Hungry for Change

EVMS partners with local foundation to reduce diabetes in Portsmouth

There’s a perfect health storm threatening Portsmouth, says Amy Paulson, MPH, Instructor of Pediatrics and Director of the Consortium for Infant and Child Health based at EVMS.

“Portsmouth is a community with a lot of strengths,” Ms. Paulson explains. “There are so many interesting, wonderful things about the city and its people. But many of its residents are at risk for diabetes, for a variety of reasons.”

Those reasons include lack of physical activity, high obesity rates and difficulty accessing transportation, fresh food, education and healthcare. They also include food insecurity, caused by lack of steady access to food. People experiencing food insecurity sometimes choose inexpensive, calorie-rich versus nutrition-rich foods, often resulting in obesity and diabetes.

To address this concern, EVMS and the Portsmouth General Hospital Foundation created the Portsmouth Diabetes Prevention Project. Funded by the foundation, the project has three goals:

• Improve the nutritional value of the food offered through local nonprofits to people with or at risk for diabetes
• Positively affect individual behaviors
• Develop sustainable community approaches to healthy, active living

Ms. Paulson, along with Margaret Baumgarten, MD, Professor of Family and Community Medicine, are co-principal investigators of the project. 

Public statistics show Portsmouth has higher rates of poverty, food insecurity, obesity and diabetes than the rest of the state. For example, while 30% of Virginia residents are obese, in Portsmouth, it’s 57%. About 10% of Virginia residents experience food insecurity, but in Portsmouth, it’s nearly double that.

Within those numbers, the risk of diabetes increases. According to an EVMS survey, 75% of those who patronize Portsmouth food pantries have diabetes or are at risk for it.

Along with EVMS, Portsmouth General Hospital Foundation also recognized the importance of addressing diabetes prevention and care. The foundation’s mission is to improve the health, wellness and quality of life of the Portsmouth community through its philanthropic efforts.

“EVMS is a cutting-edge organization,” says Alan Gollihue, President and CEO of Portsmouth General Hospital Foundation. “They have been a real joy and delight. They work together like a well-oiled machine.”

Portsmouth’s Port Norfolk Church has one of the area’s largest food pantries, serving more than 2,100 people a month. Pastor Connie Shoemaker, who runs the food pantry, says the church aims to provide healthy choices for the community, and EVMS has been helpful with tools and education.

“If you’re going to provide food, it should be healthy,” Pastor Shoemaker says. “We don’t buy it if we wouldn’t give it out.” For example, rather than diet sodas, the Port Norfolk pantry stocks flavored waters.

The Portsmouth Diabetes Prevention Project works with food pantries around the city, like Port Norfolk’s. The pantries’ staff and volunteers receive comprehensive toolkits that contain educational materials to guide client choices toward healthy options.

The toolkit includes recipes, activity suggestions and advice on how to make food healthier, such as rinsing canned green beans to reduce sodium. The food pantries also received newsletters sharing nutritional information and fitness tips. Many pantries now host events to educate clients, including tastings where a chef prepares and shares a healthy recipe. Recently, Port Norfolk Church held a tasting that featured lentil tacos.

Early on, the project team learned that residents wanted a personal connection to help with healthy choices. So “Connect for Health,” a behavioral change program, was just launched.

“The goal is to develop long-term, sustainable community programs. Individually, we’re trying to shrink the change to something minimal and achievable. But we’re also looking at big interventions with community partners.”

– Margaret Baumgarten, MD

Participants partner with a wellness coach via phone call, email or text over 30 days to work on one small goal, like reducing soda consumption, walking 10 minutes a day or eating a vegetable three times a week. Most of the wellness coaches are volunteers who have been trained to help with behavior change.

The goal is to develop long-term, sustainable community programs, Dr. Baumgarten explains. “Individually,” she says, “we’re trying to shrink the change to something minimal and achievable. But we’re also looking at big interventions with community partners.”

One intervention involved the Craddock neighborhood. Although Craddock was designed to promote walkability, problems such as cracked sidewalks and poor lighting have created challenges. And reaching the close-by Paradise Creek Nature Park requires crossing Victory Boulevard, a four-lane highway that had no clear crosswalk into the park. EVMS worked with the city of Portsmouth to secure a grant to install a crosswalk light, making the park more accessible to pedestrians.

The team wants to change how people engage with food and activity over time. “We work to make the healthy choice the easiest choice,” says Michelle Charters, MPH, the project’s Program Coordinator.

“It’s a fast food world,” Pastor Shoemaker adds. “But what’s fast and easy isn’t usually healthy. Bringing health awareness to the new generation is important, too. Diabetes prevention isn’t just an old-people problem.”