CPHA conducts research and service projects in our local community, across the state, and throughout the country.  Explore our active research projects and learn more about eligibility criteria for each study to get involved as a potential participant.

Living Healthier with Diabetes

What is Living Healthier with Diabetes?
Living Healthier with Diabetes is a Rural Health Moonshot study being conducted by Marcia G. Ory, PhD, MPH, at the Texas A&M University Health.

What is the purpose?
The Texas A&M research team is studying how diabetes self-management education and support impacts health and health care. This study is designed to look at the effectiveness of different kinds of diabetes education. We hope the results will help us better understand the effects of diabetes self-management education and also benefit persons with type 2 diabetes.

Who are we recruiting?
The research team is looking for participants who:

  • have type 2 diabetes

  • are at least 25 years old

  • have an A1c level of 8% or greater

  • have access to a device (smartphone/tablet) and internet

  • read and speak English

  • live in the Brazos Valley and surrounding areas

What do you have to do?
You will complete a health assessment and surveys related to living with type 2 diabetes, and our research team will obtain your HbA1c level. You will be asked to complete diabetes self-management education and support sessions OR to download and use a smartphone application for diabetes self-management education and support over 3 months. Some of the participants who receive education sessions will be also asked to download and use the smartphone application.

You will be asked to complete follow-up visits 3, 6, and 12 months after you start diabetes self-management education and support services; to complete surveys; and for our research team to obtain your HbA1c level.

What do you get for participating?
You will receive diabetes self-management education and support services and up to $300 in gift cards for completing the entire study.

If you're interested in participating, click HERE to find out if you are eligible.


Your Diabetes, Your Heart

Your Diabetes, Your Heart single session online or face-to-face free course:

  • Offered by Texas A&M Health Center for Population Health and Aging
  • 1.5 hour session
  • Learn about heart health and diabetes

Access to the American Diabetes Association’s Know your Diabetes by Heart free resources:

  • Ask the Experts Q&A Series
  • Healthy Recipes
  • Monthly Newsletter

Partner with us to host Your Diabetes, Your Heart classes. Promote Your Diabetes, Your Heart to your clientele and community connections. Contact Ninfa Peña-Purcell, PhD, at for more information. 

Research Study on Dementia-Friendly Communities to Promote Active Living

Texas A&M researchers invite caregivers to participate in a survey to learn about how community environments affect the health and well-being of persons with memory loss. If you are a caregiver of someone living with memory problems in Texas, please click HERE <> to see if you are eligible to participate, and if so, proceed to take the survey and receive a $10 gift card as a token of our appreciation. Your responses will help inform the design of dementia-friendly communities. Please consider forwarding this email to friends, family, and neighbors that may qualify for this important research. For further information, please contact our Project Manager, Dr. Aya Yoshikawa, at 979-436-9527 or


Technology for Caregiving Assessment Research and Education Services (T-CARES)

What is the T-CARES?
The T-CARES is a research project funded by the Texas Alzheimer’s Research and Care Consortium (TARCC).

The study is currently being conducted by Marcia G. Ory, PhD, MPH, at the Texas A&M University Center for Population Health and Aging. The study is also being conducted at two other institutions, UT Dell Austin Medical School and The University of North Texas Health Science Center.

What is the purpose?
The Texas A&M research team is studying how to help family caregivers respond effectively to loved-ones with dementia or memory loss by testing the impact of an intervention that involves location-based wearable technology system (i.e. a smartwatch and smartphone app).

Who are we recruiting?
The caregiver should:

  • be at least 18 years old

  • be unpaid caregivers for loved ones

  • be a primary caregiver who provides at least 20 of care per week

  • use a smart phone

  • read and speak English

  • live in the Brazos Valley and surrounding areas

    The care recipient should:

  • be at least 18 years old

  • have at least two identified problems on the AD-8 assessment that is built into the screening survey

  • be community dwelling

  • be able to walk with or without assistance for at least 10 minutes at a time

  • not currently be involved in another research study about caregiving or wandering

  • read and speak English

  • live in the Brazos Valley and surrounding areas

What do you have to do?
You will be asked to schedule and attend a virtual or in-person enrollment visit where you will be trained by a study coordinator on how to use the smartwatch and smartphone application. Your care recipient will wear the smartwatch. The system will allow you to monitor the location of your care recipient, set safe zones (to minimize the need for direct supervision), and initiate two-way voice communication between you and your care recipient. You will be asked to use the smartwatch and smartphone system for three months.  During the three months, you will complete two surveys (at baseline and at three months post baseline) and participate in 1-2 intermittent telephone calls with the research team to answer some questions about your experience using the system.

What do you get for participating?
You will receive the smartwatch and six extra months of free service for the watch (approximately a $200 value). You will also receive a $25 Amazon gift card for completing the entire study.

If you're interested in participating, click HERE to find out if you are eligible.


Aging & Technology

  • Assessing the utility of dementia patient monitoring technology

    Persons living with dementia (PWD) who wander due to disorientation and underlying agitation are at increased risk for harm due to being in an unsupervised environment, which can increase the burden of care for family caregivers. This pilot study, funded by the Texas Alzheimer’s Research and Care Consortium, aims to test the feasibility of a multi-component intervention that integrates a technology-based approach to increase PWD safety with evidence-informed skills training for caregivers. It examines the usability of a specially programmed watch (e.g., amount of time worn by PWD, features used by caregivers) and user satisfaction (e.g., whether it meets user expectations and needs, ease of use, what, if any changes the users would recommend) of the wearable technology that provides location information and two–way communication between caregivers and care-recipients.

  • Gameplan 4 Care: Web-based delivery system for REACH II

    With an aging population, there is a rapidly growing number of persons with dementia, and concerns about burdens placed on family caregivers. This NIH-funded research applies technology to an existing evidence-based intervention, Resources for Enhancing Alzheimer’s Caregiver Health II (REACH II). The goal is to create a scalable and sustainable on-line family caregiver support system to be accomplished through two study aims: (1) advance the current proof-of-concept GP4C into a viable delivery system for the REACH II intervention; and (2) compare the relative impact of GP4C and GP4C-Education on a wide range of family caregiver outcomes. GamePlan4Care is a novel multifaceted intervention concept tested in a previously funded Texas Cares grant. Working collaboratively with colleagues at Baylor Scott and White Health who are designing and implementing GamePlan4Care, Center investigators are responsible for evaluation.

  • Improved AD/ADRD assessment sensitivities using a novel in-situ sensor systems

    The ability to perform various daily functions is an established predictor of cognitive decline in older adults and a useful predictor in independent living and functioning. This fast-track SBIR project funded by the National Institute on Aging addresses the critical need for better assessment tools in dementia research and care. The primary objective is to demonstrate the feasibility and effectiveness of using the Birkeland Current Sovrin IoT system to continuously and accurately assess daily functions, ADLs, and IADLs, for persons experiencing cognitive decline in a home or assisted care settings. Texas A&M is serving as the academic partner and will facilitate input from the advisory group as well as oversee the evaluation. Phase 1 has been successfully completed, and the project has moved to phase 2 where CPHA will play a major role in assessing the comparability of the traditional survey periodic health professional measurement approach to the newer technological noninvasive real-time monitoring of ADL functioning.

Aging & the Built Environment

  • Dementia-friendly communities to promote active living

    Little is known about the role of different environmental domains (e.g., built, natural and social) on physical activity, social interaction, and overall independence of persons with dementia. Funded through the National Institute on Aging as an administrative supplement to an ongoing NIH study of environmental impacts on physical activity, this project has three specific aims, centered on advancing the understanding of various housing and neighborhood environments for persons with AD/ADRD. By identifying the significant barriers and facilitators in the built, natural, and social environments in which people with AD/ADRD live, and by collaborating with dementia experts and built environmental professionals, this research aims to identify environmental strategies to promote physical activity, social interaction, and independence of people with AD/ADRD and reduce burdens on their caregivers. This project will be utilized to refine study protocols and obtain pilot data for more extensive research in this understudied area.

  • Fighting obesity by reinventing public transportation: A Natural Experiment

    Use of public transit has been associated with increased physical activity and considered a promising approach to reducing the risk of obesity and other age-related chronic conditions such as cancer, diabetes, and heart disease. This timely study uses a pre-post case-comparison design to examine the causal impact of Bus Rapid Transport (BRT) and other supporting strategies on residents’ physical activity. The specific aims are to: (1) determine physical activity impacts of BRT; (2) examine physical activity impacts of specific implementation strategies, including education (e.g., lifting the knowledge barrier by offering a smartphone app and training to assist transit trip scheduling) and modifying cost (e.g., lifting the financial barrier to transit use by executing an introductory free-fare strategy); and (3) explore benefits and costs of BRT implementation, and barriers and facilitators of BRT use.

  • Physical activity impacts of a planned Activity-Friendly Community (AFC)

    With a multidisciplinary investigative team representing public health, architecture, engineering, computer sciences and education, this NIH-funded 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 physical activity 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 Physical activity among these populations, either directly or indirectly by affecting psychosocial factors related to physical activity.

  • WoW: Promoting physical activity through tactical urbanism

    Alarming rates of obesity are a persistent public health challenge in Hidalgo County, Texas. Since 2015, Working on Wellness (WoW) coalitions in Hidalgo County have collaborated to develop and implement policy, systems and environmental (PSE) interventions that address environmental determinants of obesity. This project will serve as a training laboratory for students to design and implement a community intervention that addresses gaps in the built environment in order to create an environment that supports physical activity. Public health students will have an opportunity to collaborate with WoW coalition members, transportation planners, urban planning students and public health faculty to develop and implement a pop-up demonstration project that utilizes tactical urbanism strategies in an effort to enhance and increase physical activity opportunities for healthy living.

Health & Chronic Disease Management

  • Dementia Connections: Expansion of Dementia-Specific Case Management

    Given the aging of the population, there is an urgent need to provide better, more responsive services for individuals with Alzheimer’s disease and related dementias and their families. The purpose of this project is to conduct a rigorous evaluation of the Dementia-Specific Case Management program. With continued funding from the Administration for Community Living, the program expansion will include: (1) improved efficiencies in service provision to better address unmet needs; (2) an addition of a medication management program (HomeMeds) and medical case reviews to reduce individual’s adverse health events; and (3) planned collaborations (e.g., community organization, an integrated health system; and an academic health care center) to provide necessary referrals and information to make the business case for the dementia-specific care management model.

  • The Rural Moonshot Program

    The staggering burden of diabetes in Texas calls for a transformative new initiative. Toward this end, Blue Cross Blue Shield (BCBS) is partnering with Texas A&M to launch a Rural Health Moonshot Initiative. Building upon existing infrastructure, we are developing a diabetes intervention program with specific aims to: (1) examine the effectiveness of different diabetes self-management approaches on self-care behaviors and clinical outcomes; (2) assess the impact of the different approaches on health care utilization and associated costs; (3) conduct a process evaluation of the feasibility, usability and adherence to each intervention protocol; and (4) recommend best practices that can be both scaled and sustained over time. In addition to this intervention program, we are conducting a secondary analysis of administrative claims data to better understand patient’s clinical trajectories and related costs that can help inform the cost effectiveness of different intervention approaches.

  • Putting CDSMP to work: Implementation of the Live Healthy, Work Healthy program

    While evidence-based self-management programs have been distributed widely in the community, such programs have not been effectively translated into workplace programs. Employee health and wellness is on the forefront of employers’ minds because a healthy employee is also a productive employee. In collaboration with The University of Georgia, this project translates the Chronic Disease Self-Management Program (CDSMP) for use among middle-aged and older employees with chronic conditions. The workplace-tailored CDSMP (wCDSMP) targets employees with increased cardiovascular risk to improve work performance while maintaining health-related outcomes shown with the original CDSMP. The overall aims of this research project are to examine the influence of CDSMP workshops specifically tailored to workplace settings on health outcomes, work performance, and productivity indicators. Additionally, the project will estimate the costs of implementing the program and assess cost-effectiveness and return on investment for employers and communities.

Infrastructure Building & Training

  • Engaging community health workers to increase pneumococcal pneumonia vaccination update

    Adult vaccinations while critical for maintaining health are underutilized, especially in ethnic populations. CPHA has entered into a partnership with Pfizer Vaccines to collectively develop training materials targeting community health workers (CHW; also known as promotoras) to guide their interactions with older adults (age 65+) and promote pneumococcal vaccination coverage. The training will focus on (1) the importance of adult vaccination; (2) how to engage older adults and address their concerns and perceived barriers to being vaccinated; and (3) tools that can used to educate community members, refer them to be vaccinated, and organize events.

  • Falls Infrastructure Expansion and Integration Enhancement (FIE2)

    Falls prevention programs are being successfully disseminated throughout the nation. Yet, more can be done to ensure that programmatic efforts are meeting the needs of the increasing diverse older population. Funded by the Administration for Community Living, the purpose of the Falls Infrastructure Expansion and Integration Enhancement (FIE2) is to enhance the integration of the partner network to support the addition of A Matter of Balance to one new urban and five new rural counties and Enhance Fitness (EF) to the array of evidence-based fall prevention programs in the Tarrant County area and six new FIE2 counties. FIE2’s goals are to: 1) Provide array of evidence-based fall prevention programs to increase number of program participants in rural and urban counties; and 2) Attract healthcare payors through integrated TH@H network. As the academic partner, CPHA has a subcontract with United Way of Tarrant County to monitor participant recruitment, retention and outcomes.

Policy & Environmental Assessments & Interventions

  • Teens Think Smart: A novel approach to preventing opioid misuse among adolescents in rural Texas

    Many rural communities have been devastated by the opioid epidemic, with risk factors now recognized as starting in the younger population. Funded by the Health Resources and Services Administration, this project is a multi-component community-based opioid abuse and misuse prevention intervention targeting 300 rural seventh and eighth grade students in multiple rural Texas counties. The project will be informed by a community-based participatory methodology, which engages the community through the formation of health coalitions that will participate in a community readiness assessment, and assist with planning and implementing the Teens Think Smart curriculum, engaging school districts, local government, law enforcement, and health entities.

  • Texas A&M Triads for Transformation opioid epidemic’s impact on older adults

    While public health officials recognize the devastating nationwide impacts of the opioid epidemic on Americans of all socio-demographic backgrounds, scant attention is paid to the impact of opioid use/ misuse among older adults, especially those in rural areas. This preliminary research, funded through the President’s Excellence Award, will: (1) identify older adults who are at high risk of negative impacts due to the opioid crisis; (2) understand the myriad ways in which older adults may be affected; (3) evaluate the costs of the epidemic in terms of needed medical care and social services, both personally and to the health care system; and (4) conduct an environmental scan of effective clinical, educational, behavioral, technological and/or policy solutions for mitigating impacts of the opioid epidemic on older adults and their families.

  • Texas A&M opioid education and naloxone administration

    While Texas is not known as a high incidence state, there is emerging evidence of an unrecognized opioid-related crisis in Texas. Toward this end, Texas A&M has established an Opioid Task Force which has received pilot funding to develop strategies for better understanding and addressing the epidemic in Texas. Additionally, Texas A&M has received approximately $2 million worth of naloxone kits and will be testing the effectiveness of training university personnel as well as local community leaders in enhancing knowledge about opioids, signs and symptoms of overdose, and effective reversal treatments for saving lives.


    • Active For Life®

      Active for Life® was a RWJF-sponsored National Program Office (NPO) to examine the applicability of two research-based physical activity programs to community settings. The primary purpose was to learn how to translate research to practice with an emphasis on how research-based programs need to be altered to be responsive to community needs and structures. In addition to providing scientific leadership, the NPO, in coordination with an external evaluation team, provided technical assistance to nine grantee sites to examine process and outcomes for more than 8,000 adults, age 50 and older. This study provided substantial experience in identifying essential intervention elements and learning how to make programs more culturally and population relevant so that they could be widely disseminated and sustained over time. It serves as the namesake for our Active for Life® program, a compilation of evidence-based and evidence-driven programs and interventions to improve the health and wellbeing of older Texans.

    • After Cancer Care Ends-Survivorship Starts for Adolescents and Young Adults (ACCESS-AYA)
      This Cancer Prevention Research Institute of Texas (CPRIT) grant was designed to: (1) develop and deliver professional education to Central Texas medical professionals including family and internal medicine doctors, nurses and nurse practitioners, social workers and physical therapists; (2) engage with AYA survivors and their families to help them use resources to develop survivorship plans and to learn more about ways to reduce risk and improve their health and well-being; and (3) create networks, information and communication systems to improve access to survivorship services and resources.
    • 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, Si, 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 self-care 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.
    • ARRA Communities Putting Prevention to Work: Chronic Disease Self-Management Program

      The National Council on Aging served as the Technical Resource Center for this Administration on Aging Initiative which sought to enroll over 50,000 older adults throughout the Nation in chronic disease self-management programs. The evaluation team at the School of Public Health was responsible for the analytical aspects of the national evaluation. In collaboration with Stanford University, lead evaluators assessed the impact of the Chronic Disease Self Management Program on self-reported health status, behaviors, and health care utilization among 1,000 seniors.

    • Assessing the built environment in Colonias to influence policy promoting physical activity in Mexican American children and families
      Funded by the Robert Wood Johnson Foundation Program in Salud America!, this study addressed how environmental and policy factors affected physical activity in economically-disadvantaged, understudied, Mexican American children and families in the Rio Grande Valley. Study objectives included obtaining and evaluating key stakeholder feedback. It involved conducting environmental assessments of different neighborhoods and presenting findings to key community stakeholders for action.
    • Assessing existing screening guidelines for physical activity for older adults

      Goals for this Robert Wood Johnson funded project included: (1) reviewing existing literature regarding exercise guidelines and the extent of adverse events associated with exercise interventions and different screening approaches for older adults; (2) surveying the trans-NIH Behavior Change Consortium to provide the latest empirical data on screening criteria utilized in these premier behaviorally-based physical activity interventions; and (3) conducting focus groups and organize informal working group sessions at selected national professional meetings. A screening round table of key stakeholders was organized to discuss strategies for disseminating best practices and tracking any adverse events associated with new recommendations. A major product was the development of the EasyForYou Screening tool.

    • Cancer Prevention and Control Research Network

      Funded as a Special Initiative Project of the CDC Prevention Research Centers, the Communities of Texas: Cancer-Activity-Education-Research-Support (CTxCARES) was a member center of this CDC-funded thematic network. Our network was a catalyst for the adoption of evidence-based cancer prevention and control interventions in Central Texas. CTxCARES, as part of The Texas A&M School of Public Health Center for Community Health Development, partnered with Texas AgriLife Extension, Scott & White Healthcare, the Brazos Valley Area Agency on Aging, and other community and state-wide agencies to foster research on cancer prevention and control. The initial project focused on examining strategies for improving quality of life in cancer survivors.

    • Changing mobility patterns of the senior generation
      Funded by the Institute for Mobility Research (Germany), this multi-disciplinary research project was designed to develop new knowledge about seniors’ mobility. Combining experts across disciplines including sociology, psychology, transport studies, econometric modeling, urban planning, and travel survey methods, researchers employed descriptive and multivariate statistical analyses of travel survey data from five countries (China, Germany, Japan, United Kingdom, and the US) and five decades. Objectives included: (1) an analysis of historic and current travel behavior of people 65+ years; (2) identification of factors possibly changing mobility patterns of people 65+ ; (3) quantitative estimation of future travel behavior of people 65+; and (4) implications of future travel behaviors for transport system and BMW group.
    • Community Research Center for Senior Health

      This NIA-funded project was designed to develop, implement, evaluate and disseminate evidence-based interventions that address multiple social and behavioral determinants of senior health. Specific Center aims were to: (1) create a sustainable infrastructure that promotes an interdisciplinary and multi-contextual approach to Senior health intervention research; (2) develop community-academic health center relationships which foster community participation in research planning, study participation, and dissemination of findings; and (3) provide guidance and support to investigators and community leaders in research design, evaluation, and data analytic techniques that balance the need for rigorous science and the practical realities of conducting health research in community settings. The School of Public Health serves as the academic partner of this activity, a major project of which was the development of a tool kit to identify and select evidence-based programs. (

    • Developing partnerships for delivering evidence-based self-management programs

      Chronic Disease Self-Management Program and Diabetes Self-Management Program workshops have been disseminated in the Brazos Valley and other regions in East Texas with support of the Texas Department of Aging and Disability Services. A grant from WellCare Health Plans, Inc. provided the opportunity to partner with a number of organizations in the Houston/Galveston area to build a private-public partnership for creating a sustainable system for delivering evidence-based self-management programs. This partnership enabled program delivery and training, technical assistance in program recruitment and selection, and evaluation of the program by documenting reach, adoption, and fidelity processes and outcomes.

    • 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 under-served 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.
    • Dissemination of Fit & Strong! in the Brazos Valley

      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.

    • Doctor-patient encounters: Communications about lifestyle recommendations and other geriatric conditions

      This was a small grant supported by The Texas A&M Health Science Center School of Public Health and Baylor Scott and White Health Services Research Program. The purpose was to examine how doctors communicate to their older patients regarding lifestyle recommendations and the influence of patient, physician, and setting factors. Additionally, we examined the amount of time spent in different lifestyle discussions. The study concluded that precious little time was spent on provider-patient discussions about lifestyle behaviors.

    • 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.
    • Enhanced breast and cervical cancer prevention for low income and underserved using transdisciplinary collaboration in a family medicine setting

      This grant tested innovative ways of increasing breast and cervical cancer screening and prevention activities in the Brazos Valley using nursing students and community health workers. The overall goal was to improve family medicine, nursing, and public health practice related to evidence-based, culturally-appropriate care in women’s cancer services. This proved to be a successful model to expand breast and cervical cancer services in rural and underserved areas.

    • Enhanced colorectal cancer screening in a family medicine residency program

      This Cancer Prevention Research Institute of Texas (CPRIT) grant addressed 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 improved 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 tracked the availability, accessibility and appropriateness of cancer screenings.

    • Enhancing self-care activities of patients with diabetes using a PDA: A pilot study

      The specific aims of this Baylor Scott and White Health Services Research Program project were to: (1) assess the feasibility of PDA use in diabetes self-care by patients aged ≥18 years with type 2 diabetes; (2) identify which patients would benefit most from the use of a PDA; and (3) explore whether the use of a PDA as an adjunctive diabetes self-care device leads to better or improved patient adherence to diabetes self-care activities. This work was foundational in our development of self-assessment tools and related mobile health applications.

    • ÉPICO: Education to Promote Improved Cancer Outcomes

      The program was 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 were 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. A critical role was advisement on translation and dissemination efforts.

    • Establish self-management programs and wellness using evidence-based designs

      The Texas Health and Human Services Commission received federal funding through the Centers for Medicaid and Medicare’s to implement an 1115 Transformation Waiver project to provide quality care for low-income Texans. The Center for Population Health and Aging provides a centralized resource for training, implementing, and evaluating evidence-based self-management and wellness programs. In conjunction with the Texas Active for Life® Coalition, the Center 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. Current activities are centered on disseminating Making Moves with Diabetes, a program which has the potential to improve clinical outcomes and result in substantial health care cost savings.

    • Examining disparities in hospital treatment leading to lower extremity amputation (LEA) among residents living along the Texas/Mexico border

      Specific aims of this pilot study were to examine differences in race/ethnicity, age, gender or insurance status among those who undergo LEA, exploring geographic and SES differences in total charges for care and particular treatments and therapeutic interventions. The high incidence of lower extremity amputations at the border was documented.

    • Falls Reduction Education and Empowerment (FREE)

      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,” was awarded funds by the Administration on Active Living, to reduce falls and falls risk in Texas. The School of Public Health oversaw the Texas Falls Free Coalition and evaluated the effectiveness of implementing A Matter of Balance (AMOB) among participating Area Agencies on Aging. The goal of graduating at least 4,000 participants in AMOB in Dallas/Fort Worth, Austin, San Antonio, Corpus Christi, and El Paso metropolitan areas was met. Through the TFPC, FREE provided training for FPPs to master trainers, physical therapists, emergency medical professionals and community health workers. FREE’s key sustainability partners, Texas Healthy at Home and WellMed, were consulted on best strategies to generate funding for program delivery and sustainability.

    • 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 Resource Center (HMCRC)

      The Health Maintenance Consortium represented twenty-one funded NIH grants examining factors associated with long-term behavioral maintenance. The Resource Center 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 HMC-supported research, making this one of the largest group of studies of behavior change strategies.


      Funded as a small grant through Baylor Scott and White HealthCare, ICANFIT was a web and mobile technology-based solution for older cancer survivors to promote physical activity and increase quality of life. Specific study aims were to: (1) gain an in-depth understanding of cancer survivors’ needs and preferences for health PA promotion programs; (2) develop a state-of-the-art, web and mobile device accessible program “ICANFIT” using a user-centered design approach; and (3) assess the feasibility and initial efficacy of ICANFIT by pilot testing it among 100 older cancer survivors (post-treatment) recruited from clinics and communities. A major accomplishment was the creation of an ICANFIT website (

    • Impact, sustainability & scalability of multi-component falls prevention programs

      Working collaboratively with the Centers for Disease Control and Prevention (CDC) and the three funded State Health Department Injury Programs, the goal was to facilitate the evaluation of the processes and impacts of state-driven fall prevention programs for older adults. The two primary aims during the initial three years of the states’ five-year, multi-component fall prevention program implementation were 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. This work resulted in a lessons-learned report shared with CDC staff and grantees.

    • It takes a village – A multi-disciplinary, multi-level evaluation of learning network

      Affiliated with the Active for Life® program, the Learning Network was designed to create a mechanism for sharing resources about successful approaches to active aging. Partnering with the National Blueprint, this project created an interactive Learning Network for the Building Healthy Communities Recognition Program which promotes the pairing of smart growth principles with activity programming for older adults.

    • 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.

    • Medication use, dietary intake, and functional outcomes among homebound elders

      This was a small grant supported by The Texas A&M University System School of Public Health and Baylor Scott and White Health Services Research Program. This project examined medication use, dietary intake, and functional outcomes among a large and diverse sample of frail elders in the community. The project delineated drug-use patterns that may influence dietary intake and nutritional status, physical performance, and disability, and it identified appropriate targets for tailored interventions.

    • Nationwide evaluation of evidence-based programs (EBPs) for seniors

      Working collaboratively with the Administration on Aging, the following objectives were addressed in a three-year cooperative agreement: (1) assess the current state of knowledge about EBP practice and evaluation; (2) identify strength and gaps in reaching aging populations, delivering EBP services, and building training and evaluation capacity; (3) recommend a nationwide evaluation plan, specifying design, measurement, desired outcomes, and other critical elements; and (4) indicate key players/areas of expertise needed to conduct the proposed evaluation plan. This activity was coordinated with the Healthy Aging Research Network.

    • 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.

    • A new tool applies research to assisted living design

      This Phase I and II SBIR grant was funded by the National Institute on Aging to improve outdoor access for residents of long-term care facilities. In Phase I, an educational tool was developed that made it easier for decision-makers to apply evidence-based research to the design of new or existing facilities, leading to potential benefits for residents. The specific aims were to: (1) develop the relevant behavioral design principles; (2) create an interactive multimedia instructional format on CD/ DVD; and (3) evaluate the prototype for usability and effectiveness with representative target users in the design and provider industries.

    • 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 self-management 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 and other physical activity among obese and diabetic patients in integrated healthcare plans

      Funded through the Baylor Scott and White Health Services Research Foundation, this pilot study examined 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. Factors influencing doctor/patient interactions and the doctor’s understanding and application of environment-behavior-health linkages were examined. A major product was the development of a community resource guide for use by health care providers and patients to identify accessible places for physical activity.

    • Reinventing public transportation programs to fight obesity epidemic: A pilot study in El Paso, Texas

      Little is known about the causal impact of a rapid bus transit system on nearby residents’ physical activity. There are many methodological challenges to overcome in designing a rigorous longitudinal case-control study to understand how new transportation options affect obesity risk factors among a predominantly lower-income Hispanic population. With internal Texas A&M University funding (PESCA), a multidisciplinary team with expertise in architecture, urban design, transportation sciences, and public health conducted pilot work to develop valid, reliable, and culturally sensitive recruitment strategies and data collection protocols needed to submit a competitive NIH grant proposal in 2017. The R01 submission was reviewed successfully and Fighting Obesity by Reinventing Public Transportation: A Natural Experiment was funded in 2018.

    • Research core project for the Texas A&M University System CDC-funded prevention research center

      The purpose of this research core was to improve the health of rural and underserved populations through better implementation, dissemination, and sustainability of clinical and community prevention and disease management guidelines. Two primary questions were addressed: (1) why community and clinical practice guidelines, which are designed to improve health, were not better utilized? And (2) what strategies for better guideline implementation, adherence, and dissemination in especially vulnerable populations (including poor rural populations) were most effective? This activity served as the foundation for our later diabetes prevention and management research and practice efforts.

    • Research and Translational Research Core. Program for Rural and Minority Health Disparities

      This NIH-funded program addressed rural and minority health issues by: (1) providing critical information on how population and setting characteristics impact food choice, dietary patterns, and the risk of obesity in minority and rural populations; (2) developing interventions to reduce the risk of obesity, particularly among rural, minority, and underserved individuals; (3) testing the differential effectiveness of diabetes self-management models in rural, urban and minority populations; (4) strengthening the ability of the Texas A&M System to support disparities research and the recruitment and training of faculty committed to disparities research; and (5) developing a health disparities institute that will serve the 9 universities and 6 state agencies of the Texas A&M System. Critical roles included serving as Co-Director of the Research and Translational Research Core and Co-Investigator on the Diabetes Intervention Study.

    • South, West and Central Consortium Geriatric Education Center Of Texas (Texas A&M Health Science Center Affiliate Member)

      Funded through the Health Resources and Services Administration, the SWAC GEC was based at the University of Texas Health Science Center at San Antonio. The primary purpose was to improve patient care for the aged through interdisciplinary partnerships with faculty and practitioners in the fields of gerontology and geriatrics. This was accomplished by providing culturally appropriate geriatric training to health professionals through both on-site and distance learning mediums. Working with our other member networks, the subcontract to Texas A&M Health Science Center provided the infrastructure to direct activities in the Brazos Valley to focus on advancing the knowledge base about chronic disease management for seniors.

    • Special Initiative Project, Texas Healthy Aging Network (TXHAN) Center

      The TxHAN was a member center of a CDC-funded thematic research and practice network promoting healthy aging research. Investigators at each member Center contributed to cross-cutting research initiatives, as well as developing and implementing externally reviewed site-specific research projects which were seeded through this mechanism. The TxHAN advanced key HAN research initiatives in the areas of physical activity and environmental assessment, while also engaging in addressing new research priorities identified by the HAN network in areas including evidence-based programming, depression, nutrition, and Alzheimer’s Disease.

    • The State Driven Fall Prevention Project

      Essential elements of effective fall prevention programming at the state level were identified to accelerate and improve the dissemination of these effective models and associated findings to a broader, national audience. CDC funding supported three aims to: (1) evaluate the impact of programs as they are scaled statewide; (2) provide technical assistance to bring programs to scale; and (3) disseminate findings to key stakeholders. The ultimate impact of this initiative was to improve the health and functioning of the growing population of older Americans at-risk for falling. Evaluation Director (Implementation). 2011-2016. Texas Grow! Eat! Go! As a subcontract to a United States Department of Agriculture grant to the Texas AgriLife Extension System, Texas A&M Health Science Center School of Public Health assisted in the evaluation of two intervention programs designed to improve physical activity and eating behaviors of third graders at Coordinated Approach to Child Health (CATCH) elementary schools across Texas that included: (1) Junior Master Gardener Program (JMG), and (2) Walk Across Texas Program (WAT). Thirty-two (32) Title I schools in four counties in Texas were invited to participate in the five-year project. The School of Public Health led the process evaluation examining key stakeholders’ perspectives of the implementation, dissemination, and sustainability of this program.

    • Statewide evaluation of childhood obesity prevention policies in Texas

      This RWJF-funded project examined the impact of two policy initiatives designed to improve physical activity (PA) and eating behaviors of children at risk for obesity in Texas: (1) the Safe Routes to School (SR2S) program; and (2) the revised WIC food package for children. Submitted jointly by the UT Dell Center (co-lead: Deanna Hoelscher) and Texas A&M (co-lead: Marcia Ory), this project used a mixed methods approach for evaluation of these policies and included community-level (observations, GIS), organizational (counts of active transport at school, key informant interviews), and interpersonal/ intrapersonal (social norms about PA and food, safety perceptions, child PA, purchasing & food consumption) measures. Findings from this study were disseminated through a comprehensive policy outreach educational effort, including a series of high visibility policy forums and related activities coordinated through the Texas Health Institute and the Live Smart Texas coalition website to inform future policy implementation and development.

    • Subcontract with University of Minnesota

      The purpose of this subcontract to an existing NIH grant, Theory-based Interventions for Smoking and Obesity, was to foster cross-site analyses within the NIH-funded Behavioral Change Consortium. This contract supported five challenge grants and related technical assistance, along with resources, for sending common data to the Health Maintenance Consortium Resource Center. Challenge grants involved conceptual, methodological, and analytical work related to nutrition, physical activity, and smoking.

    • SUSTAIN for Better Health and Health Care for Older Adults

      Widespread dissemination of evidence-based programs for older adults requires coordinated local and regional efforts. Funded by the Administration for Community Living as one of seven community grants to address the burdens of chronic disease among the aging population, this project will serve as the bridge to embed a suite of Stanford Patient Education Chronic Disease Self-Management Education (CDSME) programs within a 59-county region to strengthen and support Area Agency on Aging (AAA’S) services as a sustainable and reimbursable model. SUSTAIN’s objectives are to: (1) create and evaluate a replicable healthcare referral model for linking clinical and community sectors; (2) examine Return on Investments (ROI) for the healthcare sector; and (3) strengthen AAA’s by creating a business case for CDSME reimbursement.

    • Testing a low-literacy diabetes self-management education kiosk

      This three-year research study, funded by The Morris L. Lichtenstein, Jr., Medical Research Foundation, evaluated the implementation and dissemination of a computer-assisted touch screen, low-literacy, Diabetes Education Kiosk in five clinics/organizations in the Corpus Christi/Coastal Bend region. After investigating readiness for implementation, the study team focused on translational implementation research questions, using a combination of focus group, survey, on site observation and computer tracking methodologies. After some local pilot testing in the Brazos Valley to test 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 geographical settings.

    • 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 well-being in ways unimaginable just a mere decade ago. The Texas A&M University Center for Healthy Active Living (TAMU-CHAL) served 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 was 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.

    • Texas Cares: Model for Dementia Capable Communities

      Funded by the Texas Alzheimer’s Research and Care Consortium, this was a collaborative effort between Texas A&M and Baylor Scott and White Health to provide Persons with Dementia (PWD) and their family caregiver’s access to local services and supports that have been proven to promote the health and well-being of the PWD and their family caregivers. Objectives of this pilot research study were to concept test a comprehensive model of care to: (1) promote dementia friendly communities for Texans; (2) personalize educational and support services through candid interviews with dementia caregivers; and (3) create an online adaptation of an evidence-based intervention to provide tailored resources and coaching. This seed funding has resulted in funded projects to further develop and pilot test behavioral, environmental, and technological approaches to dementia care.

    • Texercise: Evaluating Its Reach and Effectiveness (TERE)

      Texercise, a health promotions/disease prevention program of the Texas Department of Aging and Disability Services (TDADS), provides education, motivation and recognition tools to help older adults and people with disabilities engage in healthy lifestyles. In collaboration with the Community Resource Center for Senior Health centered at Baylor Scott and White Health Care in Temple, Texas, TERE examined the existing Texercise program and its resources in order to document its evidence base. Major aims were to: (1) review past experiences with the implementation and dissemination of Texercise; (2) modify current materials for replication; (3) examine the program reach and effectiveness in at least ten program sites in Texas, and 4) publish findings in peer-reviewed Journals to increase the visibility of Texercise. The major accomplishments was the standardization of a new Texercise Select Program to be further tested.

    • Texas Falls Prevention Coalition

      This two-year project, funded through the Department of Aging and Disability Services, examined the implementation and outcome of A Matter of Balance, an evidence-based falls prevention program delivered throughout Texas. Technical assistance on study design, data protocol issues, and evaluation tools to assess major impacts on heath and fall-related outcomes was provided. This project was coordinated with the Texas Healthy Lifestyles Program and the A Matter of Balance Program in the Brazos Valley. Established in 2007 to promote, implement, and evaluate evidence-based programs and policies to reduce falls and injuries in older adults, the Texas Falls Prevention Coalition transferred activities to the Texas A&M School of Public Health to reconstitute a Steering Committee of broad-based stakeholders to promote a multi-faceted approach to falls prevention and chronic disease self-management throughout Texas.