The University of Texas at Austin School of Nursing Center for Health Equity Research

Summer Newsletter 2021

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Summer 2021 SoNStar Recipient The University of Texas at Austin School of Nursing

The SoNStar for the Summer 2021 session is Angela Bigham, a Lay Health Worker for the AMEN program and a Community Health Network Leader for The Alliance for African American Health in Central Texas. Congratulations Angela Bigham!

Angela received several nominations. She has a contagious sweet spirit, is outgoing, caring, ready to jump in and support others in any way they can at all times, and serves with a genuine heart. She takes the time to communicate ideas and opportunities to UTSON faculty/staff on how to engage with the community to ensure that individuals being served are supported based on their needs. She follows up with people in need, ensures that the solutions provided are maintained, and works to offer practical, sustainable solutions when more support is needed.

Angela works tirelessly to support the community both within and beyond the AMEN program – VaxNow and VAMOS initiatives. She has dedicated numerous hours each day calling community members to schedule their COVID vaccination appointments, assists at the mobile clinics to ensure that people have a positive experience, and offers education and reassurance to those who are uncertain or fearful about getting vaccinated.

Angela has gone above and beyond her duties, such as driving to congregant’s homes to drop off supplies, assisting with home care needs, and ensuring that individuals have access to healthcare providers. She has gone to great lengths to ensure congregants receive calls, education, and have access to local resources. Angela also runs a community garden, offer healthy cooking classes for the community, and delivers fresh produce to homebound adults. She spearheaded an event during COVID to cook greens from the garden and deliver a warm meal to homeless residents in the community.

Angela readily steps up to do needed tasks, works hard to learn the designed system, streamlines it, makes it more achievable, and constantly adapts to the work that needs to be accomplished. Her energy and willingness to serve is infectious and inspires other team and community members to join her efforts. She inspires us all when we get weary.

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Faculty Spotlight

We talked to Gayle M. Timmerman, a researcher at the University of Texas at Austin School of Nursing about her latest research and how she contributes to the mission of HER.

Gayle M. Timmerman, PhD, CNS, FNAP, FAAN is a professor and associate dean at the University of Texas at Austin School of Nursing. She is also a lead researcher for HER. We talked to her about her latest research and how she contributes to the mission of HER.

Until recently, Gayle Timmerman didn’t really think of herself as a self-management scientist. She is best known in the academic community and popular press for her seminal research on mindful restaurant eating in perimenopausal women who wanted to lose weight. “This research is really about guiding people through a process of behavior change. In this case, we helped study subjects learn to slow down and think about what they were eating and why they were eating it. For example, are you finishing the French fries on your plate because they taste good and you want them, or just because they happen to be sitting there?” explains Dr. Timmerman. Then, she was approached by Miyong Kim, PhD, director of HER, to pilot a study on dietary self-management in chronic kidney disease (CKD) patients. “I’d never studied kidney disease—I’d always thought of myself as a food and behavior change researcher. But it occurred to me that implementing an intervention that provides study participants with tools and information they can use to make better decisions about managing their disease is about behavior change—and ultimately, a part of self-management science.” Her article appeared in the Journal of Behavioral Medicine; click the image to access the article.

Chronic kidney disease affects 31,000,000 Americans. In its early stages, it is often without symptoms, so many people are diagnosed when the disease has already caused end organ damage. It often occurs with other chronic illnesses–obesity, hypertension, and Type 2 diabetes—all of which negatively impact kidney function. “Dietary adjustments are often aimed at better managing chronic diseases that contribute to CKD. Common changes are reducing sodium and adjusting protein intake. Some patients may need to watch their potassium intake—others may not, so recommendations are not going to be the same for all,” says Dr. Timmerman. Another goal of dietary change in renal disease is to reduce wear and tear on the kidneys by limiting amount of filtered waste. For example, altering protein intake to fit body size and kidney function reduces the amount of waste processed through the renal (kidney) system. Decreasing sodium intake also lessens renal workload. It may also lower hypertension, which strains the renal vascular system.

But changing habits—dietary or otherwise—is never a straightforward process. That’s where self-management and mindfulness come in. The purpose of self-management in chronic illness is not only to educate patients, but to provide them with a sense of control and empowerment that allows them to implement changes on their own. Mindfulness is the practice of bringing one’s attention to the present moment; for the purpose ofthis study, its aim was to assist clients in dietary decision making. The two concepts naturally support each other—mindfulness supports the patient in making beneficial self-management decisions.

Dr. Timmerman collaborated with local providers and colleagues from the University of Texas at Austin’s schools of pharmacy and nutrition to devise a six-session nutritional education intervention designed for 19 early stage CKD patients. Outcome measures included weight, body mass index (BMI), eGFR (a measure of kidney function), and serum carotenoid levels (a measure of fruit and vegetable intake). The intervention had several components: information and problem-solving strategies on how to improve dietary practices, behavioral change strategies to improve self-management activities, such as reading food labels, as well as mindful eating and mindful eating meditations.

Dr. Timmerman developed the education modules and conducted the sessions herself. “Participants really seemed to enjoy the sessions—only 10 percent left the study. And the outcome measures demonstrated some positive change, particularly in terms of weight and body mass index (BMI). Nearly half of participants lost an average of 8.4 pounds, and plasma carotenoid levels reflected a significant increase in fruit and vegetable consumption.” More research is needed to determine the generalizability of the intervention, but this study is paving the way for further exploration in helping people with CKD to help themselves.

To learn more about Dr.Timerman’s research visit: