CENTER FOR HEALTH PROMOTION AND DISEASE PREVENTION

ABSTRACTResidents of North Carolina and the rural southeastern US experience some of the highest chronic diseaserates and greatest health disparities in the country, influenced significantly by social determinants of health(SDH). The goals of this application are to: (1) with our community partners, build and maintain a strong Centerinfrastructure to support applied prevention research, translate research findings, and disseminate evidence-based products, and (2) determine the processes by which our proven lifestyle intervention (Med-SouthLifestyle Program - MSLP) can be efficiently translated into public health and clinical practice supported bycommunity-based resources to combat food insecurity. The MSLP, based on the Mediterranean diet buttailored to the taste preferences and food availability of a southern low-resource population, has resulted inpositive health outcomes for hypertension, diabetes, and obesity. Although the scientific rationale forimplementing lifestyle interventions is robust, evidence is limited on supporting the broad-scale implementationof these interventions in clinical and public health settings. We propose an Implementation Core ResearchProject with 3 phases informed by multiple implementation theories and the Knowledge into Action Framework.Our research is designed to determine the processes by which the MSLP can be most efficiently andeffectively translated into public health (local health departments) and clinical (community health centers)practice to positively impact chronic disease risk reduction among minority, rural, and medically underservedpopulations. In Phase 1, we will identify facilitators and barriers to implementation and develop, pilot test, andrefine implementation strategies that will be used to take the MSLP to scale. In Phase 2, we will apply aneffectiveness-implementation hybrid design to compare two formats for scaling up MSLP on implementationoutcomes (primary aim) and confirm MSLP impact on behavioral and clinical outcomes (secondary aim). InPhase 3, we will initiate MSLP's full-scale implementation in North Carolina in coordination with NC's currenttransition to Medicaid Managed Care where state health department (HD) policies will “guide plans andproviders toward implementation of a whole-person centered, well-coordinated system of care, whichaddresses both medical and non-medical drivers of health.” We are discussing integrating the MSLP in thecoverage plans of several health insurance companies applying to serve as Pre-paid Health Plans in the newMedicaid Managed care system. We will use our nationally recognized Center for Training and ResearchTranslation to disseminate MSLP materials along with other evidence-based interventions produced by HPDPand the PRC Network, highlighting those supporting the new CDC-funded programming. Finally, we willcontinue working with the State HD to inform a robust Statewide Resource Platform - a database and callcenter linking public health and clinical practitioners to resources in their communities addressing socialdeterminants of health like food insecurity. The Platform will track connections and monitor outcomes.