A Conversation with Dr. David Schlundt

Dr. David Schlundt, a long-time professor of psychology at Vanderbilt University, has spent decades studying the intersection between health and behavior. His research career, which began in 1985, has taken him from eating disorder clinics to diabetes centers to community health initiatives, always with a focus on how our environment and behaviors shape our well-being. Dr. David Schlundt, a long-time professor of psychology at Vanderbilt University, has spent decades studying the intersection between health and behavior. His research career, which began in 1985, has taken him from eating disorder clinics to diabetes centers to community health initiatives, always with a focus on how our environment and behaviors shape our well-being.

“My interest in health and behavior was truly ignited during my clinical internship,” Schlundt shares. “I was rotating through an eating disorder clinic when bulimia nervosa was first gaining recognition. It was a revelation to see how widespread the problem was and how many people suffered in silence.” This experience spurred Schlundt’s research on eating disorders, eventually leading him to explore the larger connection between diet, lifestyle, and chronic diseases.

Schlundt underscores, “one major challenge for researchers at the intersection of health and behavior is the tendency to focus on individual blame rather than acknowledging the systemic issues that contribute to health disparities. We need to consider the social determinants of health – factors like income, education, and access to healthy food – to truly make a difference. Another challenge is the lack of resources and research in rural areas, where health disparities are often more severe.”

One of the early successes of the MVA was their involvement with the Vanderbilt Diabetes Center where Dr. Schlundt worked. By leveraging the Alliance’s unique expertise, they were able to secure funding to address health disparities in diabetes among African Americans in Nashville. “I didn’t know much about diabetes then,” he admits, “but I was eager to learn.” It was here that he began collaborating with Dr. Margaret Hargreaves, a nutrition expert at Meharry Medical College. Together, they embarked on a series of groundbreaking studies that explored the complex relationship between nutrition, behavior, and health disparities. This led to the creation of the Nashville Diabetes Disparities Coalition, which continues to work tirelessly to improve health outcomes in the community.

Another impactful collaboration with Dr. Hargreaves was the development of a weight management program for African American women. “We conducted focus groups, asking open-ended questions about the challenges these women faced,” Schlundt explains. “This qualitative approach allowed us to gain deep insights into their experiences and tailor the program to their specific needs.” The resulting study, published in 2001, has been cited over 200 times and continues to inform interventions for weight management and health disparities.

Hargreaves and Schlundt also collaborated on the Southern Community Cohort Study, a large-scale epidemiological study with a focus on African Americans. The MVA’s established relationship with Matthew Walker Health Center, a federally qualified health center in Nashville, proved instrumental in recruiting over 90,000 participants. Schlundt states, “Vanderbilt realized it needed to build its strength in epidemiology. It was a basic science place in the 80s and 90s. Vanderbilt recruited Bill Blott from the International Epidemiology Institute in Maryland and he assembled a group to do a pilot study for a prospective cohort study that was heavily represented African Americans in the South that became the Southern Community Cohort study. I was able to get onto that team. And so was Margaret. And I think the fact that we had worked with Matthew Walker was very inspiring to Vanderbilt. The team decided to go through federally qualified community health centers in the southeast to do the study recruitment. That turned out to be wildly successful.”

Schlundt, who played a key role in the nutrition and behavior component of the study, recalls, “We set up a table in the lobby, offering $25 to anyone willing to enroll. It was a wildly successful strategy, and the data we collected has been invaluable for understanding health disparities in the South.”

In the late 1990s, State Farm Insurance recognized a troubling trend: African Americans were disproportionately affected by motor vehicle injuries and fatalities. Seeking to address this issue, they partnered with Vanderbilt University Medical Center and Meharry Medical College to support community-led initiatives focused on self-management and behavior change. The partnership aimed to empower communities to take ownership of their safety and well-being, moving away from traditional educational approaches.

One of the key focuses of this collaboration was advocating for stronger seatbelt laws. At the time, many states had secondary seatbelt laws, which meant drivers could only be ticketed for not wearing a seatbelt if they were stopped for another offense. The Meharry-Vanderbilt Alliance and partners sought to change these laws to primary enforcement, where law enforcement could stop and ticket drivers solely for not wearing a seatbelt. This effort involved a team of African American lawyers and public relations experts who worked to persuade state legislatures to adopt stronger safety measures.

More recently, Schlundt has teamed up with Dr. Rebecca Selove on several community-engaged research projects, including the ambitious EPIC project. “I came on board because of my experience with community engagement,” he says. “People recognized that I understand how to work with diverse groups and address the social determinants of health.” This collaboration has shed light on the complexities of working with churches to promote health and the importance of addressing the broader social and environmental factors that influence health behaviors. Schlundt explained, “working with churches has been humbling. Their leaders are genuinely dedicated to helping their communities, but addressing health disparities is a complex challenge. We’ve learned that we need to understand and respect the unique cultural context of each church to effectively implement health programs. It’s a rewarding process, and I’m continually inspired by the goodness and compassion of these leaders.”

Schlundt’s work exemplifies the vital role psychologists play in addressing health disparities. “It’s not just about telling people what to do,” he emphasizes. “It’s about understanding their motivations, barriers, and the broader context of their lives. Only then can we develop interventions that truly empower people to take charge of their health.”

Schlundt went on to explain that understanding why individuals don’t always act in their best health interests, even when presented with crucial information, is a complex puzzle. At the heart of effective health communication lies the ability to grasp human motivation and address the underlying reasons behind these contradictions.

One powerful tool that has emerged in recent years is motivational interviewing (MI), says Schlundt. MI is a communication style that equips healthcare professionals like nurses, doctors, and dietitians with concrete techniques to foster behavior change. “Through open-ended questioning, active listening, and empathetic exploration, MI helps identify barriers, clarify values, and ultimately empowers individuals to set and achieve their own health goals.”

“MI goes beyond simply providing information; it focuses on building a collaborative relationship where patients feel heard and understood. By tailoring interventions to individual needs and values, MI increases the likelihood of sustainable behavior change and improved health outcomes.”

David Schlundt is hopeful for the future of the MVTCP and transdisciplinary research, pointing out that, “While interdisciplinary research involves well-defined roles and contributions from each field, transdisciplinary research emphasizes a more fluid and dynamic interaction between researchers. The goal is to create a shared understanding of the problem and co-create new knowledge through a collaborative process. This requires strong communication and teamwork skills, as researchers must be able to bridge disciplinary divides and work towards a common goal. By breaking down silos and fostering collaboration across disciplines, transdisciplinary research offers a powerful approach to solving complex problems and generating new knowledge that can benefit society as a whole.”

His advice to young researchers, “collaboration is key. Complex problems require diverse perspectives and skillsets. Don’t be afraid to step outside your comfort zone and partner with experts from other disciplines. Also, be open to qualitative research, as it offers valuable insights into the lives of the people you’re trying to help. And finally, remember that your research can have a real impact on people’s lives. Embrace that opportunity and work towards creating a healthier, more equitable world.”

With his wealth of experience and passion for community engagement, Schlundt continues to be a driving force in the field of health psychology. His work serves as a testament to the power of collaboration, the importance of qualitative research, and the enduring impact of understanding the psychology behind health.

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