Research Profile

My project's area of diabetes research is in prevention. Rural Appalachia is a low resource area fraught with unhealthy behaviors, high rates of obesity, pre-diabetes, and type 2 diabetes among children. This project targets children with overweight and obesity living in rural Appalachia. Appalachians die more frequently and at younger ages from obesity-related conditions than those living elsewhere. The high number of children with overweight and obesity in Appalachia increases the severity of diabetes. Our Mentored Planning to be Active plus Family program provides 2 components delivered over two academic years: 1) Ten peer mentoring sessions for youth to become more physically active (e.g., aerobic activity, muscle strength, and bone strength) at home. During the summer months and into the second academic year, a 6-month family reinforcement program provides a home-based, parent-guided program to support physical activity adherence, promote water for hydration, and reinforce self-regulation skills.

The goal is to reduce the high rates of overweight and obesity contributing to type 2 diabetes in rural Appalachia youth. Through a peer-mentoring approach, we work with children and families to build and sustain lifestyle behaviors that all can benefit from. Mentored Planning to be Active + Family promotes exercise at home without reliance on equipment and on overcoming healthy-lifestyle challenges (lack of: organized sports, recreational facilities, exercise equipment,) prevalent in Appalachia. Children and families design a PA plan using “what they have already at home” and learn to use their own bodies to build strength. By doing so, we hope to "break the cycle" of early-onset diabetes seen within many families. Working together with the children, parents, and peers, our program will provide resources and skills for all to build and sustain better lifestyle behaviors to improve quality of life. Ultimately, our goal is to reduce early onset of diabetes through modifiable behaviors.

As nurse from rural Appalachia with a specialty in health promotion and risk reduction nursing, I have worked with vulnerable and at-risk populations, especially children, teens, and youth. I am an advanced practice nurse with expertise in family-based and community-based interventions. Through my research, I have extensive experience with capacity building within Appalachian families, schools and communities. It is through my work with children in rural Appalachian schools that I became concerned about the early-onset of type-2 diabetes among young children and the health effects from such an early diagnosis of this disease. To date, my work has focused on working in school settings with children to improve health behaviors. This award with allow me to expand the work in important ways: become more family-focused and strengthen the sustainability of the program so the children and parents can truly maintain improved lifestyle behaviors.

As a public health nurse, much work must be directed towards prevention. We must develop and test interventions that target intergenerational (within families) behaviors over the life course to prevent the onset of diabetes and its comorbid conditions. We must move from the bedside to the community. Community-driven interventions to reduce behaviors associated with diabetes risk are needed. At the same time, bench science must continue to develop new therapies to help patients with diabetes better manage their disease. Type 2 diabetes, especially in under-resourced areas such as Appalachia, is a complex and multi-faceted problem. To be successful, the research team should include the community members as key stakeholders and active voices.