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Partnering to prevent cancer and Alzheimer¡¯s disease in midlife and older adults
Physical activity reduces risk for several types of cancers and Alzheimer¡¯s disease. Residents in Acres Homes who do not get enough exercise could benefit from a yoga-based exercise class, which combines low-impact movement and mindfulness. The exercise class is meant to be adapted and expanded across Houston, based on insights from participants in Acres Homes, including interviews and wearable fitness tracking devices.

• Aim 1: Quantitatively assess modifiable risk factors for cancer and Alzheimer¡¯s disease and related dementias (ADRDs) among midlife and older adults residing in Acres Homes who are at increased risk for obesity-related cancers and ADRDs.
• Aim 2: Qualitatively understand preferences for physical activity, perceived risk of developing cancer and ADRD, and preferences for risk communication to inform the adaptation of Harmony & Health (HH), a yoga-based intervention, for midlife and older adults in Acres Homes.

Principal Investigator:
Community Partner: BakerRipley

Examining Culinary Medicine programming in Acres Homes using the Healthy Cooking Index (HCI)
The first goal of this project is to test a system for categorizing and evaluating nutrition courses, the Healthy Cooking Index (HCI), in Acres Homes. This pilot project is also meant to establish best practices for nutrition researchers to collaborate with local organizations to establish larger trials of nutrition classes.

• Aim 1: Evaluate the curricula of existing Be Well Acres Homes culinary medicine programs to determine alignment with HCI constructs.
• Aim 2: Conduct a quasi-experimental trial to examine baseline cooking habits and preliminary changes to home cooking practices and diet variables after participation in a culinary medicine class series, using the HCI score and qualitative interviews

Principal Investigator: Margaret Raber, Dr.P.H., M.P.H.
Community Partner: Beauty¡¯s Garden and any interested nutrition education program in Acres Homes

Nourishing the community through Culinary Medicine: Cooking and nutrition education for the Acres Homes community
This research will test a culinary medicine and nutrition education program in the Acres Homes community to assess if the program can improve diet, cooking behaviors, weight and lower blood sugar levels among Acres Homes residents at risk for diabetes and obesity-related cancers. The goal is to use feedback from residents to expand offerings of the cooking class to other communities.

• Aim 1: Conduct a pilot study of the ¡°Nourishing the Community through Culinary Medicine¡± program with patients at UT Physicians clinics serving Acres Homes to assess feasibility and preliminary efficacy.
• Aim 2: Explore participant experiences in the pilot study to explain findings and finalize protocol for a future application.

Principal Investigator: , Ph.D., M.P.H.
Community Partner: UT Physicians Victory and Greens

Barriers and facilitators of physical activity, sedentary behavior and healthy diet in the Acres Homes community
This project will serve as a baseline assessment for primary outcomes for all researchers to use as comparisons when evaluating the effects of the Acres Homes CPC and Be Well^TM Acres Homes. The survey will also reveal new areas where programming can assist residents with healthy living.

• Aim 1: Estimate the prevalence of and investigate factors associated with physical activity, sedentary behaviors and healthy diet in Acres Homes.?
• Aim 2: Examine perceptions and attitudes (e.g., access to parks, healthy foods, community support) associated with physical activity, sedentary behaviors and health diet at Acres Homes.?

Principal Investigator: 
Community Partner: Be Well Acres Homes Steering Committee

Assessing perceptions of crime and safety on physical activity behavior in the Acres Homes community
This pilot study will inform larger studies that aim to create a safe physical environment, provide spaces to strengthen social relationships, and ultimately improve cancer outcomes in similar neighborhoods.

• Aim 1: Conduct a comprehensive examination of neighborhood characteristics, including objective and perceived crime and neighborhood safety, climate and safety (e.g., heat/weather related), and physical activity behavior in the Acres Homes community.?
• Aim 2: Evaluate the impact of crime and safety-related interventions in the Acres Homes community on resident¡¯s physical activity behavior.?
• Aim 3: Assess the impact of community-based physical activity on Acres Homes resident¡¯s perceptions of neighborhood crime and safety.

Principal Investigator: 
Community Partner: Be Well Acres Homes Steering Committee

Exploring the activation of environmental supports for community-based physical activity among children and their parents in partnership with Acres Homes
The goal of this research is to understand how Acres Homes residents engage in physical activity (PA), particularly in out-of-school time (OST). The study will culminate in a community forum in which findings will be presented and the next steps for improving physical activity in Acres Homes will be identified.

• Aim 1: To describe current child active commuting practice, participation in OST PA programing, and utilization of community spaces (e.g., school yards) along with related barriers, facilitating factors, and recommendations for these PA practices according to Acres Homes parents/guardians.?
• Aim 2: To identify community places (e.g., multi-service centers) and spaces (e.g., school yards, parks) where children and parents go for physical activity in Acres Homes community, along with their perceived challenges and opportunities for promoting utilization of these spaces according to parents, community leaders and PA providers working in Acres Homes.?
• Aim 3: To explore the perceived role of increased temperatures in shaping child outdoor PA in Acres Homes and recommended mitigating strategies among Acres Homes parents, community leaders and PA providers.?

Principal Investigator: 

Exploring the interplay between area-level food insecurity, urbanicity, rurality, persistent poverty and cancer-related health outcomes in Texas
This research aims to predict area-level food insecurity based on neighborhood characteristics. The end goal of this project is to develop an online dashboard in which people in Texas can look at the cancer risks in their neighborhoods.

• Aim 1. Examine associations of persistent poverty, urbanicity, and rurality with area-level food insecurity. ?
• Aim 2. Examine associations of area-level food insecurity with area-level cancer risk factors and health outcomes.?
• Aim 3. Iteratively, develop a user-friendly web-based mapping dashboard.?

Principal Investigator: 

Impact of Brighter Bites on obesity-related health outcomes and psychosocial wellbeing among parents in Acres Homes
The overall goal of this pilot study is to assess the effects of the school-based Brighter Bites program on adults¡¯ obesity measures, metabolic parameters, dietary intake, household food insecurity and mental health status among under-resourced adults with children who are residents of Acres Homes.

• Aim 1: To quantitively assess the association among structural and individual non-medical drivers of health, health outcomes and psychosocial wellbeing among parents with children attending elementary schools in Acres Homes.
• Aim 2: To quantitively assess the impact of Brighter Bites on health outcomes among parents with children attending elementary schools in Acres Homes.
• Aim 3: To qualitatively understand the multilevel challenges to household food security, perceived risks of developing obesity-related cancers and preferences for risk communication to inform the engagement and adaptation of holistic interventions parents in Acres Homes.

Principal Investigator:

Heat island effects on physical activity
The overall objective of this proposal is to investigate the impact of rising temperatures, specifically heat island effects, on physical activity and active transportation behaviors, with a focus on persistent poverty (PP) areas, in order to help reduce cancer risk in this population in the context of climate change.

• Aim 1: To compare climate vulnerability effects in PP vs non-PP areas in the United States.
• Aim 2: To determine the cross-sectional association between climate vulnerability and heat islands in PP areas in Birmingham, Alabama, and Houston, Texas, and their association with physical activity and active transportation in PP areas.

Principal Investigator: , University of Alabama at Birmingham (UAB) and

Promotion of physical activity among perimenopausal and post-menopausal individuals in Acres Homes
The overall goal of this pilot study is to fill the research gap by assessing adherence to the American Institute of Cancer Research guidelines, identifying psychosocial and structural impediments through the Community Assessment Survey data analysis, conducting focus groups and testing the acceptability of MD Anderson¡¯s digital resources offered to support home-based physical activity.

• Aim 1: Quantitatively identify behavioral, structural (e.g., access to physical activity resources) and social (e.g., community cohesion) risk factors of cancer among perimenopausal and post-menopausal individuals residing in Acres Homes.
• Aim 2: Using focus groups, qualitatively assess the preference for physical activity, perceived risk of cancer due to weight gain, and preferences for risk communication among perimenopausal and post-menopausal residents residing in Acres Homes to inform the physical activity programs in the community among perimenopausal and post-menopausal individuals using focus groups. In addition, qualitatively explore the perspectives of Acres Homes physical activity program leaders on effective risk communication modalities for this population.
• Aim 3: Test the acceptability of the physical activity videos prepared by MD Anderson.

Principal Investigator:

Excessive weight, breast cancer and endocrine disrupting chemicals (EDCs): Findings from Active Living After Cancer (ALAC) with Environmental Vitality
The overall goal of this pilot study is to assess the knowledge gap among ALAC participants regarding environmental health, with a focus on endocrine disrupting chemicals (EDCs) in personal care products. Additionally, we seek to explore the relationship between excessive weight and non-persistent EDC exposures among cancer survivors. The preliminary findings will advance our understanding of the complex relationship between excessive weight, breast cancer and EDCs in the context of survivorship. Furthermore, this work will inform the development of Active Living After Cancer with Environmental Vitality (ALAC-ENV), a tailored intervention that integrates an emerging environmental health risk with physical activity.

• Aim 1: Determine breast cancer survivors¡¯ environmental exposure knowledge. Participants (n=30) will participate in focus group interviews to assess their interest and understanding of environmental exposures with an emphasis on personal care products.
• Aim 2: Determine the relationship between exposures to prevalent EDCs and BMI. A cross-sectional design to examine associations between BMI and measurements of non-persistent EDCs in urine samples of cancer survivors.

Principal Investigator: