Program on
Healthy Aging
2015
Texas A&M Health Science Center
School of Public Health
Marcia G. Ory, PhD, MPH, Director
Introduction
What is healthy aging and how do we achieve it?
Healthy aging is the development and maintenance of optimal physical, mental, and social well-being and function
in older adults. It is most likely achieved when physical environments and communities are safe, and support the
adoption by individuals of attitudes and behaviors known to promote health and well-being; and by the effective
use of health services and community programs to prevent or minimize the impact of acute and chronic disease on
function.1
Health promotion and disease prevention efforts are important across the entire life-course from birth to death.
With increased longevity and population aging, new concerns are raised about the quality of American’s longer
lives. It is never too late to promote healthy lifestyles, medical management, and supportive environments for
older adults. Aging individuals and communities can benefit from systematic research about best practices.
Together with both public and private partners, the Program on Healthy Aging at the Texas A&M Health Science
Center School of Public Health (SPH) examines several interrelated areas, such as:

Identification of social and behavioral risk factors for health and illness,

Understanding of factors associated with self-management and coping with chronic illnesses and
disabilities,

Design and evaluation of interventions to promote health, prevent disease, and postpone disability.
Several cross-cutting themes are emphasized including:

The need to approach aging and intervention strategies from a life-course perspective,

The importance of focusing on multilevel risk factors and intervention approaches,

The desirability of reaching out to underserved and rural populations.
The faculty conducting research in this area includes individuals with training in core public health disciplines of
health promotion and community health, health management and policy, occupational health and safety,
medicine, nursing, and law. Other specialty areas include: gerontology, behavioral sciences, nutritional sciences,
chronic disease management, health economics and cost benefit analyses, assessment and program evaluation,
and translational research.
1 Definition by the CDC-funded Healthy Aging Research Network, of which Texas A&M Health
Science Center is a member center
Texas A&M Faculty, School of Public Health
Marcia G. Ory, PhD, MPH
Jane Bolin, PhD, JD, RN
Mark Benden, PhD, CPE
Y. Alicia Hong, PhD
James Burdine, DrPH
Adam Pickens, PhD
Diane Dowdy, PhD
Ranjana Mehta, PhD
Carmen Tekwe, PhD
Samuel Towne Jr., PhD
Texas A&M Faculty (Other Colleges & Schools)
Lee Ann Ray, EdD
College of Medicine
Sriram Iyengar, PhD
College of Medicine
Chanam Lee, PhD
Landscape Architecture & Urban Planning
Gerard Cote, PhD
Biomedical Engineering
Roozbeh Jafari, PhD
Biomedical Engineering
Michael Madigan, PhD
Biomedical Engineering
Mark Lawley, PhD
Industrial & Systems Engineering
Adjunct Faculty
SangNam Ahn, PhD, MPSA
School of Public Health
University of Memphis
Jinmyoung Cho, PhD
Baylor Scott & White Healthcare; School of Public Health
Samuel N. Forjuoh, DrPH, MD, MPH
Baylor Scott & White Healthcare; School of Public Health
Angie Hochhalter, PhD
Baylor Scott & White Healthcare; School of Public Health
Alan Stevens, PhD
Baylor Scott & White Healthcare; School of Public Health
Ninfa Pena-Purcell, PhD, CHES
AgriLife Extension
Matthew Smith, PhD, MPH, CHES, CPP
College of Public Health, University of Georgia
Judith Warren, PhD
AgriLife Extension
Deborah Vollmer Dahlke, MPA
President,
DVD Associates, LLC
Nicole Pardo, MD, MSM, MBA
HealthHelp, LLC,
Remind Technologies, Inc
Research Staff
Doris Howell, MPH
Program Director,
Evidence-Based Program (EBP)
Resource Exchange
Rachel Foster
Evidence-Based
Program Trainer
Debra Kellstedt, MPH
Research Assistant
Cindy Quinn
Evidence-Based Program Coordinator
Ashley Wilson, MPH
Research Assistant
Kelly Jo Eblen
Promotions Coordinator
Graduate Assistants
Kayla Fair
Katherine Hall
ShinDuk Lee, MSP
Yajuan Li, MS
Jessica Smarr
Aya Yoshikawa, PhD
Taylor Neher
Obioma Nwaiwu, PhD
Student Worker
Moroni Berrios
Funding Agencies

Administration for Community Living

Baylor Scott and White HealthCare

Cancer Prevention Research Institute of Texas

Centers for Disease Control and Prevention

Health Resources and Services Administration

National Council on Aging

National Institutes of Health

Robert Wood Johnson Foundation

Texas Department of Aging and Disability Services

Texas Department of State Health Services

Texas Health and Human Services Commission

United States Department of Agriculture

United Way of Tarrant County

WellCare Health Plans, Inc.

WellMed Charitable Foundation
Highlights
Promoting Health & Wellness Throughout the School
Affiliated with the Program on Healthy Aging, the SPH Health & Wellness Committee’s mission is to emphasize,
encourage, and engage the SPH community to make healthy choices through individual and organizational change.
This committee meets monthly and is comprised of staff, faculty, and students. In addition to sponsored events
such as Lunch & Learns and community events, our committee has provided health and wellness resources
through newsletters, social media, print materials, and signage. We have also made improvements to our physical
space at the School of Public Health by adding a refrigerator for students, a water filtration system, and partnering
with the Sustainable Environmental Group to provide a community garden.
Achieving CEO Gold Standard
In an effort to help organizations seek accreditation and reduce the risk of cancer for their employees and families,
the Texas A&M Health Science Center School of Public Health and Texas A&M AgriLife Extension Service have
produced theGoing for the Gold: Achieving CEO Cancer GoldStandard™ Accreditation Guidebook. Eradicating
cancer is the goal of theCEO Cancer Gold Standard™,a workplace wellness initiative. The CEO Roundtable on
Cancer, a nonprofit organization of chief executive officers of major U.S. companies founded by former President
George H.W. Bush, developed this initiative in collaboration with the National Cancer Institute. To earn Gold
Standard accreditation, an organization must establish programs to reduce cancer risk by eliminating tobacco use;
encouraging physical activity; promoting healthy diet and nutrition; detecting cancer at its earliest stages; and
providing access to quality care.
Building the Evidence Base for Older Adult Programs & Policies
Evidence-Based Programming For Older Adults, edited by Dr. Marcia Ory and Dr. Matthew Smith, was published as
a Frontiers Research Topic in the Frontiers Journal Series’ set of open-access scholarly articles
(http://journal.frontiersin.org/researchtopic/2551/evidence-based-programming-for-older-adults). This Research
Topic features articles about evidence-based programs for older adults, including a range of articles that focus on
the infrastructure needed to widely disseminate EBP as well as individual participant impacts on physical, mental,
and social aspects of health and well-being. This topic will advance knowledge that aims to enhance practice,
inform policy and build systems of support and delivery in regard to the reach, effectiveness, adoption,
implementation, and maintenance of evidence-based interventions for older adults.
Designing & Evaluating Award Winning Programs
The Program on Healthy Aging’s Texercise Select was highlighted in the June 2015 Association of Schools &
Programs of Public Health newsletter as a recipient of local innovators award by the Society of Behavioral
Medicine. The article, “Texas A&M Researchers Confirm Value of Statewide Health and Wellness Program,”
showcases the 12-week free program for seniors delivered throughout Texas in various locations where trained
facilitators lead the program that includes education and discussion on physical activity and nutrition, and guided
exercise.
Infrastructure & Training Programs
Meeting the needs and preferences of older Americans requires infrastructure resources and commitment to
conduct translational research, provide education and training, and to deliver age- appropriate and culturally
relevant services.
Brazos Valley Obesity Prevention Network
The Brazos Valley Obesity Prevention Network (BVOPN) is a local coalition that works to enhance community
partnerships in order to promote awareness and expand opportunities to combat obesity in the Brazos Valley
region. BVOPN partners worked together to receive a grant to fund UP-BEAT, a local project designed to examine
the impact of community and environmental strategies for increasing physical activity. In conjunction with the
BCOPN efforts, the Brazos Valley Council of Governments has recently been recognized by the Environmental
Protection Agency, receiving a Building Healthy Communities for Active Aging Award.
Community Research Center for Senior Health
The Community Research Center for Senior Health is designed to develop , implement, evaluate, and disseminate
evidence-based interventions that address multiple social and behavioral determinants of senior health. The
Center provides a sustainable infrastructure that promotes an interdisciplinary approach to senior health
intervention research, develop community-academic health center relationships which foster community
participation, and provides guidance and support to investigators and community leaders in research design,
evaluation, and data analytic techniques. This project is a three-way partnership between Scott and White
HealthCare, The Temple–Belton Aging and Disability Research Center, and the Texas A&M Health Science Center
School of Public Health.
Communities of Texas: Cancer Activity Research Education Support
CTxCARES, formed in 2009, is one of 10 Centers for Disease Control and Prevention (CDC) and NIH-funded
research institutions which comprise the Cancer Prevention and Control Research Network (CPCRN), which
provides infrastructure for applying relevant research to local cancer prevention and control needs. CTxCARES is a
collaboration between Texas A&M Health Science Center School of Public Health, Texas A&M AgriLife Extension,
and Baylor Scott & White HealthCare. The mission of CTxCARES is to reduce cancer risk and burden by promoting
the adoption of evidence-based cancer prevention and control programs in Central Texas Communities. Initial
activities are focused on strategies for promoting the health and well-being of cancer survivors.
Geriatric Care & Education
With the anticipated opening of an Active Senior Health Center focused around a newly designed senior living
community adjacent to the Health Science Center campus, there is an opportunity to develop strong communityclinical collaborations for education, research and healthcare services to improve the health and functioning of the
growing number of seniors in the Brazos Valley. This will provide an opportunity for both Health Science Center
faculty and students to engage in a variety of integrated efforts for promoting healthy living, active lifestyles, and
managing chronic conditions.
Health, Technology, and Patient Empowerment Initiate
The Health, Technology and Patient Empowerment Initiative will draw together faculty from a variety of disciplines
within the Texas A&M School of Public Health (SPH) as well as from other colleges at Texas A&M University
(TAMU) to engage in collaborative research and translation and demonstration projects at this nexus of health
technology and patient empowerment. The rapid emergence of a variety of new health technologies has the
potential to address current health care needs of patients and reduce the burdens and costs of care for all Texans.
There is a timely need to explore the potential of mobile applications and wearable sensors for improving the
health, functioning and well-being for the growing number of Americans with chronic conditions—or at risk of
developing preventable chronic diseases and disabilities. Dr. Marcia Ory and Dr. Mark Benden will co-direct this
initiative in which initial projects are envisioned in a variety of settings and populations such as the home, clinical,
occupational, school, and transpiration settings.
South, West, and Central Consortium—Geriatric Education Center of Texas
The South, West, and Central Consortium, Geriatric Education Center of Texas (SWAC-C GEC) is based at the
University of Texas Health Science Center at San Antonio. The SWAC GEC has facilitated the improvement of
patient care for the aged through interdisciplinary partnerships with faculty and practitioners in the fields of
gerontology and geriatrics. To date, the consortium has provided culturally appropriate geriatric training to more
than 50,000 health professionals both on-site and by distance learning. As a Consortium Center, SPH will focus on
coordinating educational and training efforts related to chronic disease management, especially around the
implementation, dissemination, and sustainability of evidence-based chronic disease management programs.
Texas A&M Evidence-Based Program Resource Exchange
Funded through the Texas Health and Human Services Commission (HHSC), who received federal funding through
the Centers for Medicaid and Medicare’s (CMS) 1115 Transformation Waiver project, the EBP Resource Exchange
provides a centralized resource for training, implementing, and evaluating evidence-based self-management and
wellness programs. The EBP Resource Exchange seeks to facilitate health care providers and agencies’ capacity to
select and implement evidence-based health promotion/disease prevention to reduce the burden of illness in our
nine county Regional HealthCare Partnership (RHP) 17 region.
The Texas A&M University Coalition for Healthy Active Living
Rapid advances in sensor technologies, big data analytics and processing, electronic health and medical records,
and the realization of the so called “Internet of Things” have created a world in which devices and data can be
harnessed to promote health and wellbeing in ways unimaginable just a mere decade ago. The proposed Texas
A&M University Center for Healthy Active Living (TAMU-CHAL) serves as a research, education, outreach, and
clinical nucleus within which multi-disciplinary research teams can be empowered to develop, test, and deploy
new techniques and strategies which exploit this new ecosystem of data, services, and sensors to improve public
and individual health. The core mission of this center is to engineer technologies and techniques for data collection
and analyses, facilitate new forms of health research and analyses, and enable novel lines of health interventions,
monitoring, and promotion for targeted populations of at-risk individuals. In partnership with Baylor Scott & White
Health (a leading healthcare services provider), the TAMU-CHAL integrates and coordinates the research efforts
across the TAMU Colleges of Engineering, Geosciences, Education & Human Development, Medicine, and the
School of Public Health, serving as a concrete example under the banner of the TAMU One Health Initiative.
Texas Falls Prevention Coalition Promotions
WellMed is providing support for The Texas Falls Prevention Coalition established in 2007 to “promote, implement
and evaluate evidence-based programs and policies that help reduce risk factors of falls and injuries in older
adults; provide education and resources to increase public awareness, mobilize communities and effect policy
change for a falls free Texas.” In May 2014, coordination responsibilities were transferred to Texas A&M Health
Science Center Program on Healthy Aging for the purpose of reconstituting a Steering Committee of broad-based
stakeholders to promote a multi-faceted approach to falls prevention throughout Texas. Under the leadership of
Dr. Marcia Ory, a Steering Committee has been appointed with representation from the state aging (Department
of Aging and Disability Services) and health (Department of Health and Human Services) agencies, the Texas
Association of Area Agencies on Aging (T4A); health care partners and providers (e.g., Baylor Scott and White
Healthcare, WellMed Charitable Foundation, Texas Hospital Association, and the Texas Physical Therapist
Association); and academia (Texas A&M). This grant will support promotion activities.
Evidence-Based Disease Prevention Programs For Seniors
Whether delivered at the national, state, or local levels, the Program on Healthy Aging provides needed
technical assistance and evaluation to improve the reach and effectiveness of evidence-based programs.
Falls Reduction Education & Empowerment
The United Way of Tarrant County (UWTC), in partnership with eight Area Agencies on Aging (AAAs), the Texas
Falls Prevention Coalition (TFPC) and other organizations, collectively known as “Falls Reduction Education and
Empowerment (FREE) Partners,” have been awarded funds by the Administration on Active Living to reduce falls
and falls risk in Texas.The School of Public Health will oversee the Texas Falls Free Coalition and evaluate the
effectiveness of implementing A Matter of Balance (AMOB) among participating Area Agencies on Aging. The goal
is to graduate at least 3500 participants in AMOB in the Dallas/Fort Worth, Austin, San Antonio, Corpus Christi, and
El Paso metropolitan areas. Though the TFPC, FREE will provide training for fall prevention programs to master
trainers, physical therapists, emergency medical professionals and community health workers. FREE’s key
sustainability partners, Texas Healthy at Home and WellMed, will generate funding for program delivery and
sustainability.
Healthy Aging & Independent Living
The Community Research Center for Senior Health (CRC-Senior Health) serves as the evaluation unit for the HAIL
initiative with the United Way of Tarrant County.Working collaboratively with the CRC-Senior Health, the Program
on Healthy Aging is involved in designing evaluation tools, providing technical assistance on data protocol issues,
and providing final reports of major impacts on relevant outcomes such as self and family health status, quality of
life, and health care utilization. Furthermore, based on protocol-driven interviews with five funded agencies,
Alzheimer’s Association, Easter Seals, Meals on Wheels, North Texas Area Community Health Center, and Senior
Citizen Services, the evaluation team will develop strategies and guidelines to promote understanding and reliable
evaluation for the HAIL initiative with a focus on addressing program evaluation in general, as well as offering
information specific to protocols and roles with the HAIL initiative.
Impact, Sustainability & Scalability of Multi-Component Falls Prevention Programs
Working collaboratively with the CDC and the three funded State Health Department Injury Programs, this
program facilitates the evaluation of the processes and impacts of state-driven fall prevention programs for older
adults. The two primary aims are to : 1) determine the impact of the designated multi-component fall prevention
interventions on health, health care utilization, and costs using quantitative and qualitative methods; and 2) build
states’ capacity for ensuring program successes by providing technical assistance on strategies for enhancing and
monitoring the reach, fidelity, sustainability, and scalability of evidence-based fall prevention programming.
It Takes A Village— A Multi-Disciplinary, Multi-Level Evaluation of the State Driven Fall
Prevention Project
During the three year “Village” evaluation, three aims will be achieved to identify essential elements of effective
fall prevention programming at the state level and then accelerate and improve the dissemination of these
effective models and associated findings to a broader, national audience. Aim 1 will focus on evaluation of impact
of programs as they are scaled statewide, Aim 2 will focus on providing technical assistance to bring programs to
scale, and Aim 3 will disseminate findings to key stakeholders. The ultimate impact of this initiative is to improve
the health and functioning of the growing population of older Americans at-risk for falling.
National Study of Evidence-Based Chronic Disease Management Programs
The National Council on Aging serves as the Technical Resource Center for this Administration on Aging Initiative
which seeks to enroll over 50,000 older adults throughout the Nation in chronic disease self-management
programs. Working collaboratively with the NCOA and the Stanford Patient Education Research Center at Stanford
University, The Program on Healthy Aging will conduct a national study of 1,000 older adults to document
individual outcomes of the Stanford Chronic Disease Self-Management Program, such as self-reported health
status, quality of life, health behaviors, and health care utilization. Data will come from approximately 30 delivery
sites across the Nation, with an emphasis on getting a diverse population of participants from both urban and rural
areas. This collaboration provides a synergy that will help bridge the research-to-practice gap and further our
knowledge about the outcomes of widely disseminated evidence-based programs.
Policies, Programs, & Partners for Fall Prevention
PPPFP is a collaborative effort, funded through the CDC, with the University of North Carolina Schools of Medicine
and Public Health. Working with over 40 State Fall Prevention Coalitions, PPPFP address the urgent need to
identify more effective public health strategies for reducing falls, fall-related injuries, and fall-related rates of
emergency room visits among the growing population of seniors. Additionally, through implementation of new
training structures, PPPFP will build upon existing partnerships to increase impact and sustainability of evidencebased fall prevention programs delivered to vulnerable older populations. The project will develop strategies and
train community health workers in Texas and North Carolina in implementation of Otago, a community-based falls
prevention program delivered primarily in the home by physical therapists.
Texercise Select– Building the Evidence-Based Program
Texercise Select is a statewide health promotion created collaboratively between the Texas Department of Aging
and Disability Services and Texas A&M School of Public Health Program on Healthy Aging. The program combines:
(1) education about the importance of physical activity and healthy eating; (2) skill-building sessions for learning
how to set and achieve attainable lifestyle goals; and (3) a multi-component exercise program designed to increase
strength, endurance, balance, and flexibility. Major objectives are to examine: 1) the impact of Texercise Select on
increased physical activity and healthy eating, enhanced social interaction, improved perceived quality of life, and
better physical functioning, 2) the relationship between intervention dosage and study outcomes, 3) potential
differential impacts across participant characteristics, 4) programmatic costs and quality-adjusted life years
(QALYs) attributed to participation in Texercise Select, and 5) factors affecting (i.e. barriers, facilitators) program
implementation, dissemination, and long/short-term sustainability.
Population & Disease Specific Programs
Generic public health strategies can be tailored to specific populations, settings, and
diseases to improve the health and functioning of seniors with specific concerns.
Colon Cancer Screening, Training, Education & Prevention
This Cancer Prevention Research Institute of Texas (CPRIT) grant will address a critical unmet need for colon cancer
screenings in the Brazos Valley by increasing the number of low-income underserved Texans 50 years and older
who are referred to the Texas A&M Family Medicine Residency Clinic for CRC screenings. This project will also
improve access to cancer screenings and follow-up care through culturally relevant case management from
Promotoras/Community Health Workers (P/CHW), while simultaneously increasing the pool of family medicine
residents and practicing family physicians trained in colonoscopy screenings in Texas. The evaluation team will
track the availability, accessibility and appropriateness of cancer screenings.
Enhanced Breast & Cervical Cancer Prevention for Low Income & Underserved Using
Transdisciplinary Collaboration in a Family Medicine Setting
This breast and cervical cancer (B&CC) prevention program uses a transdisciplinary training approach for family
medicine residents, nursing students, public health students, and community health workers/promotoras
(CHW/Ps), to bring B&CC screening and prevention services to women in rural and underserved communities in
the nine-county Brazos Valley region of Texas. The program will provide education, screening, and treatment
services for B&CC to medically uninsured, low-income women. The goals include to 1) Provide and facilitate access
to B&CC screening and diagnostic services, across the continuum of care, for women in nine Texas counties; 2)
Provide interdisciplinary (simulated and live) culturally-appropriate joint training to family medicine residents,
nursing students, and CHW/Ps in various aspects of women’s B&CC screening, diagnostic procedures, and patient
care; 3) Utilize CHW/Ps, staff, students, and volunteers to provide community outreach and education about the
value of B&CC screening and importance of vaccination against human papillomavirus to the public; 4) Improve
family medicine, nursing, and public health practice related to evidence-based, culturally-appropriate care in
women’s cancer services. This project will create a model for improving women’s B&CC prevention, screening, and
cancer care throughout Texas and nationally.
Healthy Survivorship: A Texas Comprehensive Cancer Survivorship Education Program
In partnership with the Texas Department of State Health Services Comprehensive Cancer Control Program, the
Healthy Survivorship Education Program is a mobile application designed to support and inform a broad range of
cancer survivors. Expanding on the AYA Healthy Survivorship tool, the app assesses survivors’ overall health by
providing scores for lifestyle, physical activity, diet and nutrition, and well-being. In addition, this interactive tool
will provide timely information to survivors about late effects, screening guidelines, care planning, and local
resources such as those identified in MyHealthFinder. The platform for the app includes social media components
to connect the growing number of survivors in Texas. This tool will be shared widely with members of the Cancer
Alliance of Texas.
ICANFIT
This-based mobile application will help disseminate community resources and promote physical activity for older
survivors by determining locations and programs based on zip codes, setting up personal goals and tracking
progress, developing social network with peers, and opening access to senior-friendly resources. The proposed
study will be one of the first web and mobile technology-based solutions for older cancer survivors to promote PA
and increase quality of life. The data collected will be used to determine feasibility, refine ICANFIT, and provide
pilot data for future funding applications.
MyHealthFinder
Patient and provider access to, and awareness of, community resources for an increasing number of Americans
suffering from chronic conditions can improve population health. After polling providers across the U.S., we found
that many still rely on paper and print-outs to locate resources. Mobile health technology can help meet the triple
aims of better health, better care, and better value, providing a more efficient mechanism to more holistically
address health needs of entire populations. MyHealthFinder is a mobile web resource locator designed to help
individuals, families, caregivers, healthcare professionals, and more locate resources for healthy living. This unique
tool’s map allows users to search by location or by categories such as Community Services, Food and Nutrition,
Counseling Support, Faith-Based Services, and more.
Obesity, Stress, & Neuromuscular Function in Older Adults
Obesity prevalence among older adults is a growing concern as obesity has been associated with increased falls
risk and declines in mobility and functional independence. At the same time, stress is considered as one of the
most significant health problems in the 21st century that has a burdening impact on both physical and mental
health. While obesity is an established risk factor for cerebral health and impaired cognition, there is very little
information available regarding obesity-related changes in brain function during physical activities in older adults.
Funded by the National Institute on Aging, the R15 AREA award aims to identify the impact of obesity and stress on
brain function associated with loss of physical functioning in older adults that can inform development of
intervention strategies to promote brain (and subsequently) physical health. An additional objective of this award
is to strengthen the research environment at the School of Public Health Texas A&M Health Science Center and to
expose (under)graduate students to multidisciplinary biomedical research, thereby broadening their range of
career choices.
Childhood, Family & Community Programs & Policies
In addition to a focus on seniors, it is important to understand factors influencing healthy behaviors and lifestyle
factors in a family and community context. Interventions in early life are important for ensuring that children grow
into healthy adults and seniors.
Physical Activity Impacts of a Planned Activity-Friendly Community
With a multidisciplinary investigative team representing public health, architecture, engineering, computer
sciences and education, this longitudinal, case-comparison study will examine how an activity friendly community,
which embodies the best practices in environmental design and policy, can increase residents' levels of physical
activity and influence when and where they are physically active. It will also provide insights into why
environmental and psychosocial factors influence physical activity, and how place impacts lifestyle behaviors
related to the burden of obesity. The specific aims are to (1) examine the short-term and long-term changes in
total PA levels and in spatial and temporal patterns of PA after sedentary or insufficiently active individuals move
from non-AFCs to an AFC; and (2) determine what built and natural environmental factors lead to changes in PA
among these populations, either directly or indirectly by affecting psychosocial factors related to PA. This project
will be jointly directed under a multi-PI arrangement by Texas A&M School of Public Health and College of
Architecture faculty.
Texas Grow! Eat! Go! Using Family Focused Garden, Nutrition & Physical Activity Programs
to Reduce Childhood Obesity
The goal of this Integrated Research and Extension project is to assess the efficacy of a coordinated school health
(CSH) program enhanced with family-focused, experiential garden, nutrition, and physical activity programs on the
prevalence of child overweight and obesity in 3rd grade students. The home food and physical activity
environments will be targeted through two Extension programs designed to build upon CSH. Independent and
combined effects of different programmatic approaches will be evaluated.
Working on Wellness
In response to the CDC Funding Opportunity on Programs to Reduce Obesity in High Obesity Areas, a Working on
Wellness (WoW) community-based program will be established to address obesity in Hidalgo County, Texas where
more than 40% of its 800,000 residents are obese. Texas A&M AgriLife Extension Service and Texas A&M Health
Science Center School of Public Health are partnering to address the obesity issue in Hidalgo county by combining
the skills and expertise of both organizations to improve access to healthier foods and safe places for physical
activity. Bringing a wide array of specialists to support project implementation and evaluation, both organizations
have a strong presence in Hidalgo County and considerable experience implementing and evaluating community
prevention programs in border communities. Utilizing a community-based participatory approach, community
assessments will be conducted and proposed strategies for addressing high rates of obesity vetted with
community stakeholders. The School of Public Health is responsible for the process and outcome evaluation.
Completed Projects
Projects conducted over the past several years demonstrate the importance of translating research to practice, the
benefits of approaching interventions from multiple levels, and building on best practices about achieving
behavioral change over time in different populations and settings.
Active for Life®
Funded by the Robert Wood Johnson Foundation, Active for Life® examined the effectiveness of two different
evidence-based programs to increase physical activity in older adults. The program was designed to test the
applicability of the RE-AIM framework and demonstrate that evidence-based physical activity programs can be
successfully translated. This study provided substantial experience in identifying essential intervention elements
and learning how to make programs more culturally and population relevant.
Adolescents & Young Adult Healthy Survivorship
AYA Healthy Survivorship is a mobile application designed for Adolescent and Young Adult (AYA) cancer survivors
(ages 15-39). Developed by a CTxCARES team and reviewed by community and advocacy group partners, the app
assesses AYA survivors’ health habits using an interactive assessment tool that providesscores for lifestyle, physical
activity, diet and nutrition, and well-being. Users can save scores and re-take the assessment once to assess the
effects of lifestyle and behavior changes. AYA Healthy Survivorship offers personalized tips for being more active,
eating better, and living a healthier life; all delivered via email. AYA Healthy Survivorship links users to a secure
and private Healthy Survivorship website(www.healthysurvivorship.org) where AYA users can register for a unique
personalized profile and can create cancer survivorship plans based on survey-driven templates.
Aging & the Built Environment
This NIH-funded innovative translational research program is disseminating information on the health and quality
of life benefits associated with providing outdoor space at senior communities. The “Access to Nature for Older
Adults” program is based on an award-winning multimedia tool that translates current research findings to
practical guidelines for industry professionals. Other components include an interactive website, supplemental
readings on dementia, and continuing education credit. The program was developed by an interdisciplinary team
from the Texas A&M College of Architecture and Texas A&M Health Science Center School of Public Health.
AgriLife Diabetes Management Programs
Do Well, Be Well with Diabetes is a nine-session Texas A&M AgriLife Extension program that improves lives and
saves health care costs by reaching out across Texas to communities without access to diabetes education. Small
groups of persons with diabetes are taught about what diabetes is, first steps to diabetes management through
better nutrition and physical activity, managing medications and blood glucose, and preventing and managing
complications. An economic analysis revealed an estimated potential lifetime health care savings of $57, 826 per
female and $44,320 per male participant. Developed for low literate, Spanish-speaking Hispanic/Latinos, ¡Sí, Yo
Puedo Controlar Mi Diabetes! (Yo Puedo) is a six-week diabetes self-management education program employing
novellas to deliver health messages in a culturally relevant manner. An initial pilot study at the Texas-Mexico
border demonstrated that Yo Puedo could increase diabetes management self-confidence, improve diabetes selfcare behaviors, and help participants maintain good blood glucose control. This program is now being widely
disseminated as a model program for federal qualified health centers in Texas.
Assessing the Built Environment in Colonias to Influence Policy Promoting Physical Activity
in Mexican American Children & Families
Funded by the Robert Wood Johnson Foundation Program in Salud America!, this study proposes to produce
environmental policy recommendations promoting physical activity in economically-disadvantaged, understudied
Mexican American children and families in the Rio Grande Valley. It involves conducting environmental
assessments of different neighborhoods and presenting findings to key community stakeholders for action.
Diabetes Prevention & Management
Funded as a core research program of the Prevention Research Center, the Diabetes Prevention and Management
Project aimed to improve the health of rural and underserved populations through better implementation,
dissemination, and sustainability of clinical and community disease prevention and management guidelines. The
research project has focused on advancing dissemination research and attention to determinants and intervention
research. The project’s primary goal was to examine gaps in real world utilization of disease prevention and
control guidelines and develop strategies for closing these gaps. Data from various assessments supported the
need for diabetes and chronic disease self-management research in the Brazos Valley.
Education to Promote Improved Cancer Outcomes
This program is designed to increase delivery of comprehensive cancer services through development of a
replicable, sustainable, tailored training program for promotores on prevention, treatment, and healthy
survivorship for colorectal, breast, and cervical cancers among at-risk residents in the Lower Rio Grande Valley
(LRGV) on the Texas-Mexico border. Specific aims are to: 1) equip promotores to educate residents on prevention,
treatment, and survivorship issues related to colorectal, breast, and cervical cancers, 2) enable promotores to use
tailoring strategies to improve their outreach efforts, and 3) increase residents’ prevention, treatment, and healthy
survivorship behaviors.
Fit & Strong!
Combining mini-grant funding from Scott & White Healthcare’s Community Resource Center for Senior Health
(CRC-Senior Health) and St. Joseph’s Healthy Communities, Fit & Strong! is an evidence-based physical activity
program for older adults. In conjunction with the Brazos Valley Area Agency on Aging (BVAAA), the program,
originally designed for older adults with osteoarthritis, is eight weeks long and combines flexibility, strength
training, and aerobic walking with health education to reduce arthritis symptoms, maintain independent
functioning, and increase participation in physical activity among older adults.
Friend to Friend
Successfully adapting the research-tested intervention program, Friend to Friend (National Cancer Institute, 2006)
for delivery by Texas A&M AgriLife Extension agents is likely to have a lasting impact on reducing the burden of
cancer in rural and frontier Texas counties. Increasing the number of these women who find cancer in earlier
stages not only reduces mortality and suffering, but the higher costs for treating later stage cancer and the
frequently devastating financial repercussions for their families. Urban women with cancer may travel a few miles
for cancer treatments, but rural Texas women will likely travel hundreds of miles to the nearest treatment source.
The Program on Healthy Aging is providing consultation about the RE-AIM planning and evaluation framework for
Friend to Friend.
Health Maintenance Consortium
Since 2004, SPH has served as the Resource Center for this consortium of twenty-one funded NIH grants
examining factors associated with long-term behavioral maintenance. The Resource Center has created an
infrastructure to: 1) foster ongoing cross-site communications among the funded projects; 2) provide technical
assistance to identify common questions, methods, and measures related to maintenance and sustainability and to
address cross-cutting issues that add synergy to the individual projects; 3) establish a central clearinghouse for
behavioral change concepts, assessment instruments, intervention protocols, methods, and data that can be
beneficial for other researchers and practitioners; and 4) disseminate research findings to both researchers and
practitioners. Nearly 50,000 individuals from adolescence to adulthood to old age were involved in this HMCsupported research, making this the largest group of studies of behavior change maintenance funded to date.
Learning Network
The Learning Network was affiliated with the Active for Life program and built community capacity for translating
research to practice. The Learning Network was designed to create a mechanism for sharing resources about
successful approaches to active aging. By partnering with the National Blueprint, this project created an
interactive Learning Network for the Building Healthy Communities Recognition Program which promoted the
pairing of smart growth principles with activity programming for older adults.
Pilot Evaluation of the Chronic Disease Self-Management Program
A collaborative effort between the National Council on Aging, Texas A&M Health Science Center, and Stanford
University, the purpose of this pilot evaluation is to conduct a study of the impact of the Chronic Disease SelfManagement Program (CDSMP) on health outcomes, utilization, and costs in an existing sample of participating
beneficiaries maintained by the National Council on Aging using Medicare Administrative data. The information
generated by this pilot evaluation effort will be used both to provide an initial reporting of program’s effects in
CMS’s September 2013 report to Congress and to inform the methodology that will be used in future evaluation
efforts of wellness and prevention programs .
Planning for a National Evaluation & Implementation of Evidence-Based Programs for
Seniors
The national roll-out of evidence-based disease prevention programs funded through the Administration on Aging
(AoA) requires technical assistance in planning, implementation, and evaluation. Working collaboratively with
Healthy Aging Network consultants as well as National Council on Aging (NCOA) colleagues, the Program on
Healthy Aging has assisted the AoA in designing a national research strategy for understanding the processes
involved in delivering evidence-based programs as well as documenting program reach and benefits. Activities
involve creating a common data base, assisting States in conducting research and presenting study findings around
the RE-AIM Planning and Evaluation framework, and advising on strategies for enhancing quality assurance and
fidelity processes. A major contribution will be designing on-line modules related to quality assurance and
identifying innovative quality assurance practices that can be shared throughout the aging services network.
Program for Rural & Minority Health Disparities Research
The Disparities Program is a collaborative initiative between the Center for Community Health Development at SPH
and the Center for the Study of Health Disparities at TAMU. Funded by the National Center on Minority Health and
Health Disparities at NIH, this program focuses on the intersection of setting and population characteristics and
how they impact health—with specific attention to nutrition, physical activity, obesity, and diabetes. The
program’s core research project, Employing Diabetes Self-Management Models to Reduce Health Disparities in
(central) Texas, is addressing many aims of relevance including: 1) documenting the nature and magnitude of
health disparities among patients with type 2 diabetes; 2) evaluating different diabetes self-management
intervention approaches on patient behavioral and clinical outcomes; 3) assessing the cost-effectiveness of these
different approaches to diabetes self-management education; and 4) exploring the reach of our intervention
efforts and the broader organizational impacts of diabetes self-management education, examining how selfmanagement interventions get linked back into clinical practice. Program on Healthy Aging faculty co-direct the
research and translation core, and participate in research to investigate behavioral and social strategies for
diabetes management.
Promoting Walking & Other Physical Activity among Obese & Diabetic Patients in
Integrated Healthcare Plans
Despite the recognition of the environment as a major determinant of activity levels, little is known about how
primary care practitioners include environmental factors in their recommendations for obese patients. Funded
through the Scott and White Research Foundation, this pilot study which is a collaboration between Scott and
White, the College of Architecture, and the School of Public Health will examine both physician and environmental
influences on patient activity levels by:
1.
Assessing if, and how, healthcare providers encourage walking and engagement in other physical
activity to their obese and diabetic patients; and
2.
Identifying specific built environmental facilitators of, and barriers to, walking and engagement in other
physical activity in the neighborhood.
Testing a Low-Literacy Diabetes Self-Management Education Kiosk
In response to concerns about the need for more culturally sensitive self-management tools, an educational KIOSK
was developed by team members to provide basic self-management information about diabetes to low literacy
populations in both English and Spanish. This research is supported by the Morris L. Lichtenstein, Jr., Medical
Research Foundation and is designed to evaluate the implementation and dissemination of a computer-assisted
touch screen in multiple clinics and organizations in the Central Texas and Coastal Bend regions. The over-arching
goals of the KIOSK are to improve the availability of diabetes self-management education and improve
sustainability of consumer’s ability to self-manage diabetes through the ready availability of diabetes education
tools; and decrease or delay diabetes complications. After some local pilot testing in the Brazos Valley to assess
the feasibility and use of the KIOSK, we have redesigned the basic educational module to run off a web-based
system so that we can more easily place KIOSKs in different geographic settings.
Texas Falls Prevention Coalition
The Texas Falls Prevention Coalition was funded through the Department of Aging and Disability Services and
examined the implementation and outcome of delivering an evidence-based Falls Prevention Program, A Matter of
Balance-Volunteer Lay Model, statewide in Texas. TFPC coordinates the efforts of organizations throughout Texas
that provide falls prevention activities and establishes a statewide network of stakeholders to share information.
The program promotes, implements, and evaluates, evidence-based programs and policies to help reduce risk
factors of falls and injuries in older adults. The Program on Healthy Aging served as the state-wide evaluators of A
Matter of Balance, and is now the home of TFPC activities supported by the Texas Association of Area Agencies on
Aging (AAA) through funding from Humana Health Care.
Texas Childhood Obesity Prevention Policy Evaluation
Funded by the Robert Wood Johnson Foundation, the Texas Childhood Obesity Prevention Policy Evaluation
Project (T-COPPE) was created to evaluate the impact of two national policies as they are implemented in Texas.
T-COPPE is a 5-year study running from 2009-2013, which will evaluate the effect of the Safe Routes to School
(SR2S) and the Texas Women, Infants, and Children (WIC) Nutrition Program on the health of Texans. This is the
first major initiative supported by a statewide coalition of more than 80 partners including academics, prevention
advocates, community leaders, and government agencies collectively called Live Smart Texas (LST).
Texas Healthy Aging Research Network Collaborating Center
Together with the Collaborating Center of the Healthy Aging Research Network (HAN), other HAN sites and the
CDC, TxHAN works to continue the advancement of the translation of prevention research to community-based
practice focused on an aging population. Through partnerships with local, county, and state agencies, TxHAN
seeks to identify public health, aging services, and related community resources and engage them in collaboration
for healthy aging. The TxHAN will advance key HAN research initiatives in the areas of physical activity and
environmental assessment, while also engaging in new research priorities including depression, nutrition, and
Alzheimer’s disease.
Texas Healthy Lifestyles
With funding from the Texas Department of Aging and Disability Services, Texas Healthy Lifestyles: Communities
Putting Prevention to Work disseminates the Chronic Disease Self-Management Program to over 3000 older
Texans. The State has selected five geographic areas–Tarrant County, Bexar County, Central Texas, Rio Grande area
and the East Texas Coalition–as regional sites for delivery and dissemination of this program. The School of Public
Health directs the state-wide evaluation effort to track program dissemination, document the adoption by local
community agencies, and provide technical assistance on standardized data collection and fidelity processes
among partnering communities. Texas Healthy Lifestyles seeks to create a knowledge base for the risks associated
with chronic diseases and the benefits of a healthier lifestyle and help older persons learn to take responsibility for
day-to-day self- management of their conditions. Coordinating local efforts with the Brazos Valley Area Agency on
Aging, seniors in our community will have the opportunity to participate in a variety of evidence-based chronic
disease management programs delivered through the aging and public health as well as other community sectors.
Our Brazos Valley AAA has recently formed a partnership with the Texas A&M University College of Nursing and is
training nursing students as class leaders for our evidence-based programs. This partnership has proven to be an
excellent educational opportunity as well as means for disseminating and sustaining the delivery of evidencebased programs throughout the state.
Texercise: Evaluating its Reach & Effectiveness
Texercise is a statewide health promotion program of the Texas Department of Aging and Disability Services that
encourages individuals and communities to adopt healthy lifestyles habits such as regular physical activity than can
sustain or improve mobility among the more than 2.5 million older Texans. Texas A&M Health Science Center
Prevention Research Centers Healthy Aging Research Network has partnered with the Baylor Scott and White
HealthCare Community Research Center for Senior Health to evaluate Texercise’s reach and effectiveness. Major
objectives are to (1) help standardize the existing program for widespread dissemination as an evidence-based
program; and (2) conduct a systematic evaluation of the processes and outcomes associated with Texercise.
UP-BEAT Project & City-BEAT Walking Circuit
UP-BEAT (Umbrella Partnerships- BE Active in our Town) is a collaboration between the BVOPN and the Brazos
Valley Community Action Agency, Inc (BVCAA), with evaluation support from the Program on Healthy Aging. With
funding from the Department of State Health Services, UP-BEAT facilitates new and current partner efforts to
increase access to physical activity among limited resource youth and families in Brazos County. UP-BEAT works
toward environmental and policy changes to increase access to physical activity within the Brazos Valley. UP-BEAT
has implemented the City-BEAT walking circuit in downtown Bryan to highlight walkable areas and to encourage
visitors and residents to use the downtown area for physical activity. Working with the City of Bryan, the CityBEAT walking circuit is being coordinated with the existing audio walking tour of downtown. Additionally, UP-BEAT
is training community youth to conduct environmental assessments of limited resource neighborhoods in Brazos
County. The youth will then share their findings with local key stakeholders and policy-makers in efforts to make
changes to increase physical activity opportunities in the Brazos Valley. In conjunction with the BVOPN efforts, the
Brazos Valley Council of Governments has recently been recognized by the Environmental Protection Agency,
receiving a Building Healthy Communities for Active Aging Award.
WellCare: Developing Partnerships for Delivering Evidence-Based Self-Management
Programs
While Chronic Disease Self-Management Program and Diabetes Self-Management Program workshops have been
disseminated by the Program on Healthy Aging in the Brazos Valley and other regions in East Texas with support of
the Texas Department of Aging and Disability Services, a new grant from WellCare Health Plans, Inc. allows a
significant opportunity in 2012-2013 to partner with a number of organizations in the Houston/Galveston area.
Such private-public partnerships are essential for building a sustainable delivery system for reaching underserved
populations. Our goal in the next year is to empower at least 400 older adults in the Houston/Galveston area to
better manage their chronic disease and diabetes. This will be accomplished with the introduction of evidencebased programming in partnership with the collaboration of partners in the Houston Consortium. The Texas A&M
Health Science Center Program on Healthy Aging will assist in program delivery and training, provide technical
assistance in program recruitment and selection, and evaluate the program by documenting reach, adoption, and
fidelity processes and outcomes.
Wisdom, Power, Control
Texas A&M AgriLife Extension in collaboration with Texas A&M School of Public Health (SPH) is piloting Wisdom,
Power, Control through a 2012-2013 grant funded by the USDA National Institute of Food and Agriculture.
Wisdom, Power, Control was developed by Texas A&M AgriLife Extension in response to the need for an evidencebased, culturally relevant type 2 diabetes self-management education (DSME) program targeting African
Americans. Employing an experiential, hand-on approach in instruction, the seven-week empowerment-based
program aligns with the American Diabetes Association’s standards for DSME. Study aims are to examine
programmatic effects on hemoglobin A1c, diabetes knowledge, self-efficacy, and self-care skills. As part of this
effort, this project is seeking to reach underserved African Americans who have limited access to health resources
and build capacity in the targeted communities. Following the one-year pilot project, AgriLife Extension and SPH
have plans to establish community partnerships to adopt Wisdom, Power, Control as a method to promote longterm sustainability.
Contact Information
Program on Healthy Aging
Health Promotion & Community Health Sciences
School of Public Health, Texas A&M Health Science Center
212 Adriance Lab Rd.
College Station, TX 77843
Dr. Marcia Ory
979.436.9368
mory@tamhsc.edu
Doris Howell
979-436-9370
dhowell@sph.tamhsc.edu
Web
Sph.tamhsc.edu/pha
Fallsfreetexas.org
Email
Healthyaging@sph.tamhsc.edu