Grant to Target Rio Grande Valley: $7 Million Will Help Fight Diabetes, Obesity

Joseph B. McCormick, M.D.

A five year, $7 million grant from the National Center on Minority Health and Health Disparities (NCMHD) of the National Institutes of Health (NIH) will help to establish The Center of Excellence on Diabetes in Americans of Mexican Descent at The University of Texas School of Public Health Brownsville Regional Campus. The new center will be a part of the existing Hispanic Health Research Center.

"This grant renewal will provide the support for vigorous intervention programs to reduce the burden of obesity and diabetes in our population," says Joseph B. McCormick, M.D., regional dean of the UT School of Public Health Brownsville Regional Campus. "Over the last five years we were able to build an infrastructure for research on obesity and diabetes and to define the size and characteristics of these problems in the Lower Rio Grande Valley. We are now in a position with this renewal to try and make a measurable difference in the health of our children and their parents."

The mortality rate from diabetes in Hispanics is 1.5 times higher than in non-Hispanics. Within the past two decades, the rate of type 2 diabetes has nearly doubled in the Mexican-American population along the U.S.-Mexico border. The increase in type 2 diabetes is also found in the children of these populations and the rates for all ages show no sign of slowing, says McCormick who is on faculty at the UT Graduate School of Biomedical Science (GSBS).

The Center of Excellence will work to understand the changes related to the development of diabetes, the mental health impact of diabetes and the potential for early intervention. The center will be located in Cameron County, where more than 80 percent of the population is Mexican American.

"The research from this grant has provided actual data to confirm our clinical observations regarding the most important cause of morbidity and mortality along the south Texas-Tamaulipas border, which is obesity," says Brian R. Smith, M.D., M.P.H. regional director of Health Service Region 11 of the Texas Department of State Health Services. "If this and future studies assist us as a society to tackle the problem successfully, the payback on the funding will be multiplied many times over."

The funding, known as P20 or the "Export" grant, provides a way to integrate ongoing, cutting-edge minority health and health disparities research. The second phase of the grant, through the new center, will focus on opportunities previously established in the Hispanic Health Research Center of the Lower Rio Grande Valley. This renewal and the original grant are shared with The University of Texas at Brownsville and Texas Southmost College.

"We are working with various media outlets to create messages around physical activity and food choices, as well as complementing this with community strategies," says Belinda Reininger, Dr.P.H., assistant professor of behavioral sciences at the UT School of Public Health Brownsville Regional Campus. "We plan to take this synergy of both interventional approaches into the next phase and rigorously evaluate this media intervention, look at the dosage of exposure and see how it impacts the clinical results."

The utilization of the strong family unit in the Mexican-American population to reduce the risk of obesity and diabetes in children through parental intervention will be targeted through a study called "En Vivo: Live Outside the Box."

"For the new portion of the project, we will build upon the experiences learned with the En Vivo pilot study and will call parents at home using a counseling technique called motivational enhanced interviewing (MEI)," says Steven H. Kelder, Ph.D., principal investigator for "En Vivo: Live Outside the Box." Kelder also is co-director of the Michael & Susan Dell Center for the Advancement of Healthy Living and professor of epidemiology at The University of Texas School of Public Health Austin Regional Campus.

Cristina Barroso, Dr.P.H., assistant professor of health promotion and behavioral sciences at the UT School of Public Health Brownsville Regional Campus, also is involved in many aspects of this project and is currently working on a pilot study with Kelder focusing on childhood obesity. "The project will specifically address parental influence," says Barroso. "Our goal is to motivate parents to encourage their children to reduce their television screen time by going outside and becoming more active."

Along with practical applications of media influence and physical activity, certain genetic factors also will be taken into consideration for the ongoing project.

"In one core of the research, we've recruited a cohort of 2,000 randomly selected individuals from the community. These people are now extensively documented with information on genetics, diabetes and other conditions, such as mental health," says Sue Fisher-Hoch, M.D., professor of epidemiology at the UT School of Public Health Brownsville Regional Campus and a GSBS faculty member. "With the new grant we will now re-examine these same people. Our work will include detailed study of the period when people with pre-diabetes develop full-blown diabetes and also studies of several of the complications of diabetes in those who already have the disease."

The scientific goal will be to research the physiologic progression to diabetes and its complications among Mexican Americans. The center will also develop diabetes prevention strategies and test innovative approaches to effective interventions for the disease. The center will contain an administrative core, a research core including three research projects and two pilot studies, a training core and a community engagement core. Additional research will include population- based epidemiologic research, clinical research, translational research, behavioral intervention research, laboratory research, health economics research, nutrition research, genetic research and applied statistical research.

"The presence of such an innovative and productive minority health research program in the Valley was recognized as one of our institutional strengths that resulted in our success in being selected as recipients of one of the first 12 NIH - CTSA awards,"says Peter Davies, M.D., Ph.D., executive vice president for research at The University of Texas Health Science Center at Houston and on the GSBS faculty. "This award has allowed us to create a very dynamic program of clinical and translational research both at our Houston campus and in Brownsville. The leadership of the National Center on Minority Health and Health Disparities has cited the program that Dr. McCormick has developed in Brownsville and its partnership with the UT Houston Center for Clinical and Translational Sciences as one of the finest examples of the achievement of the goals of the NCMHD in bringing "the full strength of NIH's research, training and outreach programs to bear on the challenge of eliminating domestic health disparities."

Public Health established regional campuses offering the MPH degree in San Antonio, El Paso, Dallas, Brownsville and Austin.

By Natalie Wong Camarata, Institutional Advancement

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