Research

Similar to the goals of Healthy People 2010 and Healthy People 2020, my research goals strive to increase the quality of healthy years and reduce disparities attributable to ethnicity, gender, or age in attaining nutrition and wellness. My research addresses three aspects of this process: evaluation of nutrition and health knowledge, development and testing of educational materials, and evaluation of program impact. In particular, my goals center around healthy aging throughout the lifespan, specifically targeting diabetes and osteoporosis prevention and treatment.

My osteoporosis prevention program reflects my research findings from a needs assessment of Illinois elders (J Extension 34(2):19-23, 1996) where calcium intake was substantially below recommended intakes. In investigating why calcium intake was low, I conducted focus groups evaluating ethnic eating behaviors. Analysis of that data revealed that the barriers to increased calcium intake included an apprehension of increased calories and dietary fat, as well as fear of gastrointestinal disturbances (J Amer Coll Nutr, 14(4):336-340, 1995). Using results from these studies and my background in behavioral theory, I developed and tested an eight-week program for osteoporosis prevention and treatment that significantly increased women’s dietary calcium intake (Journal of Nutrition Education and Behavior 36(2): 99-100, 2004; J Amer Dietetic Assoc 105(1):92-97, 2005). This program is considered a model for an integrated program of needs assessment, program development, and impact evaluation. Not only is the program sought by colleagues after proving efficacy as described in the section on Extension activities, but the scholarship in evaluation techniques is recognized and valued. This is evidenced by the requests from students in Ohio and Texas, for example, to review the assessment instruments they are using for their research, and by requests to serve on proposal review panels. This research has continued we an additional intervention trial and further investigation of the validity and reliability of related survey instruments we have used in earlier trials (J Amer Dietetic Assoc 105(8):19, 2005; J Amer Dietetic Assoc 105(8):20, 2005).

My research in diabetes education addresses “real life” problems of translating best practices of medical care into lifestyles and behaviors people will really adopt. My students and I have found that being in a research project motivates people to comply with dietary changes, but a significant barrier to change includes gaps in basic knowledge (Ham and Chapman, 1994a; 1994b; Chapman et al., 1995). Our Dining with Diabetes program has shown significant improvement in knowledge as well as in behavioral variables influencing action (Chapman-Novakofski et al., 2004; Chapman-Novakofski K, Karduck J, 2006), and our work was recognized by the American Dietetic Association with a research paper award. Unfortunately, the statistically significant improvement left too many people who still could not identify carbohydrate-containing foods, a key skill in diabetes management, after the program. In order to address this real life need, we developed the material in a venue where the client could repeat the “class” as many times as possible, Your Guide to Diet and Diabetes online (Diabetes Technology and Therapeutics, 11(3): 1-9, 2009). This concept has been applied to a Hispanic web-based intervention (J Nutr Educ Behav 41(5):374-376, 2009) and a middle school (Accepted Diab Tech Ther October, 2010).

My goals in diabetes osteoporosis research include investigating how people learn basic food knowledge; applying that information to interventions that will move the individual from thinking about making a lifestyle change to making that change a daily habit; and expanding from focusing primarily on dietary changes to also include physical activity. Health literacy is an important, but complex, issue vital for successful self-care and is imperative to successful disease prevention. Because of this, we have recently begun evaluating health and nutrition literacy.