Prevention Research Centers

Building the Public Health Research Base with Community Partners
At A Glance 2011

 

 

What is the Prevention Research Centers Program?

In 1984, Congress authorized the U.S. Department of Health and Human Services (HHS) to create a network of academic health centers to conduct applied public health research. CDC was selected to administer the Prevention Research Centers (PRC) Program and to provide leadership, technical assistance, and oversight.

Today, CDC supports 37 centers associated with schools of public health or medicine throughout the country. Each center conducts at least one core research project with an underserved population that has a disproportionately large burden of disease and disability. In addition to conducting core research, the centers work with partners on special interest projects (defined by CDC and other HHS agencies) and on projects funded by other sources. As a result, the PRCs conduct hundreds of projects each year.

The PRCs involve community members, academic researchers, and public health agencies in finding innovative ways to promote health and prevent disease. These partners work together to design, test, and disseminate strategies—often as new policies or recommended public health practices.

All centers share a common goal of addressing behaviors and environmental factors that contribute to chronic diseases such as cancer, heart disease, and diabetes. Several PRCs also address injury, infectious disease, mental health, oral health, and global health. Some centers work with distinct populations, such as African Americans and Latinos in inner cities, Mexican Americans along the U.S.–Mexico border, American Indians in New Mexico and Oregon, residents in rural communities who live below the poverty level, and people with hearing loss. Other PRCs focus on youth or older adults. The PRC Program reaches nearly 30 million people in 103 partner communities.

In the Fiscal Year 2010–2014 funding cycle, five developmental centers are funded to strengthen community connections and develop infrastructure. Thirty-two comprehensive centers have developed infrastructure, established relationships, and put plans in place for core research. This two-tier structure reflects the PRC Program's commitment to building new capacity and sustaining long-term partnerships. Through scientific rigor, collaborative partnerships, practical application, and community acceptance, the PRCs continue to find new ways to improve the nation's quality of life.

 

How Does CDC Work with PRCs to Improve the Nation’s Health?

Networking for Knowledge

PRCs encourage interaction among faculty from different disciplines, who bring an array of expertise to solving complex health and psychosocial problems. Departments of social work, psychology, anthropology, and others work with the PRCs. Groups of PRCs collaborate in thematic networks that address research gaps in cancer prevention and control, healthy aging, physical activity policy, epilepsy management, and nutrition and obesity policy. Because each center in a network offers a unique geographic location and community relationship, researchers can simultaneously test strategies in different settings. The PRCs also work closely with health departments, the private sector, education agencies, and national and community organizations. Through these partnerships, promising research findings are translated into practical, cost-effective prevention programs in communities.

Gaining and Sustaining Community Trust

To encourage trust, the academic and community partners that make up the PRCs make long-term commitments and take time to build solid working relationships. Researchers strive to respect the dignity of project participants and the values of the community. As a result, communities are able to make the needed changes and sustain them over time. At the national level, a representative from each PRC community is appointed to the National Community Committee; members make recommendations to the PRC Program about how to ensure community collaboration.

Training Leaders in Public Health Research

The PRCs offer continuing education for health practitioners, public health professionals, and aspiring leaders seeking growth and challenge. Examples include courses in evidence-based public health, physical activity and public health, and social marketing, as well as institutes on topics such as healthy adolescent development. PRCs also offer workshops requested by state health departments for their staff and training in selected Latin American countries.

Conducting Comparative Effectiveness Research in Public Health

Four PRCs received 2-year grants through the American Recovery and Reinvestment Act of 2009 to study the impact of different public health strategies in preventing, diagnosing, and monitoring health conditions in community settings. The academic host institutions and research topics are as follows:

• New York University School of Medicine: Reducing blood pressure and colorectal cancer among African-American men by encouraging behavioral changes, guiding them through the health care system, and using a combination of these approaches.

• University of North Carolina at Chapel Hill: Reducing risk for cardiovascular disease by changing behaviors and encouraging appropriate use of medication through a Web-based versus a counselor-based program.

• Oregon Health & Science University: Detecting diabetic retinopathy among American Indians and Alaska Natives through eye examinations by traditional means (in eye care providers' offices) and by telemedicine.

• University of Pittsburgh with the Pennsylvania Department of Health: Preventing falls among older adults through usual care, an education program, and an education-plus-exercise program.

Future Directions

The PRC Program will continue to promote the widespread use of effective interventions. Core research at several PRCs focuses on translating research findings into practice. For example, the University of Washington is studying how well emergency responders share information about a fall-prevention program when they respond to calls from people who have fallen. At the University of Texas, researchers are developing a Web-based tool that explains the burden of teenage pregnancy and provides a sex education program for middle schools.

The PRCs continue to conduct policy and environmental research. For example, a group of five PRCs addresses the effects of physical activity policy changes at local, state, and national levels. The PRCs at Texas A&M Health Science Center and Case Western Reserve University are working with communities to develop retail and local policies to improve access to fresh fruits and vegetables. This research will have practical implications for communities across the country.

Prevention Research Centers: Core Projects

Developmental Centers

University of Arkansas for Medical Sciences
Bringing schools and families together to reduce childhood obesity in the Mississippi Delta.

Dartmouth College
Improving the cardiovascular health of vulnerable populations in New Hampshire.

University of Maryland
Preventing sexually transmitted disease and HIV/AIDS in Prince George's County.

University of Massachusetts Medical School
Improving diabetes self-management among Latinos in Worcester, Massachusetts.

Ohio State University
Helping parents prevent obesity in preschool-aged children in Columbus, Ohio.

Comprehensive Centers

University of Alabama at Birmingham
Reducing the health risks of adolescents in Birmingham's underserved, predominantly African-American communities.

University of Arizona
Advocating for changes to prevent and control chronic disease in communities along the Arizona–Mexico border.

Boston University
Improving the health and well-being of Boston's public housing residents.

University of California at Berkeley
Enhancing an online program to help Korean Americans reduce their tobacco use.

University of California at Los Angeles
Helping parents promote the health and well-being of their children.

Case Western Reserve University
Increasing access to healthy foods in Cleveland, Ohio.

University of Colorado Denver
Changing school policies to promote healthy behaviors among children in the Rocky Mountain region of Colorado.

Columbia University
Reducing hypertension among African-American adults living in Harlem.

Emory University
Increasing physical activity and improving nutrition in rural southwest Georgia.

Harvard University
Reducing obesity among young people by improving nutrition and physical activity.

University of Iowa
Promoting healthy eating in rural Iowa.

Johns Hopkins University
Helping youths living in Baltimore avoid depression and become healthy and productive adults.

University of Kentucky
Preventing and controlling cervical cancer in rural Appalachian Kentucky.

University of Michigan
Preventing sexually transmitted disease and HIV/AIDS among underserved African-American young adults.

University of Minnesota
Promoting healthy adolescent development in the Twin Cities.

Morehouse School of Medicine
Preventing sexually transmitted disease and HIV/AIDS among African-American males in prison.

University of New Mexico
Promoting physical activity among Hispanics and American Indians living in Cuba, New Mexico.

New York University School of Medicine*
Reducing diabetes among recent Asian-American immigrants in New York City.

University of North Carolina at Chapel Hill*
Reducing the risk for obesity among rural, low-income, minority women by empowering them to make life changes.

Oregon Health & Science University*
Reducing hearing loss among American Indians in the Pacific Northwest.

University of Pittsburgh*
Promoting healthy, active lives for older adults in Pennsylvania.

University of Rochester
Reducing obesity among people in Rochester, New York, who are deaf and use American Sign Language.

Saint Louis University and Washington University in St. Louis
Increasing the adoption of evidence-based physical activity and healthy eating programs in Missouri.

San Diego State University (with University of California at San Diego)
Increasing physical activity and improving health among Latinos in San Diego.

University of South Carolina
Promoting physical activity among African Americans in Sumter County, South Carolina.

University of South Florida
Using community-based prevention marketing to improve health in Hillsborough County, Florida.

Texas A&M Health Science Center
Increasing access to healthy foods in east-central Texas and on the Texas–Mexico border.

University of Texas Health Science Center at Houston
Promoting healthy adolescent development in Houston, Texas.

Tulane University
Increasing access to healthy foods in neighborhoods in New Orleans, Louisiana.

University of Washington
Promoting healthy aging by disseminating proven programs.

West Virginia University
Expanding a proven teen smoking cessation program to achieve statewide dissemination.

Yale University
Preventing or reducing diabetes among residents of Connecticut's economically disadvantaged cities.

* Awarded a comparative effectiveness research grant.
 

PRC Success Stories

Helping Teens Delay Sexual Behavior: University of Texas Health Science Center at Houston

A 2005 CDC survey of 7th-grade students in seven U.S. cities found that 11%–33% were sexually experienced. Unfortunately, few school-based sex education programs have been found to be effective in changing the behavior of middle school students.

To address the sensitive issues of teenage sexual health, the University of Texas PRC and its partners produced and tested a middle school sex education program called It's Your Game: Keep It Real. This innovative program includes 24 lessons (12 for 7th-grade students and 12 for 8th-grade students) with three components: a school curriculum with role modeling, group discussion, and journaling; computer activities consisting of quizzes, a virtual world interface, and educational activities that address risk-taking behaviors; and parental involvement through homework designed to promote dialog between parents and children.

An evaluation of the program showed a significant reduction in initiation of sexual activity by the ninth grade. As a result, the National Campaign to Prevent Teen and Unplanned Pregnancy includes It's Your Game on a list of effective programs, and it is one of 28 teen pregnancy prevention programs eligible for federal funds. Efforts are under way to disseminate the program in middle schools in Harris County, Texas, which is the fourth largest county in the United States, and in school districts across the country.

Despite the effectiveness of programs about avoiding teen pregnancy and sexually transmitted infections, getting parents, school officials, and policy makers to implement such programs can be challenging because of the subject's sensitivity. PRC researchers are developing an Internet-based tool to help adult decision makers—including parents, school board members, teachers, and members of the clergy—understand the burden of teenage pregnancy in Texas and how an evidence-based program that is effective can help reduce the burden.

Producing a Community Guide for Latin America: Saint Louis University and Washington University in St. Louis and San Diego State University (with the University of California at San Diego)

The risk for obesity, diabetes, and cardiovascular disease is high throughout the Americas. In the United States, a task force of experts has reviewed and compiled The Guide to Community Preventive Services (the Community Guide), a free resource that recommends effective public health strategies that reduce risk factors for disease. The Community Guide is intended to help public health practitioners in the United States choose programs and policies to improve health and prevent disease in their communities.

No such resource exists in Latin America, but researchers at the Saint Louis PRC began working with an international network of public health partners in 2005 to create one. The partners identified scientific literature for more than 3,500 public health research projects on physical activity published in Spanish, Portuguese, and English. They reviewed the projects by using a similar process to that of the Community Guide to develop the Guide for Useful Interventions for Physical Activity (GUIA).

On the basis of the review, the GUIA team recommended that school-based physical activity programs be offered to children in Latin America. Team members also evaluated Academia da Cidade, a citywide exercise program in Recife, Brazil, and found that people who had participated in the program in the past were twice as likely to engage in moderate or high levels of leisure-time physical activity as those who had not participated.

They also found that current participants were 11 times more likely than nonparticipants to engage in moderate or high levels of activity. These findings have encouraged Brazilian officials to disseminate this effective program to more cities and states throughout the country.

GUIA and related work in Latin America have produced 20 peer-reviewed scientific publications, including a supplement to the Journal of Physical Activity and Health (May 2010). Building on this work, researchers from the San Diego PRC are now adapting the Academia da Cidade program for Latino communities along the Mexico border in California. They also are working with public health partners in Mexico to produce a resource of interventions similar to GUIA for the Mexican population and for Latino communities in the United States.

Changing Tobacco Policies Through Research: University of North Carolina at Chapel Hill

Online cigarette sales threaten to undermine progress in reducing tobacco use in the United States because online vendors do not charge excise taxes. In response to this concern, the North Carolina PRC reviewed the sales practices of 2,800 Internet cigarette vendors (ICV) to determine their impact on public health and policy issues such as cigarette tax evasion and youth access to tobacco products.

The ICV Study found that online vendors do a poor job of verifying the age of their customers, allowing minors to buy cigarettes. Vendors often do not collect the excise taxes required by law, depriving governments of needed revenue, some of which could be used for tobacco control programs.

The study results brought attention to the shortcomings of the regulation of online cigarette sales, and 33 states passed laws to regulate Internet and mail order sales. In 2010, the U.S. Senate cited the ICV Study in its unanimous decision to pass the Prevent All Cigarette Trafficking Act. The act curtails the sale of untaxed cigarettes and other tobacco products over the Internet and bans the delivery of tobacco products through the U.S. mail.

Conducting Community Health Surveys to Improve Health and Empower Communities: University of Michigan and Texas A&M Health Science Center

Health departments and community organizations often rely on PRCs to collect and analyze local health data. These data are used by public health practitioners to develop programs and apply resources efficiently to improve community health.

Since 2005, the Michigan PRC has conducted the Speak to Your Health! Community Survey, a biannual telephone survey, in Genesee County, Michigan. Designed by community, health department, and university partners, the survey collects data on socioeconomic factors, as well as on the behaviors and attitudes of the residents of Flint and surrounding Genesee County.

Community organizations can request data from the PRC, and researchers will provide a free analysis. During 2004–2009, PRC researchers received more than 100 such requests from about 20 agencies and organizations, which use the data to design and evaluate public health strategies that address local needs. For example, the Genesee County Health Department used the survey's findings to develop and monitor progress toward reaching the goals of its 5-year strategic plan.

In September 2010, the Texas A&M PRC released the findings of its third regional health assessment survey in collaboration with the Brazos Valley Health Partnership, which works to improve the health of residents in a seven-county area of central Texas. This comprehensive assessment is used by service organizations in the area to support strategic plans, grant writing, advocacy activities, and educational programs across jurisdictions.

One of the key findings of the 2010 assessment was the lack of public transportation in this mostly rural area of south-central Texas. Many health services are concentrated in one area, and some residents have to travel as far as 45 miles to get to them. To address this problem, the partners developed a regional transportation strategy to increase rural residents' access to health services. As a result of these efforts, which include a volunteer transport program, more than 17,000 rides have been provided over a 6-year period.

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