I was born and raised in Baltimore. After graduating from Loyola College in MD with a B.S. in biology and working for several years in a breast cancer laboratory, I enrolled in the doctoral program in Human Nutrition at the Johns Hopkins Bloomberg School of Public Health. In my graduate studies, I examined familial factors influencing obesity and physical activity among adolescents in Baltimore City.
I received my first faculty appointment (Assistant Professor, Department of Pediatrics) in 2009 followed by a secondary appointment in the Department of Epidemiology and Public Health in 2011. Since becoming an Assistant Professor, I have been competitively selected to attend two national leadership trainings: the Dannon Nutrition Leadership Institute (2009) and Association of American Medical Colleges Early Women in Medicine and Science Leadership Training (2011); and have been selected to attend New Connections Symposia/ Research & Coaching Clinics (sponsored by the Robert Wood Johnson Foundation for junior faculty from disadvantaged backgrounds, 2009-2011). These opportunities provided mentorship from nationally recognized scholars, connected me to a powerful group of peer leaders, and helped build leadership skills that I have implemented in my current role.
I am currently building three areas of research expertise:
- Measures Development. Much of my research has focused on developing and validating measures of obesity-related constructs. For example, we developed and validated a Toddler Silhouette Scale (Hager et al, Obesity, 2010) to determine maternal accuracy and satisfaction with the body size of her toddler. We applied this scale to low-income mothers, finding that mothers of overweight toddlers were inaccurate yet satisfied with their toddler’s body size, with opposite findings for mothers of underweight toddlers (accurate and dissatisfied; Hager et al, Arch Ped Adol Med, 2012). We also validated a 2-item Food Insecurity Screen (Hager et al, Pediatrics, 2010) that is being used in multiple national studies. I received funding from the Robert Wood Johnson Foundation through an Active Living Research/New Connections grant to develop and validate an instrument to measure the perceptions of the physical activity environment within schools (2009-2011) that we are currently using in a school-based study.
- Assessment of Physical Activity As a graduate student, I received training in physical activity assessment from my mentor, Margarita Treuth, PhD, an exercise physiologist. Because of this skill, I have been invited to serve as co-investigator on 2 obesity prevention randomized trials. I have also received two grants to validate ankle accelerometry, one with adolescent girls (NORC P&F, 2009-2010) and one with toddlers (NORC P&F, 2010-2011).
- Pediatric Obesity Prevention My research perspective in this area has evolved due to my experience working with Active Living Research and to an overall shift in the field. I have outlined below my pediatric obesity prevention work and the evolution of my focus moving from micro-level influences (individual/family) to macro-level influences (policy):
- Individual/ Family. As a graduate student, I worked with Challenge!, an obesity prevention trial based in Social Cognitive Theory targeting low-income urban African American adolescents (Black, Hager et al, Pediatrics, 2010). My dissertation was titled “Familial Determinants of Overweight and Physical Activity Behavior Change Among Urban African American Adolescents”. I also served as co-investigator for the family-based Toddler Overweight Prevention Study (USDA/NICHD, 2005-2011).
- Schools. I then extended my research focus to schools and the school environment to expand the reach of interventions. I became a co-investigator for Challenge! in Schools (NICHD, 2008-2013) and was the principal investigator on a small grant that sought to develop a program to promote a healthy school environment (Wilson Foundation, 2009-2010).
- Built Environment. I am currently shifting my focus beyond the school and into the neighborhood, by seeking out opportunities to gain skills evaluating the built environment. I was competitively selected to attend the week-long Built Environment Assessment Training Institute (2012) that provided a detailed introduction to methods for assessing the built environment. I recently received a career development award from the University of Maryland BIRCWH K12 Scholar Program which provides funding and protected time to gain skills in GIS mapping and multi-level modeling. I recently had a manuscript published that examines the characteristics of the neighborhood surrounding schools that are associated with physical activity among adolescent girls (Hager et al, Ann Beh Med, 2013). I will also begin work on an R03 grant (NICHD) to examine environmental influences on toddler diet and physical activity.
- Policy. Over the past year, I have built a collaborative partnership with local and state policy makers, including the Maryland Department of Health and Mental Hygiene (DHMH), the Maryland State Department of Education (MSDE) and the Institute for a Healthiest Maryland (a collaboration between the University of Maryland, Baltimore and DHMH to bring together academic institutions with local public health departments and community leaders to provide evidence-based resources that promote health and reduce disparities). I am a co-investigator on a CDC community transformation grant subcontract from DHMH to promote healthy eating and active living in schools throughout the state of Maryland through wellness policy implementation, partnering with the MSDE (2011-2014). This partnership has been expanded through a CDC Special Interest Program grant to evaluate barriers/enablers to wellness policy implementation in low-income, urban schools in Maryland (2012-2014).
My ultimate goal is to reduce obesity-related health disparities among low-income, African American girls and women through programs, policies, and environmental change. Although my career has begun to take on a policy/built environment focus, I believe that the most effective way to change behavior is through a multi-level approach (i.e.: environment/policy change + individual behavior change).
- Pediatric Obesity Prevention
- Built Environment
- Health Policy
- Measures Development
- Health Disparities
- Public Health
- Food Security
Grants and Contracts:
"The Home Environment and Toddler Diet/Physical Activity: an EMA Study"
National Institute of Child Health and Human Development, R03
Scholar (PI: P. Langenberg)
"The Built Environment and Health Promoting Behaviors among Low-Income, Urban, Adolescent Girls"
National Institute of Child Health and Human Development
University of Maryland’s Organized Research Effort in Women's Health BIRCWH K12 Scholar Program
Co-Investigator and Site PI (PI: C. Voorhees)
“Implementation of Local Wellness Policies in Low-Income, Urban Schools”
CDC Special Interest Program, Nutrition and Obesity Policy Research and Evaluation Network (NOPREN)
Co-Investigator (PI: M. Black)
“Active Living/ Healthy Eating in Schools”
CDC: Community Transformation Grant, Subcontract
Co-Investigator (PI: M. Black)
“Challenge for Communities/Challenge for Youth”
General Mills Champions for Healthy Kids LEGACY Award
Co-Investigator (PI: M. Black)
“Challenge in Schools: Adolescent Overweight Prevention”
National Institute of Child Health and Development, R01
Snitker S, Le KY, Hager E, Caballero B, Black MM. Influence of Physical Activity and Body Composition on Glucose Homeostasis in a Community Sample of Adolescents. Archives of Pediatric and Adolescent Medicine. 2007; 161(7): 677-683.
Black MM, Hurley KM, Oberlander SE, Hager ER, McGill AE, Quigg AM. Participants' Comments on Changes in the Revised WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) Food Packages: The Maryland Food Preference Study. Journal of the American Dietetic Association. 2009 Jan; 109(1): 116-23.
Hager ER, McGill AM, Black MM. Development and Validation of a Toddler Silhouette Scale. Obesity. 2010 Feb;18(2):397-401.
Hager ER, Quigg AM, Black MM, Coleman SM, Heeren T, Rose-Jacobs R, Cook JT, Ettinger De Cuba SA, Casey PH, Chilton M, Cutts DB, Meyers AF, Frank DA, Children’s HealthWatch Research Group. Development and Validity of a Brief 2-Item Screen to Identify Families at Risk for Food Insecurity. Pediatrics. 2010 Jul;126(1):e26-32.
Black MM, Hager ER, Le K, Anliker J, Arteaga SS, DiClemente C, Gittelsohn J, Madger L, Papas M, Snitker S, Treuth M, Wang Y. Challenge! Health promotion/obesity prevention mentorship model among urban, black adolescents. Pediatrics. 2010 Aug;126(2):280-8.
Black MM, Arteaga SS, Sanders J, Hager ER, Anliker JA, Gittelsohn J, Wang Y. College Mentors: A View From The Inside of an Intervention To Promote Health Behaviors and Prevent Obesity Among Low-Income, Urban, African American Adolescents. Health Promotion and Practice. 2012 Mar;13(2):238-44.
Hager ER, Candelaria M, Latta LW, Hurley KM, Wang Y, Caulfield LE, Black MM. Maternal Perceptions of Toddler Body Size: Accuracy and Satisfaction differ by Toddler Weight Status. Archives of Pediatric and Adolescent Medicine. 2012 May;166(5):417-22.
*** Included in the issue of this journal: Published Commentary “Respecting Cultural Values of Toddler Weight Perception While Discouraging Parental Overfeeding” by Eliana M. Perrin, MD, MPH and “Advice for Patients: Healthy Eating and Body Size for Toddlers” by Megan A. Moreno, MD, MSEd, MPH,
***Enormous amount of press, including television, radio, and internet coverage on over 50 websites
Hager ER, Witherspoon DO, Gormley CE, Latta LL, Pepper MR, Black MM. The Perceived and Built Environment Surrounding Urban Schools & Physical Activity among Adolescent Girls. Annals of Behavioral Medicine. 2013 Feb;45 Suppl 1:68-75.
Links of InterestDr. Hager on New Connections
Growth and Nutrition Division
Nutrition and Obesity Policy Research and Evaluation Network
Institute for a Healthiest Maryland