Papers by Shelly-Ann Bowen
Diabetes
In 2012, the CDC Diabetes Prevention Recognition Program approved its first recognized organizati... more In 2012, the CDC Diabetes Prevention Recognition Program approved its first recognized organization. Since then, it has recognized 4,000+ organizations to deliver the National DPP lifestyle change program to 600,000+ participants at type 2 diabetes risk. This analysis examined data from 624,422 participants to determine the impact of 5 organization types on priority population outcomes: community centers, higher education, government, healthcare providers, and for-profit/insurers. Most participants (65.7%) enrolled in for-profit/insurer organizations. Community centers enrolled the highest percentage of participants who identified as Hispanic/Latino (20.8%) and Native Hawaiian/other Pacific Islander (3%), and government organizations the highest percentage of Black/African American (17.7%) and American Indian/Alaska Native participants (10.8%). Higher education organizations enrolled the highest percentage of Asian/Asian American participants (3.4%). Men primarily enrolled in for-pr...
Journal of Nutrition Education and Behavior
The Journal of Rural Health
Health Promotion Practice, 2021
The Centers for Disease Control and Prevention (CDC) created a health communication marketing and... more The Centers for Disease Control and Prevention (CDC) created a health communication marketing and promotion support system (support system) to help 10 CDC-funded national organizations (recipients) grow enrollment of underserved populations in the National Diabetes Prevention Program. This article describes the creation of a successful support system to increase the use of effective marketing approaches and key messaging. The support system was developed using a systematic approach. It included a needs assessment, audience research, marketing strategy identification, expert panel review, materials development, and dissemination guidance. Hands-on, individualized, and group end-user training and technical assistance was also included. Recipients received culturally and linguistically tailored marketing materials to support their specific priority audiences, as well as corresponding training on recommended dissemination methods. In in-depth key-informant interviews, staff from six rec...
Nutrients, 2019
Plant-based diets are associated with reduced risks of various chronic diseases in the general po... more Plant-based diets are associated with reduced risks of various chronic diseases in the general population. However, it is unclear how these benefits translate to Blacks living in the United States, who are disproportionately burdened with heart disease, cancer, diabetes, obesity, and chronic kidney disease. The objectives of this study were to: (1) review the general evidence of plant-based diets and health outcomes; (2) discuss how this evidence translates to Blacks following a plant-based diet; and (3) provide recommendations and considerations for future studies in this area. Interestingly, although the evidence supporting plant-based diets in the general population is robust, little research has been done on Blacks specifically. However, the available data suggests that following a plant-based diet may reduce the risk of heart disease and possibly cancer in this population. More research is needed on cardiovascular disease risk factors, cancer subtypes, and other chronic disease...
Diabetes, 2020
Background: Remote delivery of health care services through telehealth technology holds promise f... more Background: Remote delivery of health care services through telehealth technology holds promise for expanding access to and engaging individuals in underserved communities. Systematic Screening and Assessment and Evaluability Assessment methods were used to identify and evaluate promising CDC-recognized National Diabetes Prevention Program Lifestyle Change and Diabetes Self-Management Education and Support (DSMES) programs utilizing telehealth technology. Objective: To describe how 8 Lifestyle Change and DSMES programs utilize telehealth technologies effectively to expand access to services in underserved communities. Methods: Eight effective programs were selected to participate in an in-depth study. Information was gathered to understand activities, adaptations, and implementation challenges through in-depth interviews with stakeholders and on-site observation. Results: In all program sites, telehealth technology seamlessly integrated into existing program models to increase patie...
Diabetes, 2018
Under a 4-year federally funded program, states (18) and large cities (4) are implementing approa... more Under a 4-year federally funded program, states (18) and large cities (4) are implementing approaches to scale and sustain the National Diabetes Prevention Program (National DPP) a structured, evidence-based, year-long lifestyle change program to prevent or delay onset of type 2 diabetes in people with prediabetes or at risk of developing the disease. This study examines grantee utilization of health marketing strategies to increase enrollment in the National DPP, targeting both general and high-risk populations experiencing health or socioeconomic disparities, and the technical assistance (TA) provided to grantees to implement and evaluate their marketing strategies. Analysis of Yr2 annual performance measure reports indicated that 2.2 million people were reached through traditional (print, television, radio, etc.) and social media (Facebook, Wiggio, YouTube, etc.). Over 17,000 new participants enrolled in National DPP with more than 2,000 from high-risk populations. Qualitative an...
Diabetes, 2018
This study discusses preliminary outcomes from a subset of national grantees implementing evidenc... more This study discusses preliminary outcomes from a subset of national grantees implementing evidence-based engagement strategies to scale the National Diabetes Prevention Program (National DPP) and reach people at risk for type 2 diabetes, including population subgroups who experience health or socioeconomic disparities. Quantitative and qualitative analyses were conducted using progress reports submitted in years 1 and 2 by grantees (health departments in 17 states and 4 large cities). Evaluation reports were analyzed using MAXQDA software to identify facilitators and barriers to implementing these strategies. Grantees worked to increase prediabetes screening, testing, referral, and enrollment among vulnerable, high-risk participants. Major strategies implemented included (1) developing tailored marketing plans to reach and engage persons with prediabetes, (2) implementing culturally tailored media campaigns, and (3) funding lifestyle coach trainings and professional development oppo...
Diabetes, 2019
CDC’s State Public Health Actions 1305 Cooperative Agreement funded all 50 state health departmen... more CDC’s State Public Health Actions 1305 Cooperative Agreement funded all 50 state health departments and DC for 5 years to increase the use of diabetes self-management education and support (DSMES) programs and the National Diabetes Prevention Program (National DPP) lifestyle change program (LCP) through strategies such as implementing referral policies in health care systems. Objectives: (1) Describe activities implemented by states to increase awareness, access, utilization, and coverage of DSMES and CDC-recognized LCPs; (2) share findings from baseline to year 5 for CDC-recognized LCPs and DSMES-related activities, and (3) describe facilitators and barriers to implementing prevention and management programs. Qualitative and quantitative data were abstracted from state health departments’ annual evaluation and progress reports and health impact statements. Qualitative data were analyzed using thematic analysis. Quantitative data were analyzed to determine year-to-year percent chang...
Diabetes, 2019
CDC’s State and Local Public Health Actions 1422 Cooperative Agreement funded 17 states and 4 lar... more CDC’s State and Local Public Health Actions 1422 Cooperative Agreement funded 17 states and 4 large cities for four years to develop and sustain the National Diabetes Prevention Program (National DPP) lifestyle change program (LCP) by implementing comprehensive environmental, health system, and community-clinical linkage strategies for populations at high-risk for type 2 diabetes. Objectives: (1) Describe health system and community-clinical linkage strategies implemented; (2) share findings from baseline to year 4, and (3) highlight key facilitators and barriers to scale and sustain the National DPP. Qualitative and quantitative data were analyzed from awardees’ annual performance reports and health impact statements. Performance measure data from baseline to year 4 were analyzed to determine year-to-year percent change. Qualitative data from awardees were analyzed to identify barriers and facilitators to implementing activities, and understand how barriers were overcome. Recipient...
Preventing chronic disease, Dec 7, 2017
The Centers for Disease Control and Prevention (CDC) developed a cooperative agreement with healt... more The Centers for Disease Control and Prevention (CDC) developed a cooperative agreement with health departments in all 50 states and the District of Columbia to strengthen chronic disease prevention and management efforts through the implementation of evidence-based strategies, such as CDC's National Diabetes Prevention Program. The National Diabetes Prevention Program supports organizations to deliver the year-long lifestyle change program that has been proven to prevent or delay the onset of type 2 diabetes among those at high risk. This article describes activities, barriers, and facilitators reported by funded states during the first 3 years (2013-2015) of a 5-year funding cycle.
Background: The Institute for HIV Prevention Leadership (Institute) is a capacity- building progr... more Background: The Institute for HIV Prevention Leadership (Institute) is a capacity- building program for HIV prevention program managers working in minority-based community-based organizations (CBOs) across the U.S. The Institute is funded by CDC through a cooperative agreement with the Association of Schools of Public Health. Institute participants transfer knowledge and skills in HIV prevention and strategic planning and management to their work in their CBOs and diffuse them to CBO staff and peers in other organizations. Methods: Institute staff conduct site visits at CBOs of program participants. Individual and group interviews are conducted at multiple levels with coworkers, supervisors, and community members and other stakeholders to assess both the transfer and diffusion of knowledge and skills acquired at the Institute. Interviews are audio-taped and transcribed verbatim for analysis using NVivo 7.0. Results: Results indicate increased capacity at the individual (personal and...
Objective:We present findings from a health assessment survey of a SC DPCP partner’s targeted pop... more Objective:We present findings from a health assessment survey of a SC DPCP partner’s targeted population- African American women, and discuss appropriate strategies for future collaborative program planning to serve this population. Methods: A total of 255 participants completed a cross sectional survey during the 2009 IMARA Tour. Descriptive and Chi-square statistics were computed using SAS 9.1 software. Results: Median age of participants was 53.5 years. Most respondents were more than high-school educated (84%), unmarried (58%), employed (63%), homeowners (85.4%), and lived above 200% federal poverty level (62%). Most reported no financial (55%) or food (63%) worries in the past 12 months, rated their general health as good or better (81%), and 93% expressed satisfaction with life. Nearly 89% of participants were insured, could identify (93%) and had visited (90%) a personal doctor; yet 20% lacked access to care due to cost. Most respondents were overweight or obese (80%) and did...
Health Education & Behavior, 2010
Most HIV-prevention funding agencies require the use of evidence-based behavioral interventions, ... more Most HIV-prevention funding agencies require the use of evidence-based behavioral interventions, tested and proven to be effective through outcome evaluation. Adaptation of programs during implementation is common and may be influenced by many factors, including agency mission, time constraints, and funding streams. There are few theoretical frameworks to understand how these organizational and program-related factors influence the level of adaptation. This study used constructs from both Rogers’s diffusion theory and Rütten’s framework for policy analysis to create a conceptual framework that identifies determinants hypothesized to affect the level of adaptation. Preliminary measures of these constructs were also developed. This framework and its measures assess organizational and program-related factors associated with adaptation and could serve as a model to assess implementation and adaptation in fields outside of HIV prevention.
American Journal of Public Health, 2007
Objectives. We examined the psychosocial and personal factors that influenced African Americans’ ... more Objectives. We examined the psychosocial and personal factors that influenced African Americans’ decision not to evacuate New Orleans, La, before Hurricane Katrina’s landfall. Methods. We conducted 6 focus groups with 53 African Americans from New Orleans who were evacuated to Columbia, SC, within 2 months of Hurricane Katrina. Results. The major themes identified related to participants’ decision to not evacuate were as follows: (1) perceived susceptability, including optimism about the outcome because of riding out past hurricanes at home and religious faith; (2) perceived severity of the hurricane because of inconsistent evacuation orders; (3) barriers because of financial constraints and neighborhood crime; and (4) perceived racism and inequities. Conclusions. Federal, state, and local government disaster preparedness plans should specify criteria for timely evacuation orders, needed resources, and their allocation (including a decentralized distribution system for cash or vouch...
American Journal of Health Promotion, 2013
Purpose.The study uses qualitative research to gain a better understanding of what occurs after l... more Purpose.The study uses qualitative research to gain a better understanding of what occurs after low-income women receive an abnormal breast screening and the factors that influence their decisions and behavior. A heuristic model is presented for understanding this complexity.Design.Qualitative research methods used to elicited social and cultural themes related to breast cancer screening follow-up.Setting.Individual telephone interviews were conducted with 16 women with confirmed breast anomaly.Participants.Low-income women screened through a national breast cancer early detection program.Method.Grounded theory using selective coding was employed to elicit factors that influenced the understanding and follow-up of an abnormal breast screening result. Interviews were digitally recorded, transcribed, and uploaded into NVivo 8, a qualitative management and analysis software package.Results.For women (16, or 72% of case management referrals) below 250% of the poverty level, the impact o...
Circulation, 2022
Background: Plant-based diets may reduce risk of cardiovascular disease (CVD) and help with weigh... more Background: Plant-based diets may reduce risk of cardiovascular disease (CVD) and help with weight management, particularly in communities where the burden of chronic disease is high. However, little research has been done on plant-based diet implementation in rural Black communities that are disproportionately affected with obesity/CVD. Since dietary behaviors are closely linked to cultural identity in this community, intervention strategies are needed to preserve cultural traditions while addressing lifestyle behaviors that reduce CVD risk. Methods: The Veggie & Soul pilot program was a 12-week plant-based nutrition and lifestyle intervention implemented in 2020 to prioritize and educate Black adults in rural Georgia about the benefits of a healthy diet and encourage increased consumption of fruits, vegetables, and whole grains. Weekly nutrition education sessions were implemented, in addition to support groups and cooking classes. Multiple instruments for dietary assessment were ...
Journal of the South Carolina Medical Association (1975), 2009
Page 27. The Journal of the South Carolina Medical Association 246 Background The incidence and m... more Page 27. The Journal of the South Carolina Medical Association 246 Background The incidence and mortality rate of in-vasive cervical cancer have decreased steadily over the past several decades in both whites and African American women. ...
Preventing chronic disease, Jan 25, 2018
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Papers by Shelly-Ann Bowen