My research program is focused on translating evidence-based nutrition and lifestyle interventions into real world clinical and community settings and understanding the psychological and behavioral factors that influence weight and activity outcomes. I have expertise in the design, implementation, and evaluation of lifestyle interventions that target weight loss and increased activity and the co-occurring problems of diabetes, prediabetes, hyperlipidemia, and hypertension. My 25+ years of clinical research experience has focused on understanding drivers of health and disease-specific quality-of-life in patients with hyperlipidemia, prediabetes, diabetes, and obesity including depression, distress, diet, and medication treatment, and to probe real-world barriers to effective care. I have designed and adapted lifestyle interventions that can promote clinically significant weight loss; improve diabetes self-management and prevent diabetes; and improve emotional well- being, quality of life and other health related outcomes in adults with diabetes, and prediabetes. My current translational intervention research in diabetes emphasizes sustainable, patient-centered approaches that have potential for wide dissemination. In Real Health-Diabetes, we are evaluating the reach, engagement, and cost- effectiveness of a lifestyle program delivered in-person or via telephone conference call (a scalable delivery format) compared with medical nutrition therapy. In Food is Medicine: a Randomized Clinical Trial of Medically Tailored Meals for Individuals with Type 2 diabetes Mellitus and Food Insecurity, we will evaluate the durability of effectiveness of a medically tailored meal intervention program that includes a lifestyle change component for individuals with type 2 diabetes on glycemic control, food insecurity, hypoglycemia, diabetes distress, diabetes self-efficacy and health-related quality of life compared with a food subsidy group. In Food as Medicine for HIV: A Randomized Trial of Medically Tailored Meals and Lifestyle Intervention, we will evaluate mechanisms whereby a food insecurity intervention may improve management of type 2 diabetes and examine the role of both nutritional improvement and health-related behavior change in doing so. The knowledge to be gained will help improve diabetes-related outcomes for patients with HIV and food insecurity.
My translational research is focused on bridging the gap between the clinical efficacy evidence base for nutrition and lifestyle intervention treatment efforts for diabetes and its implementation in real-world practice and community settings. My approach to lifestyle intervention for the treatment and prevention of diabetes is informed by behavioral science theory and empirical evidence, seeks multi-stakeholder input and collaboration and focuses on evaluating interventions that are scalable and have the potential for widespread dissemination.