Research Projects

The Behavior Technology Laboratory conducts research on behavioral approaches for the assessment, prevention, and treatment of eating disorders, obesity, and body image disturbance. This research includes the development and testing of community-based, clinic-based, and internet/technologically advanced mobile-based (e.g. Smartphones, iPad apps, e-health games) interventions for health behavior change.

Research Studies                       Pennington Diabetes Model Clinic        Collaborative Studies     

 Army H.E.A.L.T.H.                           Pennington Diabetes Program                CALERIE                             

 Army H.E.A.L.T.H. Intensive                                                                            Look AHEAD

 Female Athlete Body Project (FAB)

 Sisu & You

 Expecting Success                                                

 Women's Body Initiative (WBI)                               

 BeatGene

 Bodhi Body

 


Research Studies

 

Military Health Behaviors: Weight Measurements and Standards for Soldiers

Army H.E.A.L.T.H.TM

U.S. Department of Defense (DoD):  W81WH-09-1-0616

Tiffany Stewart , Ph.D.,  Principal Investigator

The mission of the Army H.E.A.L.T.H. program is to empower soldiers in healthy and safe lifestyle change to sustain healthy weight and performance on a year-round basis. This program was developed in order to promote Soldier readiness, prevent unhealthy dieting practices, enhance compliance with standards specified by AR 600-9, and to improve eating, exercise, and sleep habits of the Soldier and family members. Core features of the Army H.E.A.L.T.H. program include customized meal plans, food tracking, personalized fitness plans, a comprehensive fitness tool to build your own workouts, remote activity tracking, and mind and body wellness components. This program is currently a population based model, completely remote, and includes technology based tailoring, self-report data, and anonymous use.

View Weight Measurements and Standards for Soldiers Study Information Here


Healthy Eating, Activity, & Lifestyle Training Headquarters II (H.E.A.L.T.H.- II)

Army H.E.A.L.T.H. IntensiveTM

U.S. Department of Defense (DoD)

Tiffany Stewart , Ph.D.,  Principal Investigator

The U.S. Army Surgeon Genderal's Performance Triad (Triad) aims to aid Soldiers in maintaining health by targeting nutrition, physical activity, and sleep. These key areas directly impact the physical and cognitive performance, readiness, well-being, and resilience of Soldiers and their family members. To advance the mission of the Triad, the Army H.E.A.L.T.H. Intensive program aims to combine evidence based tools and guidance (Army H.E.A.L.T.H.) previously tested in three PBRC military studies and a new, remote clinical intervention model (individualized remote coaching model) that also includes mobile tracking technology/devices for personal activity, weight, nutrition, and sleep. The Army H.E.A.L.T.H. Intensive program is currently being tested in a randomized pilot trial (funded by TATRC) with Soldiers and their family members. The purpose of this investigation is to test the efficacy of an intensive intervention to assist Soldiers in meeting standards for body fat and fitness and to assist family members in the improvement of nutrition, fitness and sleep.

View Army H.E.A.L.T.H. Intensive Study Information Here


The Female Athlete Body Project (FAB)

National Institutes of Health

NIH 1 RO1 MH094448-01

Tiffany Stewart , Ph.D.,  Principal Investigator

Carolyn Becker, Ph.D., Co-Principal Investigator

Consultant: Ron Thompson, Ph.D.

Given the cost of treating eating disorders (EDs) and the substantial morbidity and mortality associated with these disorders, prevention of EDs has considerable public health significance.  Research supports the use of a Healthy Weight (HW) program targeting small lifestyle modifications in the prevention of ED onset and in reducing ED risk factors. Research suggests that disordered eating among female athletes is prevalent, and is especially dangerous in female athletes because it increases risk for the Female Athlete Triad (i.e., low energy availability/disordered eating, menstrual disorders, and decreased bone mineral density/osteoporosis) and subsequent injury.  This study is a cluster randomized controlled trial to test the effectiveness of the HW intervention among 500 collegiate female athletes in three sites, including Louisiana State University (LSU; Baton Rouge, LA), Trinity University (TU; San Antonio, TX), and American University (AU; Washington, D.C.). The FAB program is now available to schools who would like to deploy it at their university. Contact us for more details.

View FAB Program Information Here


Sisu and You

A New Health Perspective: The Body Revolution Kids Need

Tiffany Stewart , Ph.D.,  Principal Investigator

Science tells us that if we don't appreciate our bodies, we don't treat our bodies well. How we view our bodies is a key component of successful health behaviors and significantly affects our quality of life. This workshop series teaches children and adults to keep their bodies healthy through nutrition, fitness, sleep, and body image. The experiences gained through these workshops will reframe the dialogue between kids and adults about healthy bodies, while empowering kids to establish positive behaviors and improve their health for the long-term. This workshop series, soon to be accompanied by a Smartphone application, is currently a partnership with the Knock Knock Children’s Museum and Mayor Broome’s Healthy Baton Rouge Initiative. The workshop is currently being deployed at the museum, schools and summer camps throughout Baton Rouge.

Sign up here:

https://www.eventbrite.com/e/sisu-you-healthy-kids-and-healthy-family-workshop-tickets-53589405354#

 

View Sisu & You Program Information Here


 

Personalized Management of Body Weight During Pregnancy

"Expecting Success"

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): 1U01DK094418 | 3U01DK094481-01S1

Leanne M. Redman, Ph.D.,  Principal Investigator

Tiffany M. Stewart, Ph.D., Co-Investigator

Corby Martin, Ph.D., Co- Investigator

Karen Elkind-Hirsch, Ph.D., Co-Investigator

Jeffrey Breaux, M.D.,  Medical Investigator

Stewart Gordon, M.D., Medical Investigator

 

More than 60% of reproductive age women in the US are overweight or obese and more than half exceed weight gain guidelines during pregnancy as recommended by the Institute of Medicine (IOM). Although pregnant women are believed to be a highly motivated population for accepting behavior change, they face several barriers to traditional in-person clinic weight management programs. The objective of this study is to implement a personalized gestational weight management program to overweight and obese pregnant women that focuses on healthy eating and achieving national physical activity recommendations.  We plan to enroll 306 overweight and obese pregnant women and randomly assign them to receive either usual care (Physician Directed Group) or a personalized lifestyle program for weight management called SmartMoms, delivered either in a traditional clinical setting (SmartMoms-Clinic) or remotely via a Smartphone (SmartMoms-Phone). 

Visit the Expecting Success website for more information on this study.

Visit clinicaltrials.gov for more information on this study.

 


Women's Body Initiative

Tiffany Stewart , Ph.D.,  Principal Investigator

Carolyn Becker, Ph.D. Principal Investigator

 

The Women’s Body Initiative is a program designed to promote positive body image in adult women 22 years of age and older. Pressure to conform to the thin-young ideal standard of beauty may be greater for this population who may aspire to meet both aspects of the ideal. The field currently lacks research in this area. This pilot study seeks to test the acceptability and feasibility of the Women's Body Initiative as a preliminary step toward examining the effects of this program.

Genetics & Binge Eating (Beatgene)

Pilot Study funded by: NIH Clinical Nutrition Research Unit (NORC), PBRC, P30 DK072476

Tiffany Stewart , Ph.D.,  Principal Investigator

Genes, behaviors, and the environment are intimately related in the etiology and maintenance of obesity. Further, the effects of the genotype can be amplified in an environment that promotes obesity.  This pilot study aims to identify genetic markers that are associated with the presence of binge eating behavior (behavioral phenotype). The primary aim of the study is to investigate the association of a behavioral phenotype, binge eating, with the melanocortin system.  This study is designed to be the first in a series of studies to investigate the relationship between genotypes and eating behaviors in humans.  This research may mark the beginnings of the attainment of knowledge towards the development of treatment programs and/or medications to be utilized in the future treatment of binge eating and/or obesity.  Ultimately, this information could aid health care providers in the development of individualized treatment and prevention programs for individuals predisposed to weight gain or behaviors that may lead to inappropriate weight gain. 


Bodhi Body

Tiffany Stewart , Ph.D.,  Principal Investigator

Body image disturbances are a core problem in eating disorders and/or obesity.  Research suggests that body image concerns may be one of the first symptoms in the development of an eating disorder and may be one of the last symptoms to improve with treatment (Stewart & Williamson, 2003). It is generally believed that these persistent body image disturbances place individuals at risk for relapse of eating disorder symptoms. In addition, it has been shown that obese persons have more body image dissatisfaction than their normal weight counterparts (Schwartz & Brownell, 2004). Body image disturbance functions as a significant risk factor, treatment factor, relapse prevention factor, and quality of life factor in eating disorders and obesity. Furthermore, research has demonstrated body image dissatisfaction rising in nonclinical men and women through the last decade. To date, body image treatment is a minor focus of eating disorder treatment programs and rarely included in obesity treatment or weight loss efforts. It is believed to be a key component to the success of individuals in these areas as well as a significant quality of life variable in the general population. Since body image concerns are rooted in biased information processing, it is hypothesized that a mindfulness-based program will be a viable way to improve body image. The purpose of the present pilot study is to investigate the efficacy of a contemplative/mindfulness-based approach to the treatment of body image in a Stage 1 study (proof of concept) with individuals who have body image disturbance, but no current clinical eating disorder diagnoses (i.e. anorexia, bulimia, binge eating disorder, eating disorder not otherwise specified).

 


  Pennington Diabetes Model Clinic Program

 

The Problem

  • 13.9% of Louisianans have diabetes and 37.5% have prediabetes
    • Some of the highest rates in the nation
  • This costs Louisiana $5.4 billion a year
  • Obesity is the cause of type 2 diabetes, because obesity is the main driver of the two primary defects in type 2 diabetes, insulin resistance and beta cell decompensation
  • A large portion of Louisiana has limited access to healthcare, and especially to medical weight management, stunting patient outcomes

*Source American Diabetes Association

 

A Proposed Solution for Louisiana

To establish a model clinic in weight management for prediabetes and type 2 diabetes prevention and remission in an underserved population of Medicaid recipients in Louisiana.  If found efficacious and cost-effective, a secondary aim will be to disseminate the program more widely. 

 

Background/Significance

Pennington Biomedical Research Center has entered into a cooperative endeavor agreement with the Louisiana Department of Health (LDH) to develop an innovative model for diabetes prevention, reversal and treatment for patients in the state of Louisiana.  The model is informed by diabetes prevention and remission research and can be described as a weight-centric treatment program delivered to members of underserved populations, with Medicaid insurance, who have been diagnosed with type 2 diabetes within the last 5 years and for pre-diabetes. Louisiana Department of Health Secretary Rebekah Gee recommended the creation of such a clinic to the Louisiana Board of Regents and LSU leadership. This Medicaid pilot demonstration clinic effort is a pragmatic example of a research-informed, evidence-based program with potential application in primary care settings. The State of Louisiana has provided support with a $2 million investment.

 

Pennington Biomedical is a research leader in diabetes prevention and management and has participated in all the landmark clinical trials including the Diabetes Prevention Program (DPP) and the Look AHEAD (Action for Health in Diabetes) Study, both funded by the National Institutes of Health. Pennington Biomedical has also developed pragmatic clinical trials of weight management in primary care settings, including Louisiana Obese Subjects Study (LOSS), Heads Up Project: Observational Study of Surgical and Intensive Medical Interventions for Severe Obesity (Heads Up) and PROPEL (Promoting Successful Weight Loss in Primary Care in Louisiana), a PCORI-funded weight management intervention underway in 18 primary care clinics, including 14 Federally Qualified Health Centers (FQHCs), across the state. Pennington Biomedical has also developed mobile (web and Smartphone-based) interventions for weight management for the Department of Defense (DOD), Army H.E.A.L.T.H. (Healthy Eating Activity Lifestyle Training Headquarters).  It is this science that we aim to translate into practical applications and ultimately help the citizens of Louisiana. 

 

 

Strategy

Obesity and type 2 diabetes are biologically linked, with obesity being a primary driver of insulin resistance and also being implicated in failure of the pancreas’s beta cells to control glucose levels. Furthermore, weight loss of 10% is a proven means for maximizing diabetes prevention in patients with prediabetes.  Weight can also dramatically improve the lives of patients with established type 2 diabetes.  However, even modest (5-10%) weight loss is difficult to achieve and sustain in the setting of the primary care office visit, thus challenging weight-centric diabetes prevention and management. The objective of the Pennington Biomedical Model Diabetes Clinic is to create a successful business model for delivery of cutting-edge approaches to diabetes prevention and remission in private practice, thus translating Pennington Biomedical Research Center’s research into practical applications that ultimately help the citizens of Louisiana. 

 

We will partner with managed care companies (MCOs) to enroll patients initially from their Medicaid insured population in Baton Rouge.  The clinic program is multimodal- including diet, medication, behavioral, and telehealth components. The program includes its own Smartphone application to make treatment accessible anytime, anywhere.

 

The Pennington Biomedical Model Diabetes Clinic has also developed a tracking and evaluation system for the program. The Pennington Biomedical analytics team will assess impact on weight loss, measures of health risks associated with weight loss (blood pressure, blood glucose, blood lipids), quality of life, and economic outcomes (i.e., total medical costs). Follow up evaluation would include a cost effectiveness analysis, comparing patient health care costs of those who received the clinical program, versus those who did not receive the program. If this pilot is successful, we plan to disseminate the program across Louisiana to improve access and treatment outcomes in primary care settings for Louisiana Medicaid recipients who are overweight or obese with diabetes or prediabetes.

 

Pennington Biomedical aims to become a leader in pragmatic, evidence-based care in our community and eventually dissemination on a wider scale. The Model Diabetes Clinic is the first step in a new strategic plan in which we envision creating a multi-modal “center” offering treatment in sub-specialty clinics for weight loss, and other specialty treatments, e.g. binge eating, pediatrics, bariatric surgery. We aim to develop a tailored app suite and telehealth platform for treatment, in addition to the face-to-face components. Pennington Biomedical Model Diabetes Clinic is a demonstration clinic. Our goal is not to compete with local physicians, but to partner with hospitals, physicians, and managed care companies to demonstrate that the program(s) work and are viable for community physician practice, as well as provide quality care to our citizens of Louisiana.

 

We aim to develop a tailored app suite and telehealth platform for treatment, in addition to the face-to-face components. Pennington Biomedical Model Diabetes Clinic is a demonstration clinic. Our goal is not to compete with local physicians, but to partner with hospitals, physicians, and managed care companies to demonstrate that the program(s) work and are viable for community physician practice, as well as provide quality care to our citizens of Louisiana.

 

If you are interested in possible enrollment into the program, please click here.

 


Collaborative Studies

CALERIE

Look AHEAD