What is the NOURISH-OK Study?

NOURISH-OK stands for Nutrition to Optimize, Understand, and Restore Insulin Sensitivity in HIV for Oklahoma. Surveys conducted by Tulsa CARES and others found that more than half of Oklahomans living with HIV have problems getting enough healthy food to eat for themselves and their families. The NOURISH-OK Study will help Tulsa CARES understand what causes food insecurity, how it may lead to health problems in HIV, and how we can help improve food security for our clients.

What is Insulin Sensitivity?

Insulin is the hormone in the body that allows the body’s cells to turn sugar into energy. When the body’s cells are sensitive to insulin, blood sugar levels can stay healthy. The opposite of insulin sensitivity is insulin resistance. When the body’s cells stop responding as well to insulin, blood sugars go up and weight gain can occur. Insulin resistance happens with many chronic diseases, including lipodystrophy, pre-diabetes, diabetes, non-alcoholic fatty liver disease, and polycystic ovarian syndrome (in women). Much less is known about why people living with HIV develop insulin resistance at higher rates and what may be causing insulin resistance. Emerging research suggests that food insecurity may be linked to insulin resistance, but we don’t know why this happens. Most scientists believe that insulin resistance can be reversed in the general population through certain eating and lifestyle changes, but we don’t know if these same things will work in people with HIV. The NOURISH-OK Study will help us to answer these questions so that food programs and nutrition services can better support the holistic health needs of clients.

How can I get involved?

Research participants are needed for all three parts of the NOURISH-OK study.

To take part in the first part of the study, you will need to be HIV-positive, taking antiretroviral therapy for at least 6 months, and earn no more than 400% of the poverty level (equals $51,040 per year if you are single).

To take part, you will complete a 90-minute visit with one of our research team members to discuss your eating, sleep, stress, physical activity, and other health habits. We will measure your body composition with a painless test and measure your body’s beta carotene (vitamin A) levels using a painless finger scan. You will also provide a small blood sample so we can see how these things may be affecting your risk for chronic disease. You will receive a copy of your nutrition results, a $50 gift card, and a small gift as a thank you for your time.

To sign up as a participant, you must first contact the study coordinator, Lacey Caywood, by calling 918-834-4194 or emailing nourish@tulsacares.org.

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Community advisors are volunteers from Oklahoma’s HIV community that meet with the NOURISH-OK research team on a regular basis (usually monthly). Advisors help the study better meet community needs by providing the team with community feedback and input. They also help to raise community awareness about the study. Advisors do not need to have any experience with research to volunteer. Are you interested in being a community advisor? Email Casey Bakhsh at CaseyB@tulsacares.org to learn more.

Frequently Asked Questions about NOURISH-OK Study Participation

  • Do I have to be in-person to participate in this study?
    Yes, this study requires completion of special tests that can only be done in person. We understand study participants have very busy lives and we offer flexible appointment times based on your availability. Please reach out to our study coordinator, Lacey Caywood, at (918) 660-3690 or nourish@tulsacares.org to discuss appointment time options.
  • If I can’t come to Tulsa CARES, is there another way I can participate?
    Possibly. Tulsa CARES is the primary enrollment location for this study and most appointments will occur at this site. We are also working with multiple medical and social service providers to help offer enrollment appointments at their locations from time to time. Please reach out to Lacey Caywood, at (918) 660-3690 or nourish@tulsacares.org to discuss enrollment site options.
  • I don’t live in Tulsa, can I still participate?
    Yes, we want to include people living in anywhere in Oklahoma, regardless of where they get their medical care. Please reach out to Lacey Caywood, at (918) 660-3690 or nourish@tulsacares.org to discuss an enrollment time and location that best fits your schedule.
  • Do I get paid or will I get anything else for participating?
    Yes, you will receive a $50 gift card and an additional gift item valued at $10. After your appointment, your will receive a personalized nutrition report in the mail based on many of the measures taken during the study appointment.
  • How is my privacy protected?
    We take every precaution to keep your information private. We will strictly follow all privacy measures instituted by the OU Institutional Review Board and that meet or exceed Tulsa CARES’ accreditation requirements. If you choose to participate, you will be assigned a unique study ID number that will be used to do identify all of your study information, including your blood sample, survey responses, and other information collected during the study appointment.
  • How is my information and data stored?
    Your personal identifiable information (including your name, email, mailing address, and phone number) is kept on a secure server, separate from all the study information we collect (including your blood sample, survey responses, and other information collected during the study appointment). Only authorized study staff will have access to the key that links you to your study ID number. After your study appointment is finished, the authorized study staff will use this study ID number to look up your personal contact information so that we can mail you your personalized nutrition report.
  • Can I smoke cigarettes before my study appointment?
    Yes, you can smoke cigarettes before your study appointment. During the study appointment there will be designated smoke breaks, if you want them.
  • What COVID-19 precautions is the NOURISH-OK study taking?
    All participants will be asked COVID-19 screening questions before coming to their study appointment. Masks will be worn by both study staff and participants at all times during the study appointment. Additionally, all study staff have been fully vaccinated for COVID-19.
  • I take my medication in the morning, can I participate?
    Yes, you can still participate if you take your medications in the morning. However, this study requires a 10 hour fast (not eating or drinking anything except water) before the appointment. If you are taking any medications that require they be taken with food, we encourage you to talk with your pharmacist, primary care physician, or other medical professional about your options to delay your morning dose until after your fasting blood draw. Please reach out to our study coordinator, Lacey Caywood, at (918) 660-3690 or nourish@tulsacares.org with any questions.
  • Will you have food/drink available?
    Yes, after your fasting blood draw is complete, we will have a variety of snacks and beverages available at no charge to you.
  • Can I tell my friends?
    Absolutely! We want all eligible individuals to have the chance to participate and be represented.
  • I use or have used recreational drugs or drugs not prescribed to me. Can I participate in the study?
    Yes, we want all eligible individuals to have the chance to participate and have their voices heard, regardless of their substance use history.
  • If I share information about my drug use history with NOURISH-OK study staff, will you report me?
    No, all study staff take every precaution to protect all your information. Additionally, as an NIH-funded study, all study information is protected under a Certificate of Confidentiality, meaning study staff cannot be forced to share identifiable information by any federal, state, or local civil, criminal, administrative, legislative, or other proceedings. The only information we are required to report by law is current child abuse, elder abuse, or if a participant threatens violence to themselves or others.
  • Are you going to test my blood for drugs?
    No, this study will only measure insulin, blood sugar, inflammation, nicotine, and immune markers. During the study enrollment process, before you agree to participate, the study staff member will go over all of the measures that will be taken from your blood sample to answer any additional questions you may have.
  • If I have other questions, who do I contact?
    If you have any questions that are not answered here, please reach out to our study coordinator, Lacey Caywood, at (918) 660-3690 or nourish@tulsacares.org
  • What forms will I have to sign in order to participate?
    You must give your informed consent before participating in the NOURISH-OK Study. The consent process includes telling you more about the study, covering what is expected of you, how the collected data is going to be used, and what your rights are as a participant. You can view the study’s main consent, HIPAA consent, and tissue (blood) research consent forms consent forms before your research appointment. At the beginning of your appointment, a research staff will review all the forms with you and answer any questions you have before being asked to sign.

Meet the Team

Casey Bakhsh, LCSW, is the Chief Programs Officer at Tulsa CARES and the site Principal Investigator for the NOURISH-OK study. Casey calls Tulsa CARES “home” and has been with the agency since 2000 serving in a variety of positions, including care coordination, mental health, and administrative roles. Fueled by her energy, loyalty and love for the community, Casey brings her all every day and strives to ensure that each client has the opportunity for a better tomorrow. Her enthusiasm and passion serves as motivation to seek out innovative ideas like this one in an effort to bring hope, health and healing into homes. Casey serves on a variety of boards and committees in the community, and in her free time, she enjoys reading, collecting kaleidoscopes, and spending time with her two young adult sons.
Marianne Wetherill, PhD, is an associate professor at the University of Oklahoma – Tulsa and the lead researcher for the NOURISH-OK study. From 2005 to 2015, Marianne worked at Tulsa CARES in several roles, including as the registered dietitian, grant writer, and program evaluator. While at Tulsa CARES, Marianne started the farmer’s market program and led the Positive Eating Program for clients. She decided to partner with Tulsa CARES for this research study because she believes food can play an important role in supporting the health and happiness for all people with HIV. In her spare time, she likes to play with her daughter, work in the garden with her chickens, and drink coffee with her best friend and husband, Micah.
Lacey Caywood is the study coordinator for NOURISH-OK. She is a second year Master of Public Health student at OU Health Sciences Center. She has assisted with various research studies examining food insecurity and food as medicine interventions. Prior to working at OU Health, she led health and wellness programming at YWCA Tulsa for over ten years. The NOURISH-OK study is important to her because “..food can be a powerful tool to improve health and every person deserves consistent access to healthy, affordable, and acceptable food to lead a healthy, active life.” She believes NOURISH-OK will lay the groundwork for future food as medicine programs that will benefit the health of Oklahomans. In her spare time, Lacey enjoys knitting, reading horror novels, and spending time with her husband, her dog, Patches, and her cat, Loki.
Nick Hollman is a graduate research assistant for the NOURISH-OK study. He is a second year Master in Public Health student in Epidemiology at OU Health Sciences Center. Nick received his undergraduate degree in Nutritional Science from Oklahoma State University. In his first year of graduate school, he assisted on projects helping underserved populations with their nutrition. He has a passion for the NOURISH-OK study because he believes everyone should have access to affordable healthy food and that nutrition is a component of helping those who live with HIV live their best lives. In his spare time, Nick enjoys doing anything active and spending time with his fiancée, and two dogs, Thor and Stella.
Ian Peake is a graduate research assistant for the NOURISH-OK study. He graduated from Yale University in 2012 and is now a medical student at the OU-TU School of Community Medicine and master of public health student at the OUHSC College of Public Health. Ian has previous experience volunteering at H.O.P.E., a Tulsa-area non-profit focused on HIV, STI, and Hepatitis C prevention, education, counseling, testing and referrals to medical care and social services for those who test positive. He is excited to continue to service the community through the NOURISH-OK project and hopes this experience will help him to better serve patients in his future medical practice.