Network created to address obesity, chronic health issues in Appalachian region

According to the Centers for Disease Control and Prevention, residents of many Appalachian counties are three times more likely to die from diabetes than someone living in other counties in the same state, or in most other parts of the United States. Now, a group of seven regional academic centers and community organizations have joined forces to change those health disparities and improve health through the creation of the Appalachian Translational Research Network (ATRN).

"The causes of health issues in this region are multifactoral, such as poverty, education and access to care," says Kelly Kelleher, MD, MPH, director of the Community Engagement Program at The Ohio State University Center for Clinical and Translational Science (OSU-CCTS), one of the ATRN member organizations. "A collaborative approach that pairs experts from many different specialties with organizations already working within the Appalachian community will help us reach better solutions faster."

Recently, the ATRN, health experts and representatives from federal, state and local organizations met at the first annual "Appalachian Health Summit: Focus on Obesity" to discuss the obesity epidemic, promising research, and possible ways to tackle the region's many health issues. The new network will be looking at these issues through a translational science lens, a perspective that uses collaborations to help accelerate the process that lab research goes through to become real world health solutions.

"We are dedicated to seeing this region escape from being one of the sickest parts of America," says Phillip Kern, MD, Director at the Center for Clinical and Translational Science and Barnstable Brown Diabetes and Obesity Center, University of Kentucky (UK). "We also believe that what we learn here could be reapplied to other underserved or rural communities in the U.S. So it's much bigger than helping people in Appalachia – we're looking for solutions that could impact everyone, everywhere."

Collaboration is key to success

The Appalachian region is a 205,000-square-mile area that spans from southern New York to northern Mississippi. It includes all of West Virginia and parts of 12 other states with an estimated population of 24.8 million. States that include significant portions of Appalachia consistently demonstrate high rankings for many chronic illnesses and diseases, with Kentucky and West Virginia having some of the worst rankings in the U.S. in cancer deaths, smoking, obesity and diabetes.

Traditionally, rural communities like those in Appalachia pose geographic challenges that make it difficult to conduct outreach and research. Further, groups working in those communities tend to have limited sharing of resources or information, making effective long term improvements elusive, something ATRN experts are confident they can change.

Notable research targets health trifecta: obesity, smoking, diabetes

While the Health Summit focused on obesity, it also featured many ongoing research projects addressing health issues related to and complicated by obesity. Many of these ongoing studies have been supported by funding from the National Institutes of Health and/or the Clinical and Translational Science Awards (CTSA) including:

• Dr. Brady Reynolds, Assistant Professor of Pediatrics at The Ohio State University and principal investigator (PI) at The Research Institute at Nationwide Children's Hospital, conducts ongoing research in the Appalachian tri-state region of Ohio, Kentucky, and West Virginia to evaluate web-based smoking cessation programs (which can be completed from home) with adolescent smokers. Pilot work also has begun to implement and evaluate a home-based smoking cessation program for pregnant smokers in Appalachian Ohio and Kentucky.
  
• Dr. Mark Dignan, PI on an NIH-funded U54 Appalachia Community Cancer Network (ACCN) based at UK working in tandem with community partners in Kentucky, Ohio, West Virginia, Virginia and Pennsylvania, provided "lessons learned" at the Summit from his many years of community-based participatory research in the region. The current ACCN project involves an intervention to address obesity as a preventative to cancer delivered via participating church communities.
  
• With funding from the CDC and Appalachian Regional Commission (ARC), Dr. Richard Crespo of Marshall University has established 66 Diabetes Community Collaboratives in nine Appalachian states since 2001, with almost 1,000 community leaders now trained to deliver courses in diabetes self-management at the community level. During the Summit, Dr. Crespo conferred with Dr. Kevin Pearce, PI of an NIH-funded Kentucky Diabetes and Obesity Collaboratives project based at UK, on how best to interface these community groups with primary care provider collaboratives in the region.