Community Medicine Community Research

Project Access: Caring for the Uninsured

The purpose of this project is to study the effect of Project Access on reducing unnecessary emergency room use and improving functional health status among the working poor. This project is a continuation of Project Access, adding a more efficient and focused evaluation and research component. Additional components include a faith-based collaborative effort promoting the integration of primary, secondary and tertiary prevention in a community-based setting. This community-based participatory research (CBPR) project is supported through a grant from the Centers for Disease Control and Prevention.

Principal Investigator: Mark DeHaven, Ph.D.

GoodNEWS (Genes, Nutrition, Exercise, Wellness and Spiritual Growth)

Physicians and other health care providers are being called upon to treat and manage epidemic levels of chronic disease. Chronic diseases presently account for the majority of deaths each year and for about 75% of the nation's medical care costs. Chronic disease prevalence is an especially significant problem among low-income individuals and ethnic minorities who suffer a disproportionate share of the chronic disease burden.

There is overwhelming evidence that the disorders and enormous direct and indirect costs associated with chronic illnesses are in large part preventable. Modifiable disease risk factors based on lifestyle and behavior, for example, account for about 50% of health outcomes and significantly affect rates of death from lung cancer, colon cancer, cirrhosis, coronary heart disease, chronic obstructive pulmonary disease, diabetes mellitus, and injuries resulting from risky behavior. However, the present health care delivery system devotes 95% of its resources to treating heart disease, hypertension, diabetes and obesity, and only 5% to preventing them.

The GoodNEWS program provides education, motivation and opportunity for adopting and practicing more healthful lifestyle practices, and is based on a community medicine approach. Community medicine exists at the intersection of clinical medicine, public health and social science, and is dedicated to preventing and reducing the disproportionate burden of disease affecting society's most vulnerable communities. The program's goal is to improve quality of life for participants and reduce the burden of chronic disease in congregations and the surrounding community. Its objectives are to: 1) improve individuals' knowledge, attitudes and behaviors in six dimensions of health (physical, mental, intellectual, spiritual, social and environmental); 2) modify disease risk factors and decrease disease prevalence through promoting healthful lifestyle practices; and, 3) increase the capacity of communities to support community-based health promotion and disease prevention activities.

During the past three years, the Division of Community Medicine has collaborated with numerous community partners and congregations throughout the Dallas-Fort Worth Metroplex to develop a GoodNEWS Community of Churches. Lay Health Promoters (LHPs) in participating congregations receive education and training from the GoodNEWS project team in healthful living principles and chronic disease management, and learn how to access community-based health resources. Preliminary data analysis indicates that the program is effective in stimulating the type of lifestyle changes that can reduce chronic disease prevalence and health disparities in underserved communities.

Principal Investigator: Mark DeHaven, Ph.D.
Contact: J.R. Newton, RN, Senior Research Nurse

Social Networks: Community connections and the flow of health information

Improving effective health information outreach in a community requires a needs assessment that captures the multi-dimensional factors influencing the flow of health information. The purpose of the project is to identify and document how health information is disseminated within the larger social network of the community by using a scientific technique known as Social Network Analysis (SNA), which maps individual relationships and information flow. Adult participants receiving services from the Central Dallas Ministries (CDM) Food Pantry are interviewed to obtain both qualitative and quantitative data for analysis. The study is funded by the Network of Libraries of Medicine South Central Region.

Co-Investigators: Nora Gimpel, M.D.; Alice Marcee, DVM, M.S.
Contact: Nora Gimpel, M.D.

Childhood Obesity Project

This project identifies perceptions and behaviors related to childhood obesity and overweight children among students, caregivers and teachers. The purpose of this pilot study is to describe the knowledge, attitudes, and behaviors of students, caregivers, and teachers regarding the eating habits and physical activity patterns of children that may be contributing to obesity. This pilot project is gathering qualitative data from third-grade students, parents/caregivers and teachers in the Dallas Independent School District (DISD) through focus groups as well as an on-line teacher questionnaire for third-grade teachers. The pilot study findings will be used to design a comprehensive school-based intervention for reducing and preventing childhood obesity.

Principal Investigator: Nora Gimpel, M.D.
Co-Investigator: Mark DeHaven, Ph.D.
Contact: Nora Gimpel, M.D.