Christine L. Williams - US grants

The purpose of the Healthy Start Program will be to determine the effects of a two-year program of day care and family-based interventions on preschool children's risk for cardiovascular disease. Healthy Start will recruit a cohort of minority 3- and 4-year old children from six large Head Start Centers. Eligibility for Head Start requires that the family be below poverty level. After baseline evaluation, six centers will be randomly assigned to one of three conditions: C/FS; curriculum plus food service modification; FS; food service modification only; and C: control. Children in the curriculum plus food service (C/FS) condition will receive two years of a behaviorally-oriented health and nutrition education curriculum which will include classroom learning activities for the child and integrated family educational activities. In addition, the food service will be modified so that meals and snacks provided to the children meet the recommendations of the NCEP pediatric panel guidelines for children over two years of age. Children in the food service modification condition (FS) will receive the modified school food program only. The primary outcome of interest is dietary intake of total fat and saturated fat. It is hypothesized that at post-test, children exposed to the C/FS and FS program interventions, after controlling for baseline values, will have lower dietary intake of total fat and saturated fat compared with controls. A secondary outcome of interest is serum cholesterol levels compared with children in the control condition. Observations will also be made to determine effects on growth patterns.

DESCRIPTION (Adapted from the Investigator's Abstract): Depression is a pervasive problem in nursing home residents with Alzheimer's disease (AD). Depressive symptoms and dysphoric mood have been linked to loss of function out of proportion to the stage of AD (excess disability). Exercise is a realistic intervention which shows promise in the treatment of depression and dysphoria in this population. The long term objective for this research is to decrease excess disability due to depressive symptoms and dysphoric mood in nursing home residents with AD. The immediate objectives of this study are to: 1) Examine the effects of exercise over 16 weeks on mood and depressive symptoms in institutionalized elders with Alzheimer's disease and 2) Examine the effects of exercise over 16 weeks on excess disability in institutionalized elders with Alzheimer's disease. This study will be a randomized pretest-postest design with raters blinded to treatment. Subjects will be pre-screened for depressive symptoms and randomly assigned to one of two groups: exercise (supervised walking) or control group (social visits). Fifty subjects in the exercise group will receive up to 30 minutes of walking five times a week for four months. Another fifty subjects in the control group will receive attention in the form of social visits five times a week for the same amount of time. Depressive symptoms will be measured using the Cornell Scale for Depression in Dementia and mood will be measured with the Dementia Mood Assessment Scale and the Dementia Mood Picture Test. Excess disability will be measured using the Refined ADL Scale, The Physical Self-Maintenance Scale, and the Six-Minute Walk. Data will be analyzed using univariate and multivariate repeated measures analysis of variance. The primary test of the hypotheses will be for the interaction effect between group membership and time. Four groups of measures will be examined for their influence on the outcome measures and their potential utility as covariates in testing the hypotheses: sociodemographic measures, use of medications, comorbidity, and severity of dementia. Nursing home residents with AD are increasing in number. Most will become extremely inactive and consume a disproportionately large share of nurses' time. Depression hastens the decline in self-care abilities in nursing home residents with AD, increases distress and burden for caregivers, and may lead to complications such as falls and pressure ulcers. If found effective, this intervention may help to maintain residents with AD at the highest functional level for as long as possible.

Cardiovascular disease, the leading cause of death in the United States, has roots in childhood with the establishment of behaviors which lead to increased CVD risk. The Healthy Start Trial (Cardiovascular Risk Reduction in Minority Preschool Children, 1995-1998) is testing the effectiveness of nutrition interventions (food service change and a preschool nutrition curriculum) on blood cholesterol and diet among preschool children (age 3-5 years) attending Head Start Centers in upstate New York. Preliminary results indicate that the results are favorable, with significant effects on blood cholesterol, diet and menu content (percent energy from total and saturated fat). The continuation proposes to extend measurement of the Healthy Start Cohort through 8 years of age. The study will examine hypotheses related to a) long term intervention effects (blood cholesterol, dietary total and saturated fat, nutrition knowledge); b) tracking of lipids, blood pressure, obesity, and growth velocity from age 3 to 8; c) preschool intentions to smoke cigarettes, parental smoking, and early experimentation in elementary school; and d) long term maintenance of nutrition intervention activities in participating Head Start Centers. The study cohort consists of 1786 children who completed one or two full years of preschool intervention. The cohort is low income, 42 percent Black, 31 percent Hispanic, 23 percent White, 4 percent other. Uniform measurement methods will be employed during the continuation to assure comparability with data collection during the preschool period. These measures will include: a) blood lipids; b) blood pressure and resting heart rate; c) height and weight; d) triceps, subscapular and suprailiac skinfold measurements; e) waist and hip circumference; f) health and nutrition knowledge, attitude and self-reported behavior questionnaire (including smoking); g) 24-hour dietary recall, h) family history of CVD.

DESCRIPTION (adapted from abstract) This application for a new nutrition curriculum presents objectives and specific plans for: (1) development of a comprehensive, longitudinally integrated four year nutrition curriculum in the medical school that emphasizes knowledge, skills and attitudes; (2) development of a clinically relevant nutrition curriculum for education of faculty, house staff and practicing physicians; (3) mechanisms for evaluation of the curriculum; and (4) development of collaborative efforts in interchange of the teaching modules. The overall goal is to ensure that nutrition becomes a key part of the entire medical school curriculum and to advance nutrition as a tool for health promotion and disease treatment among house staff, faculty and practicing physicians.

This project examines how social class affects the experiences of women with police. Few studies have researched police behavior against women across social class lines. This project addresses three questions: (1) How does social class influence women?s experiences with police? (2) How prevalent is police misbehavior involving women? (3) How do women draw on resources to contend with police misbehavior involving themselves and their communities? This study will provide empirical evidence regarding the impact of social class on police misbehavior involving women, including the documentation of various forms of misbehavior. Findings from this project will assist stakeholders at multiple levels of government in creating gender-inclusive police procedural and police reform policies.

This project uses a mixed-methodological design consisting of interviews, field observations, and surveys. In-depth interviews are conducted with women from different social class backgrounds about their interactions with police. Field observations include attendance at community events regarding women, police misbehavior, or police reform. Local surveys are utilized to examine the specific types of policing women report experiencing. Based on an analysis of these data, a national survey was developed to examine the prevalence and scope of police misbehavior involving women. Findings from the national survey will provide insights regarding criminological theories of policing, as well as theories regarding racial inequality and gender inequality in the operation of the criminal justice system.

This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.

Social interactions are beneficial for aging individuals, be they healthy or affected by degenerative disease. Social engagement not only brings support but also acts on brain structure, behavior and cognition to slow aging. The aging process, however, produces multiple changes that compromise people?s ability to interact with others (person too slow or frail to keep to regular outings with family; thought processes and verbal fluency too sluggish, and hearing too feeble, to secure sufficiently frequent turns-at-talk in group conversation with younger individuals; etc.), leading to attrition of numerous and varied social links. The goal of this research program, to be conducted by an interdisciplinary team of socio-cognitive scientists, mathematical physicists and geriatric nursing experts, is to gain understanding on first principles underlying preservation or loss of social interaction in aging. This is accomplished by mathematically modeling the underpinnings of social integration and segregation within heterogeneous groups of older and younger individuals, and by conducting observational studies of group activities involving elderly and younger adults in a memory and wellness center (storytelling, gentle yoga, music making). Our mathematical model of social coordination (empirically validated in young adults) allows to vary each agent?s ?coupling? capabilities, (behavioral or cognitive) slowing pace, the memory process of social adaptation and behavioral noise level. Preliminary evidence suggests that pace discrepancy and weak coupling lead to briefer, less frequent periods of coordination, which are fundamentally scale- and context-dependent. Theory also suggests that noise enhances the stability of heterogenous groups, while tending to disrupt that of more homogenous ones. All of those preliminary findings point to systemic effects: interactional opportunities not only depend on individuals, but also nontrivially on the match or mismatch between individuals and their social environment. Therefore, the contribution of this research on methodology and measurement in the behavioral and social sciences lies in a much-needed emphasis on this systemic of social behavior, that is, the effect that the whole exerts on the parts, a key property of complex systems. It leads to an exemplary framework for quantifying individual and collective behavior; provides analysis strategies to characterize their entanglement; and identifies cues to recognize when systemic effects are likely at play. The specific aims of this projects are, first and via models, to quantify the effect that the social environment exerts on elderly social interactions and second, via empirical observations, to develop translational work that connects the model?s first principle with verified outcomes so as to engineer social interactions that maximize connectedness. All of those advances will help to sustain behavioral and cognitive reserve and extend the span of healthy and functional aging. Because of its foundation in a general mathematical model of coordination, the findings and their methodology can also apply in a broad range of translational contexts, including the many facets of communicable health and communicable disease.