Elaine Sarah Belansky

Research Associate Professor; Director, Center for Rural Health and Education; Adjunct Faculty

What I do

I direct the Center for Rural School Health & Education at the University of Denver.

Professional Biography

Dr. Belansky’s research areas include studying how university and community partners can work together to translate evidence-based research into practice in school settings to increase physical activity, healthy eating, mental health, and school engagement and decrease bullying, high risk sexual behavior, and drug use. Currently, she is working with rural, low income schools in the San Luis Valley and southeastern Colorado to develop data driven, evidence-based comprehensive health and wellness plans related to the Whole School, Whole Community, Whole Child model. Dr. Belansky has received funding from Centers for Disease Control and Prevention, National Institutes of Health, Robert Wood Johnson Foundation, and The Colorado Health Foundation.

Research

I have been conducting research on childhood obesity prevention in rural schools since 1999. Using a community-based participatory research approach, our team developed a strategic planning process called AIM (Assess, Identify, Make it Happen) in 2005 to translate evidence-based research associated with increased physical activity and healthy eating into practice in rural, low-income Colorado schools. My work takes place in the San Luis Valley where residents are primarily non-Hispanic White (54%) and Hispanic (46%), have a high incidence of type 2 diabetes (with Hispanics having a two- to four-fold excess risk when compared to non-Hispanic whites), and high prevalence of obesity (adults ~30%; children 38%-43%). In 2010, I expanded my work to schools located in the southeastern quadrant of Colorado (37% Hispanic; 62% students qualify for free/reduced lunch).

I served as principal investigator of two CDC-funded Rocky Mountain Prevention Research Center’s (RMPRC) core research projects: “School Environment Project” (2004-2009) and “Working Together Project” (2009-2014). In the School Environment Project, we created and tested AIM, a strategic planning process inspired by Intervention Mapping (Bartholomew, Parcel, Kok, Gottlieb, 2003). In AIM, community and university partners join efforts to translate evidence-based research into practice using a step-by-step process that begins with a needs and assets assessment of the school, moves to identifying types of evidence-based environment and policy changes needed to increase healthy behaviors, and ends with implementation, evaluation, and plans for adoption and sustainability. In 2009, we tested AIM in the Working Together Project (WTP) as a strategy to address school-based adolescent health promotion. The WTP is a student led, adult supported classroom-based curriculum that engages rural, low-income middle school students in improving student health by implementing evidence-based environment, policy, and practice initiatives in schools. AIM’s success led to a 3-year $1.8M grant (2010-2013) from The Colorado Health Foundation (“Implementing Evidence-Based School Environment, Policy, and Curricular Changes to Increase Opportunities for Healthy Eating and Physical Activity in Low Income, Rural Colorado”) in which we studied the process of disseminating AIM to 24 rural schools and establishing a Physical Education Academy to translate evidence-based research regarding quality physical education into practice in 47 schools. We were refunded to expand our programs via a 3-year (2013-2016), $3.1M grant (“Healthy Eaters, Lifelong Movers 2”) to study the feasibility of engaging local public health departments in scaling up AIM to reach more schools with fewer resources. From 2016-18, the Foundation funded us several more times ($2M) to expand AIM to address the Whole School, Whole Community, Whole Child model.

The goal of my research is to develop strategies to shorten the time it takes to put research into practice to address childhood obesity and a range of adolescent health problems. A second goal is to track trends in the presence of evidence-based environment practices in rural schools and the impact of state and federal policies on those practices. Public schools are important settings for promoting healthy behaviors and reversing obesity trends; this is particularly true in rural settings because of the higher prevalence of poverty which is related to students qualifying for free school breakfast and lunch, lower population density, fewer adult opportunities for physical activity, and greater distances to reach organized activity opportunities. Recess and physical education are sometimes the sole place rural children report getting physical activity. While there is an extensive menu of effective practices known to increase student opportunities for physical activity and healthy eating in schools, most of Colorado’s rural schools have not yet implemented those practices or recommendations. For example, a 1996 study demonstrated that recess before lunch increased students’ consumption of healthy foods; yet 15 years later, only 46% of rural Colorado schools were offering recess before lunch. A similar set of issues exists for adolescent health issues. In the US today, teen pregnancy rates are higher than in other developed countries and suicide is the second leading cause of death among adolescents. A number of proven, school-based strategies exist for preventing these and other adolescent health issues. However, it can take up to 17 years for evidence-based practices to be put in place, and strategies are needed to accelerate this research to practice gap.