PCLT Student Research Spotlight

Tuesday, January 30, 2018
By Jessica Hoffman

One of the greatest benefits of being a PCLT student is the connection we get to outstanding mentors who not only care about our learning but who also truly care about us as people and guide us toward discovering the leaders within ourselves. I was very fortunate to have received great advice from within the PCLT family on finding my wonderful research mentor, who is a nationally-known expert clinician and researcher in childhood obesity. Our research focused on the evaluation of a free community-based wellness program (“Bull City Fit”) designed specifically for patients and families at Duke Children’s Healthy Lifestyles, which is a multidisciplinary pediatric weight management program for children with obesity. Bull City Fit offers free structured programming with various fitness and wellness activities six days per week at a local Parks and Recreation center, and it operates through a formal shared use agreement between Duke University and Durham Parks and Recreation. Integrated healthcare-community partnerships like Bull City Fit have been advocated as potential solutions to addressing the obesity epidemic because they are more accessible, engaging, and provide support for entire families, but few models have been evaluated in the literature. Through a randomized controlled pilot trial, we compared this uniquely integrated clinic-community model to clinical treatment alone.

 

Most of my research time was spent at the Healthy Lifestyles clinic on North Roxboro Street. My mentor valued me as an integral member of our research team, sought my input on study design and implementation, and trusted me to manage the logistical and data collection aspects of the trial, with regular support from her and additional support whenever I needed it. We ran our trial from within the clinic, which allowed me to work alongside every member of the Healthy Lifestyles team (consisting of nurses, CNAs, physicians, physician assistants, nurse practitioners, registered dietitians, physical therapists, mental health counselors, and a fantastic scheduling coordinator who manages the appointments for this very busy referral clinic). In addition to learning the ins and outs of conducting clinical research, working with this incredibly compassionate team (who are all trained in motivational interviewing) also taught me about the complexities of obesity and its multidisciplinary management. Moreover, I got to know and connect with the patients and families participating in our study by conducting the baseline and follow-up assessments. The vast majority of study participants lived in poverty and were of racial- and ethnic-minority backgrounds, and I learned about the many challenges and stressors they dealt with daily, along with true social determinants of health. By volunteering at Bull City Fit, I was also able to observe the vital community and social supports this program provides for families, in addition to its fun physical activity and health benefits.

 

Working on this project with these families, the Healthy Lifestyles team, and our hard-working research team was the most rewarding and humbling experience of my medical education thus far. I enjoyed my time so much that I decided to take an additional research year to finish conducting our trial and participate in some other research projects at Healthy Lifestyles as well. Although we did not observe a significant change in BMI, the most exciting finding from our pilot study was that the integrated clinic-community model delivered at Bull City Fit significantly improved child quality of life compared to the clinic-only model, and our work was recently published in the January 2018 edition of Pediatrics. Using the knowledge gained from this pilot, my mentor and her research team were recently awarded the Duke Endowment to expand this integrated model to other sites throughout North Carolina. In addition to all of these rewarding educational experiences, my mentor also encouraged me to present our work at several regional and national conferences, which helped to strengthen my public speaking and scientific presentation skills. Of course, I could not have attended these conferences without the generous financial support from PCLT, the Dean Andrews Travel Award, and from my mentor as well. I am truly grateful for the continuous support from PCLT and my research mentor, who have not only impacted my development into a strong future primary care clinician, researcher, and patient advocate, but who have also helped me grow individually as a person and gain confidence in myself as a leader in medicine.