Change from within: community-based obesity intervention in D.C.

Scientific advances that benefit the public health are only as good as their ability to reach the public. Oftentimes, though, the people most at need for those interventions and advances–such as inner city African-American communities—are also the most difficult to reach.

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Dr. Tiffany Powell-Wiley, a tenure-track investigator at the National Heart, Lung, and Blood Institute (NHLBI), is tackling these issues head on. She initiated the first stage in developing a community-based behavioral weight loss intervention program in Washington, D.C., specifically in Wards 5, 7, and 8, where data from the DC Department of Health indicates African-American obesity rates are the highest. Powell-Wiley’s project is assessing what risk factors for heart disease are most prevalent in these Wards, and whether providing tools to monitor nutrition and physical activity can help improve the behaviors of those living in these particular urban communities.

“A lack of access to resources, like healthy foods or health clinics, is a major roadblock in these underserved urban communities,” said Dr. Powell-Wiley. “But researchers also lack some basic data about health needs. Outside of obesity, what risk factors do we really need to target in these wards? Which behaviors should we focus on changing?"     

The project followed approximately 100 adults, who were recruited with the aid of local African-American churches; the participants were given handheld fitness monitors and cameras that enabled them to track their dietary habits and physical activity. They also received clinical examinations to test for common risk factors such as diabetes, hypertension, high cholesterol, and smoking.

“An advantage of working at NIH is that we have access to some great resources. We will be able to launch some new tools to measure diet and exercise that haven’t been used in community interventions before,” she said. “The unknown is how well these tools will operate in a real-world setting. How will participants use them? Will they use them at all? Are these tools useful in the context of their daily lives?”

In keeping with the community theme, the program staff will keep the people and organizations updated on the study’s progress while it is occurring. Dr. Powell-Wiley and her team will work with the same churches that helped with recruitment to disseminate information as well as take feedback.

“We’ll ask questions like, ‘What was good or bad about using the physical activity monitors or taking photos of your food?’” she said. “This will help us better tailor interventions, but also give the community a true sense of participation. This program is not intended to simply collect data and publish papers. It is a shared experience where our team will teach and learn.”

The researchers carried out a small pilot project with a handful of volunteers in February to gauge the effectiveness of the tools. They will incorporate any necessary changes identified during the pilot and launch the larger needs assessment program in September.

Dr. Powell-Wiley, who has been at NHLBI since 2011, brings solid experience into this new project, having previously worked on a similar community-based health study called GoodNEWS during her cardiology fellowship at the University of Texas Southwestern Medical Center in Dallas.

“The GoodNEWS program was a valuable learning opportunity, and I’m even more excited about this NHLBI study as I will be involved throughout the entire process, from the formative planning stages all the way through completion,” she said.

Learn more about Tiffany Powell-Wiley and her lab.