Alice Ammerman, Gillings School of Global Public Health
The PRC Network provides systems for disseminating evidence-based interventions to promote health and reduce chronic disease risk in low income, high risk populations. Initially developed in 1990, our New Leaf intervention program was designed to assist primary care providers with assessment and counseling for heart disease risk reduction in the southeastern US where CVD rates are exceptionally high. The basic approach is a streamlined assessment that requires no calculations, identifies level of dietary or sedentary risk, and guides efficient lifestyle counseling by the provider. The Dietary Risk Assessment which drives the intervention and serves as an evaluation tool, has been updated and validated multiple times in keeping with the evolving scientific literature about diet and health. Designed for flexible implementation, the New Leaf Program has been tested in over 30 community health or primary care centers, 50 health departments (including as part of the WISEWOMAN program), and over 80 African American Churches. It has been adapted for multiple cultural groups and to address cancer prevention, diabetes management, and weight loss and has been translated by another PRC for use with the deaf population. Over time it has been delivered by physicians, health educators, nurses, community health workers, and phone counselors. Significant improvements in diet and physical activity have been reported in most of the studies, as well as improved blood pressure, serum cholesterol, BMI, and blood carotenoids in many cases. Most recently we have been testing strategies for scale up and dissemination, including a streamlined web-based version of the intervention.