Research

• The primary focus of Dr. Robinson’s NIH Career Development Award is determining whether there are racial differences in the cardiovascular responses to a high-salt meal (NCT04244604).
• We have a pending study focused on a hydration intervention (with or without dietary potassium) to improve blood pressure regulation and cardiometabolic health in young Black adults (NCT06062017).

• We have an ongoing study focused on short-term sleep extension as a feasible strategy to improve cardiometabolic health and appetite regulation young adults who report inadequate sleep (NCT05918744)
• We have an ongoing study focused on the ability of concomitant ketone supplementation to counteract the potential adverse effects of short-term high salt on blood vessel function, blood pressure regulation, and kidney function (NCT05545501)

Cardiovascular disease is a major health problem among person living with HIV. Despite clinical guidelines recommend HIV clinicians address cardiovascular risk among their patients, this recommendation has not been widely adopted. Using implementation research, community engagement, and computer modeling methods, we will identify strategies to improve adoption of hypertension care guidelines among HIV clinicians.

Type 2 diabetes disproportionately affects the health and wellbeing of rural Hispanics in the US; however, access to evidence-based diabetes preventive services is limited for this population. Using implementation research and community-engaged methods, we will design and pilot-test a health unit model that provides diabetes risk screening, counseling, and referrals to Hispanics living in rural Indiana. This project represents a new iteration of outreach strategies to better serve rural Hispanic populations.

Lifestyle modification interventions can help reduce the disproportionately greater burden of cardiovascular disease facing people living with HIV. Though recommended in HIV clinical guidelines, lifestyle modification strategies are rarely used in routine HIV care workflows. This study aims to address this research-to-practice gaps by engineering a cost-effective strategy focused on integrating lifestyle modification interventions in HIV care using systems science.

Black Americans are twice as likely to develop dementia with scarce representation in interventions to support their well-being and stave off cognitive decline. One way to mitigate risk factors associated with accelerated cognitive decline (sedentary behavior, stress, social isolation) are green prescriptions, which prescribe nature activities to promote an active lifestyle and improve well-being. This Career Development Award will build upon Dr. Lassell’s previous work developing a Green Activity Prescription (GAP) program with Hispanic and Latino and Chinese Americans living with mild cognitive impairment (MCI) and mild dementia in New York. This project will expand the GAP program to include Black Americans and adapt the intervention for a new geographic location and health care system. This Award will provide Dr. Lassell with the necessary mentorship and training to: 1) cultivate leadership skills in embedded pragmatic clinical trials (ePCTs), 2) gain equity-informed approaches to engage Black communities in research, 3) apply intervention adaptation using participatory methods, and 4) gain skills interpreting data relevant to her future remote therapeutic monitoring approach. The training will support the following Specific Aim: Adapt GAP with Black people living with MCI and mild dementia and their CPs and explore a wearable device (e.g., Fitbit) as a potential pragmatic outcome measure of intervention adherence and response in a future study. This work will prepare Dr. Lassell to lead interventional research as an independent investigator and lay the foundation to test GAP in a pilot randomized controlled trial and a future ePCT to improve well-being in racially and ethnically diverse PLWD and their CPs.

Hispanic/Latino individuals are more likely to develop Alzheimer’s disease and related dementias and mild cognitive impairment as a precursor to Alzheimer’s disease than non-Hispanic white individuals. Several factors contribute to the increased prevalence of mild cognitive impairment and Alzheimer’s disease and related dementias in Latinx groups such as experiencing stressful life events including racism, living in neighborhoods that are lower resourced, lacking access to dementia care and natural environments (green space, parks). Few interventions exist that are culturally tailored for Latinx populations. Engagement in nature can align with the cultural preferences and needs of Latinx populations to improve their health and maintain quality of life and function. Green activity prescriptions can meet this need and involve co-designing nature activities with a person to match their preferences and needs based on available local green resources and include bringing nature activities (e.g., walking pets, table-top gardening) to lower resourced neighborhoods. The proposed study will co-design and test the acceptability and feasibility of a stakeholder-driven, culturally tailored green activity prescription protocol for Hispanic/Latino persons living with mild cognitive impairment and Alzheimer’s disease and related dementias in the Bronx, New York. Applying a participatory the intervention will be co-design and culturally tailored with Hispanic/Latino persons living with mild cognitive impairment and mild Alzheimer’s disease and related dementias, their care partners, domain experts, and local healthcare and green organizations (stakeholders) (Aim 1). Next, acceptability and feasibility will be assessed (Aim 2). Findings will inform an application for an R61/R33 to pilot the intervention in a randomized controlled trial.