Round 4: 2015-2016 Pilot Projects
Overcoming Immunity to Change: A feasibility study of a new method to promote medication adherence among older adults with hypertension
The prevalence of hypertension in Louisiana exceeds the national average, with 70% prevalence among those age 65+, attributed, in part, to high prevalence of obesity across all age groups. Despite availability of lifestyle behaviors and effective medications to control blood pressure (BP), only 53% of US adults have controlled disease. Furthermore, racial and gender disparities in the control of hypertension exist. Inadequate control of hypertension is associated with poor medication adherence. Despite decades of research, no single intervention has emerged as superior in improving adherence and BP control. There is an urgent need for patient-centered interventions to improve adherence. On the basis of prior work that identified 6 hidden motive' clusters associated with patients' immunity to change' their medication-taking behavior, the objective of this pilot study is to assess the feasibility of using the Overcoming Immunity-to-Change approach to improve medication-taking behaviors and BP control in nonadherent elders with uncontrolled hypertension.
Effect of Combination Therapy with Sodium Nitrite and Isoquercetin on Endothelial Function and Inflammation among Patients with Chronic Kidney Disease
Chronic kidney disease (CKD) related cardiovascular disease (CVD) and end-stage renal disease are major causes of death in Louisiana. Endothelial dysfunction and inflammation are common etiological pathways for rapid CKD progression and excess CVD risk among CKD patients. The proposed randomized controlled trial will test the safety and efficacy of combination therapy with sodium nitrite and isoquercetin on endothelial function and inflammation among CKD patients. We will recruit 70 albuminuric CKD patients and randomly assign them to combination therapy with sodium nitrite and isoquercetin or placebo for three months. The primary study outcome is endothelial function assessed by brachial artery flow-mediated dilatation (FMD). Our study has 80% statistical power to detect a 2.8% difference in FMD with a 2-sided significance level of 0.05. This study will generate necessary pilot data for an NIH-supported clinical trial to test the efficacy of combination therapy with sodium nitrite and quercetin on CKD progression.
Unintentional overfeeding of formula fed infants
Despite an almost identical energy density between infant formula and breastmilk, formula fed infants experience greater weight gain in the first year of life. We propose that unintentional overfeeding, of nearly one additional day of calories per week, due to the over-scooping of powdered formula contributes significantly to this phenomenon and potentially to the early development of childhood obesity, a significant public health problem. Research of US infants indicates that infant formula use is most prevalent in families with lower levels of education and poverty and as such infant formula is provided to families within the National Women, Infants and Children program. Thereby, the proposed project will examine the health literacy of individuals in the understanding of infant feeding and in particular in the preparation of infant formula. Infant preparation instructions will be modified in through qualitative research to make them more understandable and actionable with an aim of improving caregiver ability to accurately prepare infant formula without overfeeding. The impact of modified formula instructions will then be tested in a randomized controlled trial in comparison to existing commercially instructions provided on the most used brand of infant formula in the US. This is a novel translational study which if successful will demonstrate that with easier to follow preparation instructions, caregivers will less likely overfeed infants resulting in decrease infant adiposity and risk for childhood obesity.