interventions for chronic disease management

Ambria Crusan, PhD, RD/LD, C2DREAM Pilot Grant Scholar and

Associate Professor of Nutrition and Dietetics at St. Catherine University

Could you tell me about yourself?

By trade, I am a Registered Dietitian and an Associate Professor of Nutrition and Dietetics at St. Catherine University in St. Paul, Minnesota. I was adopted and grew up in Le Sueur, Minnesota. I am a first-generation college graduate from the College of St. Benedict, where I earned a Bachelor of Arts in Dietetics. After obtaining my bachelor's, I completed a Master of Science in Nutritional Biochemistry from the University of Minnesota while completing my dietetic internship at The Emily Program at the University of Minnesota. I worked as a clinical dietitian at Abbott Northwestern Hospital.

I started my first teaching job in Applied Human Sciences at the University of Minnesota Duluth while completing a PhD in Human Nutrition at the University of Minnesota, focusing on population health and cardiometabolic disease risk related to carotenoid intake and serum carotenoid status. In 2018, I started a tenure track position at St. Catherine University in the Nutrition and Dietetics department, where I have been since! I am married to my spouse, Mike, and we have a daughter, Thira, and a fur daughter, Wren. We enjoy the outdoors, especially hiking and exploring new places.

Why did you pursue your current career?

As a teaching assistant during my undergraduate and graduate programs, I considered a career in higher education. Working in a hospital as a clinical dietitian, I have seen disease affect many people, especially those facing barriers to healthcare and nutrition, leading me to ask what I can do to understand how nutrition impacts health. My current career allows me to foster my enthusiasm to guide future professionals who provide quality, ethical, and socially responsible care to their patients. Knowing that these students will reflect the values they learn, pushes me to be the best role model I can be.

In research, I have the opportunity to mentor students to apply their ideas into practice or pursue opportunities to improve the health of others. This fosters an environment of creative inquiry that encourages me to collaborate, grow, and listen. Mentoring students through research creates a multiplicative effect— it is a collaborative environment that empowers teams to realize the importance of research, value the ideas they have to strengthen the work, and recognize the potential to empower others. I aim to enable students to lead and create changes in the processes that determine health outcomes.

What has been your experience in the C2DREAM Pilot Grant Scholars program? How has this impacted you?

My experience with C2DREAM has provided invaluable opportunities that have opened the door for personal and professional growth.  The C2DREAM pilot award funded through the NIMHD was a rewarding and integral opportunity in shaping my career and research goals. The pilot grant allowed me to design, implement, and evaluate a mixed-methods pilot study using community-based participatory research (CBPR) methods via a mentored experience.

Being a part of C2DREAM provided opportunities for professional development. This includes writing workshops, knowledge of health access, training, communities of practice, conference presentations, and networking, which provided skills-based learning that I have been able to apply in my research and the classroom.

Could you share what your project was for the Pilot Scholars program?

My project aims to assess how improved access to fruits and vegetables, aligned with the Dietary Approaches to Stop Hypertension eating plan, impacts immigrant Hispanic/Latinx individuals with hypertension and obesity. I used a phased, iterative approach. I concluded that attention should be paid to community voices to develop appropriate nutrition interventions for chronic disease management and supporting populations with high food insecurity. This research provides formative contributions regarding interventions for chronic disease management, suggesting that tailored Dietary Approaches to Stop Hypertension plans may be effective in lowering blood pressure for Hispanic/Latine individuals with hypertension.

I had a great team of graduate and undergraduate students from St. Catherine University and the University of Minnesota (Kerrie Roozen, Angela Cuccio, Anayeli Remache, Clara Godoy-Henderson, and Kat Zamarripa) and Community Health Workers and nurses (Sue Gehlsen, Stephanie Camacho, Katie Backberg, and Karla Martinez) from St. Mary’s Health Clinics that supported the project.

What are you working on currently?

I’m working on a few projects that I am excited about:

• I am partnering with C2DREAM Project 3, Building Relationships Around Indigenous Endurance (BRAID), to increase understanding and consumption of traditional foods amongst urban Native American youth and families, who face high food insecurity and decreased food access, to reduce future health disparities such as cardiometabolic diseases.

• I have been part of an interprofessional team supporting a community-academic partnership between The Plaster/Kafika House and St. Catherine University since 2020. Focusing on program evaluation, we conducted a needs assessment for a logic model, conducted program asset mapping, and developed clinical care assessments for Kafika House in Arusha, Tanzania, using CBPR methods. We are currently working on finalizing outcome measures for self-sustaining monitoring and evaluation.

• Using the results from the C2DREAM pilot study, our next steps are to develop and deliver a hands-on nutrition education curriculum through a Food as Medicine clinic to empower patients managing diabetes, cardiovascular disease, and/or food insecurity, with medically-tailored grocery options that are aligned with the education provided. With the support of St. Mary’s Community Health Workers, CHW students, and Dietetics students, we will align information from evidence-based diet patterns and complementary and alternative medicine (such as culturally-significant foods), implementing a series of three 2-hour classes for both cardiovascular disease and diabetes recommendations.