The shows could include rap artists or salsa music and performers, for instance, and will strive to use well-known local entertainers, Snyder says. She also says some of the artists involved in the center-sponsored events might market the songs they develop for them.

The center is aiming for a younger audience with its second project, because it hopes to reach teens before they start using club drugs, Snyder says. The goal is to hold the first show in Hartford next summer, and another in New Haven during the summer of 2007.

Ultimately, the center plans to create a manual for producing successful events that other community organizations could use.

“We’re hoping these shows become widespread practices,” Snyder says. “We want to reach people in a way they want to be reached.”

In addition to the two projects to develop new communication tools, Snyder says the center will conduct research including analysis of existing health interventions and monitoring the advertising of healthy and unhealthy products. The team has already started analyzing the research literature on nutrition interventions.

During its first three years, the center also will work with public health departments in all 50 states to analyze their health communication activities and identify programs they have designed that may be appropriate for duplication in other states or nationwide.

The center will have two external advisory boards – one of research scientists and another of professionals in public health, communication, marketing, and health industries – as well as an internal executive committee. Researchers from the Health Center, several other UConn schools and departments, and the Connecticut Department of Public Health will be involved as center research affiliates.

Jeffrey Fisher, a professor of social psychology and the director of CHIP, will be assistant director of the new center, which he considers a success story. A team of roughly 40 researchers already brought together as CHIP principal investigators and research affiliates, including Snyder, responded within three weeks to the CDC’s request for grant applications last May.

“CHIP created the atmosphere where that could happen,” Fisher says. “We already had the interdisciplinary team assembled to respond quickly to the grant application and we are pleased to have this new center within CHIP.”

NIH FUNDS NEW CHIP AFFILIATE RAFAEL PEREZ-ESCAMILLA TO CREATE NEW CENTER FOR ELIMINATING HEALTH DISPARITIES AMONG LATINOS
October 24, 2005

Major NIH grant to fund study of Latino health
by Beth Krane

The National Institutes of Health’s National Center for Minority Health and Health Disparities recently awarded Rafael Pérez-Escamilla, an associate professor of nutritional sciences, and his collaborators at the Hispanic Health Council and Hartford Hospital an $8.25 million, five-year grant to establish the Connecticut Center of Excellence for Eliminating Health Disparities among Latinos.

The new center, the first of its kind in the northeastern United States, will employ a mix of research, education and training, and community outreach initiatives to address the health disparities faced by minorities. These disparities, which came to national attention in the wake of Hurricane Katrina, pose a looming problem across the country – and in Connecticut – to the growing Latino community.

Consider:

* By the year 2050, the Latino population nationwide is projected to grow to 90 million, or 25 percent of the U.S. population.
* Between 1990 and 2000, Connecticut’s Latino population grew by 50.3 percent, making Latinos the state’s largest minority population.
* Latinos are severely affected by Type 2 diabetes at a rate about twice that of Caucasians.
* Latinos experience the worst poverty rate among the six ethnic groups in Connecticut analyzed in the U.S. Census, and are substantially less likely than their Caucasian and African American peers to have health insurance.
* The ethnic group has the lowest level of education in the state.

“Latinos comprise the fastest growing minority group in the state and the country, and are severely affected by poverty and all sorts of risk factors and diseases,” says Pérez-Escamilla, who has been studying public health and nutrition issues among the Latino – mostly Puerto Rican – community in Hartford since 1994. “They face very serious issues related to lack of access to quality health care and poor nutrition, and those issues are often exacerbated by cultural, language, and educational barriers.”

The center will build upon the 10-year-old community and research-based nutrition education program Pérez-Escamilla has directed in Hartford in collaboration with the Hispanic Health Council and Hartford Hospital. The program’s established interventions include puppet shows that teach school children about proper nutrition; health and nutrition social marketing campaigns; and peer counseling programs to promote breast feeding and diabetes prevention. Pérez-Escamilla’s research group has published extensively on the impact of these interventions.

The center will have four core components: administration, research, education and training, and community outreach. The administration component will be housed on the Storrs campus, and UConn also will take the lead in research and education and training; the Hispanic Health Council will direct the community connections component, under the supervision of Pérez-Escamilla’s co-principal investigator, Grace Damio.

CHIP GRADUATE STUDY DESIGNS NUTRITION PROGRAM FOR LATINO DIABETICS
October 11, 2005
by Cindy Weiss

Photo by Peter Morenus

Avocados. Plantains. Yams. Papayas. Limas.

These are choices you don’t usually see on a food pyramid prepared for the general population. But they are familiar foods in the Latino community, so they are on the food charts and meal plans that a UConn psychology graduate student designed to help diabetics in Hartford – where the population is nearly one-third Puerto Rican – choose a healthy diet.

Chandra Osborn, a Ph.D. student working with Professor Jeffrey Fisher, is trained in the IMB model, named for “information, motivation, behavior skills,” that Fisher and his colleagues developed in the late 1980s to change the risky behavior of patients infected with HIV.

The model has had demonstrated success with HIV patients and prevention. This has led Fisher, the director of UConn’s Center for Health/HIV Intervention and Prevention (CHIP), and researchers at the center to extend the model to other at-risk health populations.

When she learned at conferences that Latinos and African-Americans are twice as likely as the general population to have diabetes and that Puerto Ricans are among those with the highest rate of the disease, Osborn wanted to find out whether the IMB model could influence the behavior of at-risk Latino diabetics.

“I decided something needs to be done,” she says.

Osborn designed an assessment to help Latinos in Hartford manage their diabetes. Nearly 13 percent of Puerto Ricans in the city have been diagnosed with diabetes, and many more may have the disease and not know it.

With the support of Noemi Cruz, a nutritionist at Hartford Hospital, Osborn’s program was introduced to 118 diabetic patients in the hospital’s adult primary care clinic. Many of the clinic’s patients do not receive personal counseling about managing their diabetes because they lack medical insurance.

The patients were surveyed about their habits and health. They were given a test to measure their average glucose level over three months and a diet plan, based on their activity level, weight, and height.
Half of them became a control group for the study, and half received more extensive counseling. Their risk factors were assessed and discussed with them individually by a Spanish-speaking community health worker, who discussed with them a diet and exercise plan tailored to their needs.

The IMB model guiding the program proposes that if patients have information, motivation, and behavior skills, they will be inclined to make healthy changes in their lifestyle.

Low-income diabetics do not have the resources to join a gym or fitness club, so the health worker recommended alternatives, such as walking to the market, climbing stairs, and joining friends for Latin dancing – anything that fit into a patient’s lifestyle and social patterns.

Chandra Osborn, a graduate student in psychology, displays some of the items she included in food charts and meal plans to help Latino diabetics in Hartford.

Patients at the clinic often have had little formal education and do not know much about diabetes.

“They often think that only sugar raises their glucose, not carbohydrates,” Osborn says. She developed a flip chart in Spanish, explaining what a carbohydrate is.

“Many of them asked to have the flip chart pages copied,” she said.

Osborn ordered brochures in Spanish from the American Diabetes Association and had a meal plan designed that is illustrated with foods in the local Puerto Rican diet – such as papayas, coconut milk, and familiar seasonings.

The community health worker was trained to teach the patients how to read food labels and how to judge the size of a single serving. The patients were taught what they should eat and how many portions to eat per day.

“This population sometimes skips breakfast, has a light lunch and a big dinner,” Osborn said.

At the clinic they were shown how to space their carbohydrate consumption more evenly.

After their first counseling session in the spring, patients left with a set of goals for diet and exercise. Follow-up sessions now underway are determining whether they have modified their behavior and whether their biological measures, such as weight and average glucose level, have changed.

If the program works, it could be implemented in Amigos en Salud, or “Friends in Health”, classes that serve Latinos in hospitals around the country.

Osborn’s project required hiring and training a Spanish-speaking health worker and developing questionnaires and brochures in Spanish. She financed this with seed money from Fisher, her adviser, and an $83,000 National Institutes of Health grant she was awarded as a minority pre-doctoral student (she is half Samoan).

Osborn came to UConn to study with Fisher after graduating from Cal State San Marcos. After she receives her Ph.D., she plans to continue working with Latino diabetics.

“I have tons of ideas on how to expand on this and improve it,” she says.