Dr. Helena Laroche spends a lot of her time thinking about choices. As Assistant Professor in the Division of General Internal Medicine, Dr. Laroche is currently working on a five-year NIH grant researching obesity, its impact on the family unit, and novel means to sustainably combat it. She’s using what her Division Director Dr. Richard Hoffman calls “a challenging research paradigm.” Dr. Laroche performs community-based participatory research, a model that relies as much on the viability of one’s thesis as it does on other people’s priorities, interests, and—here’s that word again—choices.
Dr. Laroche’s own carefully considered choices, even from a young age, have proved significant. Despite Brown University having “a strike against it” because her father and grandmother had both attended there, she went and “had a blast.” However, she was not always certain that medicine was the correct path. She majored in Sociology and after finishing her BA, she deferred enrollment at the University of Missouri School of Medicine for a year to do public health work in the bootheel of Missouri. “But in the end,” she says, “medicine seemed to be the best way to combine my love of science, my love of people, and my interest in helping people.”
After finishing her MD in 1999, Dr. Laroche did her residency at the University of Rochester because it offered a dual-track in both General Internal Medicine and Pediatrics. “I liked both ends of the spectrum. . . . Even though I’m not doing Peds now, it was a great way to train; it informs my research today.” That research began in earnest during her post-residency fellowship at the University of Michigan, and ultimately resulted in yet another choice for Dr. Laroche. “I had to choose between a job in Medicine (at the University of Iowa) and a job in Pediatrics somewhere else, and there were more opportunities for research in Medicine.”
It wasn’t long after beginning work here that Dr. Laroche got attention for her study of obesity and the impact it has on children and families. In 2008, she partnered with the Muscatine Booster Club to promote healthier options in their sporting event concessions stands. Dr. Laroche and the club devised creative approaches to promoting foods such as carrots with dip or trans-fat-free nacho cheese and found that people will choose the healthier option—not every time, but in significant enough numbers. Dr. Laroche’s resulting article was published in the Journal of Public Health and a follow-up to this ongoing research will soon appear in the Journal of School Health. (For more information about this study, you can read this Iowa Now article from 2014 or watch this CNN video starting at the 30-second mark.) Of this study and another in which she and other researchers reorganized the display of food in UI dining halls, Dr. Laroche sounds both humble and grateful. “I’ve gotten to do a lot of fun things,” she says.
In terms of its potential impact on national health, getting booster clubs to sell apples and string cheese might be small potatoes next to the work she’s engaged in now. Dr. Laroche and a team of health coaches and community resource screeners are working intensely with close to 300 hundred families, each for about 12 months, in which one of the adults has a BMI score above 30 and at least one child is between ages 6 and 12. In this randomized trial, all members of both groups of families will be screened for basic resources such as food, shelter, finances, etc. and connected with community organizations that can help meet those needs. They will also receive written materials on diet and physical activity for families on a regular basis.
The intervention group will also participate in “motivational counseling” designed to elicit the individualized trigger that will inspire the family members to work together to make positive changes to their diet, exercise, or lifestyle. They will also learn about existing community resources that can help them effect change, from discounts for memberships at local recreation centers or for bicycles and other exercise equipment. This combination—the coaching and the engaged connection to support—should theoretically produce measurable difference in behavior and attitude in the intervention group. To measure progress over 18 months, family members in both groups will be outfitted with accelerometers tracking daily activity, weighed, and measured. Questionnaires will be used also to track their diet and physical activities along with other information.
Dr. Laroche is quick to point out that this is not a one-size-fits-all approach. “But if we don’t provide this kind of intensive support for this group, we’re missing the population most in need of intervention.” This research is not without its challenges; the length of the study can make it difficult to maintain contact with a demographic whose address changes frequently. But this kind of research offers real rewards. “It really is a partnership. You have to be willing to share, to work together.” She cites small collaborations, like choosing an appropriately sensitive title for the study, but her interaction with her community partners runs deeper than that. “It keeps me closer to what I’m trying to change and it gives me a better understanding of what’s really going on.”
Dr. Hoffman is not the only colleague to recognize how her hard work and dedication are now, as he puts it, “paying dividends.” Jessica Ferdig, Project Manager and Research Associate in the Institute for Clinical and Translational Science, cites Dr. Laroche’s “wholehearted compassion” as critical to what “establishes her as a great physician, supervisor, and colleague.” Dr. Christopher Goerdt, Professor of General Internal Medicine, agrees: “Dr. Laroche is passionate about providing high-quality and comprehensive care to her patients. Her care is very patient-centered and her patients feel they have her full support.”
When not working closely with other families, Dr. Laroche relaxes with her own. She and her husband love to camp and hike with their six-year-old son. She also loves to garden with him. “There’s nothing more fun than watching my child getting our neighbor’s kids to help him pick and taste kale.” She also finds time to sing (“mainly for family events”) and to get some perspective on the world from reading a piece of historical or science fiction. We in the Department of Internal Medicine certainly appreciate Dr. Laroche’s perspective and look forward to what she shows us next.