Dr. Jennifer Caldwell Caldwell Bridges the Gap of Genetics and Nutrition to Enhance Health Outcomes

Disparities in health outcomes for African American adults involve both biological and social health determinants. Jennifer Caldwell, Ph.D., a researcher at Pennington Biomedical Research Center, is exploring the combined influence of a biological determinant (a person's genes), and a social health determinant (food insecurity) to understand the impact on African American adults' health outcomes in Baton Rouge, Louisiana. Genetics are known to play a role in 9 of 10 leading causes of death in the U.S. including heart disease, stroke, and diabetes. North Baton Rouge is a predominantly made up of African American households where 20-30 percent of households are food insecure compared to only 8-10 percent of households in South Baton Rouge.

Inspired by the North Baton Rouge community, Caldwell is researching how food insecurity affects the body's ability to heal. This community, which lacks grocery stores and fresh produce and relies solely on convenience stores, is classified as a "food desert."

Additionally, she aims to start a conversation with African American communities in this area about how genes influence their health.

"I wanted an intervention that would close that knowledge gap," she says. "We titled the project Linking GAINS; it aims to combine the analyses of genetics and nutrition to enhance health behaviors among participants undergoing a behavioral intervention."

Linking GAINS focuses on community engagement to share information on how genetics and health behaviors impact a person's health. Caldwell's goal is for residents in the African American communities in North Baton Rouge to understand their genetic makeup and use that knowledge to make informed health decisions. By bridging the gap between genetics and nutrition, Caldwell hopes to foster healthier behaviors and improve overall health outcomes in these underserved areas.

A history of inequity in Louisiana

Longstanding geographical segregation issues contribute to health disparities in Louisiana. "This initiative is crucial due to the historical segregation within Baton Rouge, Louisiana, where disparities exist between the south and north sides of the city," Caldwell explains.

"In the past, African American communities were primarily located near industrial plants or railroad tracks on the north side. Currently, the southern side is characterized by institutions like Louisiana State University (LSU), situated close to the medical corridor and areas with better access to fresh produce and economic development."

As a result, there remains a significant social and economic gap in the city that is linked to racial issues from Louisiana's historical background and antebellum past, Caldwell says.

The disparity lies in the city's economic systems,social systems and structures, and transportation is a significant contributing factor to these discrepancies.

"One critical aspect of the disparity between residents living on the north and south sides of Baton Rouge, particularly in the area near Louisiana State University, is the issue of food deserts and its impact on health equity, compounded by transportation challenges."

Caldwell's 'why'

Caldwell says she is very motivated to tailor her program to the community. "As a young professor, I am very interested in genetics, and it has been one of my top priorities. Engagement and health literacy is another one of my top priorities."

"I realized if I am going to build this lab, I have to build trust with the community and empower them to build their health literacy. We wanted to build a project that could meet the need of underdeveloped areas in Baton Rouge. North has no actual grocery stores or medical corridors."

Engaging African American community members

To build trust and meet the community's needs, Caldwell and her team are focused on maximizing recruitment efforts and engaging a diverse range of often marginalized participants.

"Our collaboration includes the Southern University Agriculture and Extension Center alongside various community outreach partners, organizations, and local churches. By situating the project in North Baton Rouge, we aim to eliminate transportation barriers and ensure accessibility for the community members."

Keeping it local shows Caldwell's determination to build a program in partnership with the community, making it easy and welcoming for people to join. "We have made sure to incorporate things that are culturally centered, like cooking classes," she says, "Louisiana has such a rich culture and food culture."

The study: Enhance health behaviors through community

Throughout the Linking GAINS study, participants will learn the impact that genetic factors that contribute to developing chronic diseases.

They will be able to understand and effectively communicate their genetic results to their primary care providers. Additionally, participants will receive guidance on adopting healthier lifestyles and modifying behaviors to improve overall well-being.

"We are establishing clinic groups within the community," Caldwell says, "And meetings are to be held at a local church." It is important to Caldwell that participants feel safe and that trust is built in a trustworthy space during the study.

Participant-centered approach

Linking GAINS intervention focuses on the participants, giving them choices and flexibility to keep them engaged. "Participants will benefit from a comprehensive 14-week behavioral intervention program, coupled with the groundbreaking inclusion of genetic testing," Caldwell explains.

"This unique initiative offers participants the opportunity to receive their genetic results and engage in one-on-one sessions with a genetic counselor for a detailed review of these findings."

Early on, Caldwell says she spoke with a therapist about using interventions in the project. The therapist gave great advice on group counseling sessions, especially about myths and stress management. Based on the therapist's advice, Caldwell says they have included group counseling sessions that will cover these topics.

Group sessions will help participants feel engaged with their peers and keep them from feeling alone or singled out.

The groups will discuss health disparities, nutrition, and healthy cooking, as well as what foods to buy and how to cook fresh produce. Sessions on heart health and similar topics will also be held. The interventions focus on lifestyle and behavior changes and are tailored to the community's needs.

Caldwell explains that community engagement is a big challenge in clinical research with African American communities. By making this project community-based and a group effort, they hope to get people involved and keep them engaged.

Interventions include health behavior programs and weekly sessions, not just on weekends. There will also be weekly physical activity programs.

Making it easy to participate

Along with situating the study in the heart of the community, Caldwell wants to ensure participants have time to join. "The project is designed to take place on weekdays after 5:30 p.m., providing flexibility for participants so they do not have to worry about leaving work early."

To that end, Caldwell wants to ensure participants feel valued for their time. "I understand that committing to research is challenging. For this reason, we compensate participants for their time, whether they need to leave work or make other adjustments. One of the key aspects of this project is its timing. We aim to accommodate participants' schedules to ensure they do not have to take time off work to engage in research."

Participation will involve individuals from two different communities. "This demographic is crucial for us to understand the impact of our interventions on a diverse group. We have collaborated with non-profits that possess valuable insights about the communities we are studying. Their contributions have been instrumental in shaping the project."

Caldwell's project, Linking GAINS, addresses crucial health disparities at the intersection of genetics and nutrition in North Baton Rouge. By focusing on empowering African American communities to learn about the combined impact of how genetics and food insecurity influences health outcomes, this intervention aims to empower community members to make informed health decisions and improve long-term health outcomes. By focusing on community engagement and culturally relevant intervention, Caldwell's work exemplifies a holistic approach to advancing health equity and can serve as a model for similar efforts nationwide.

Courtesy of the Forge Ahead Center

Provided by Louisiana State University