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The UPSTREAM Center includes a multidisciplinary team of scientists studying a wide range of upstream risk factors for adiposity and diabetes from society to biology including the following factors: societal, physical and chemical (such as neighborhood factors and chemicals that affect hu​man metabolism), medical, psychosocial, behavioral and biological factors. Our team of researchers evaluate the effect of these risk factors at different life stages including the preconception period, pregnancy, postpartum, infancy-childhood, puberty, and menopause. Our team has also experience in conducting randomized controlled trials of behavioral interventions during these critical life stages to reduce the risk of adiposity and diabetes.

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​​Our Approach​​​​​

The UPSTREAM Center integrates upstream prevention with life course epidemiology and delivery science. The center identifies upstream risk factors for adiposity and diabetes — and life stages that are susceptible to these factors — to develop and implement prevention strategies for obesity and diabetes during critical life periods before the onset of the symptoms for these conditions. The goal is to reduce the incidence or delay the onset of obesity and diabetes and implement research findings in clinical care.​​





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Why upstream prevention?



Upstream prevention refers to interventions that target the root causes of a problem, rather than its symptoms. In the case of adiposity and diabetes, upstream prevention would address the upstream factors that lead to their development, such as social, chemical and neighborhood factors, healthcare access, mental stressors, lifestyle behaviors and metabolism. ​



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Why life course epidemiology?

Once excess adiposity and diabetes have developed, they are difficult to reverse. Therefore, it is important to implement prevention strategies early in life and during critical windows when individuals are more susceptible to adverse risk factors leading to these conditions. These vulnerable periods include preconception, pregnancy, postpartum, infancy-childh​ood, puberty, and menopause. ​




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​Why delivery science?​

Delivery science seeks to improve the delivery of health care and has also been called “implementation research,” because its goal is to identify ways of implementing effective screenings and interventions in real-life health care systems. 

The UPSTREAM Center is embedded in the Kaiser Permanente Northern California integrated healthcare delivery system and its faculty members have strong ties with clinicians and health care programs.  Faculty also have experience in conducting preventive intervention at the health system level as well as facilitating the implementation of research findings in clinical care. ​


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