The UAB Reporter
Monday, June 18, 2012
By Tyler Greer
Committing to a change in lifestyle can be as difficult as committing to a significant other.
And failing to find the kind of self-motivation and commitment it takes to live a healthier life? Well, that could invite a future with potential health problems, including obesity, diabetes, high cholesterol and hypertension, to name a few.
Nefertiti Durant, M.D., assistant professor in the Division of Pediatrics and Adolescent Medicine, says many young women want to commit to a fitness or weight-loss program. However, she says, time, money, competing demands and a lack of social support can prevent even the most disciplined individual from finishing any diet or exercise program she starts.
Durant has spent the past six months coordinating two trials that were born from pilots funded by a joint 2009 Center for Clinical and Translational Science (CCTS)/Charles Barkley Health Disparities Research Award pilot grant and a 2008 Nutrition Obesity Research Center award. The monies from those grants enabled Durant to win funded projects from the Robert Wood Johnson Physician Faculty Scholars Program and the American Heart Association.
More projects in the works
Nefertiti Durant, M.D., assistant professor in the Division of Pediatrics and Adolescent Medicine, is continuing to advance her obesity research in other areas. She is currently collaborating with Gareth Dutton, Ph.D., associate professor of preventive medicine, on a pilot project funded by the Minority Health Research Center.
The project aims to develop an obesity prevention school-based program for adolescent African-American girls.
The pilot for Love Your Heart, an American Heart Association-funded study, will begin later this fall and will build on lessons learned in Commit2fit to improve the technology. Through Love Your Heart, Durant will study how increasing physical activity can decrease the risk of cardiovascular disease in young adult African-American women. This project will also involve using technology to promote physical activity and healthy eating.
“We believe this research will provide promising insight into how technology works, especially in the African-American population,” Durant says.
Commit2fit, Love Your Heart
The trials, known as Commit2fit and Love Your Heart, enroll African-American women UAB students ages 19-30 into six- and three-month programs respectively. The programs are focused on promotion of physical activity using technology as the foundation for communication.
“We are focused on the creation, refinement and testing of culturally adapted, Internet-based physical activity promotion interventions that can be utilized to promote weight loss in this population,” Durant says. “We have focused at every phase of the projects on obtaining insight from participants about what applications would be most likely to promote adherence to physical activity among young, overweight and obese African-American young women.”
Overweight and obesity is a crisis in the United States, but there are especially racial and ethnic disparities that are most evident among African-American and Latino women. The Office of Minority Health says four out of five African-American women are overweight or obese, as are 22.4 percent of African-American children and adolescents from ages 6 to 17. Among Mexican-American women, 78 percent are overweight and obese, as are 24.2 percent of children and adolescents.
Durant has watched numerous children and young women come into her clinic struggling with these issues since she joined the UAB faculty in 2006 after completing fellowships at the Harvard School of Medicine and Children’s Hospital Boston. Durant frequently sends her patients out with exercise or diet prescriptions, but she has long believed that there are not sufficient and innovative modalities available to provide her patients with the tools they need to be successful in these endeavors.
In short, she’s unable to properly monitor their progress — or commitment — to improving their lifestyle.
Promising and cost-efficient
Durant wanted to use technology to help, with the idea that she can one day use it to her advantage in the clinical setting. “Technology is promising, efficient and a platform people are using right now,” Durant says. “It’s also something you can provide to a diverse population of people at a low cost.”
Commit2fit and Love Your Heart focus on three areas of support — motivational health coaching via the study’s website, nutrition sessions with a registered dietician and promotion of supervised physical activity.
Participants in the Commit2fit study, which was completed in May, engaged in supervised, moderate intensity physical activity four days a week at the Campus Rec Center for six months. They were monitored with accelerometers and heart rate monitors by trained research assistants. The participants also attended nutrition sessions with a registered dietician that focused on healthy snacks and preparations of healthy foods that would fit into the lifestyle and wallet of a busy young adult.
These activities were bolstered by the website (including a specially designed app that could be downloaded to participants’ smart phones), which provided self-monitoring diet and physical activity tools, recipe finders, exercise demonstration videos, blogs provided by the study’s enrollees and message boards where participants shared everything from healthy recipes to disappointments and encouragement.
Coaching each other
“Participants were able to provide their own social support,” Durant says. “The enrollees were coaching each other, to a degree. The primary source of coaching was the social support the young women received from each other through the Internet and through their group exercise sessions.”
The early returns on the Commit2fit study are encouraging, and full results are expected later this summer.
Ultimately, Durant hopes this is the beginning of the creation of a Web-based tool for the adolescent overweight and obese population that is interactive for the patient and the practitioner.
“I certainly hope we can develop that,” Durant says. “The possibilities are there for a provider-patient communication tool to engage the patient with a contract with a clear goal. We’ll also be able to provide tailored motivational coaching. And there will be a parallel site that people would use on their own in more of a Facebook type of way — with a support community or network. I’m encouraged about the potential outcomes of this study and the type of commitment it could help young women achieve to reclaim their body and their health.”