University of Pennsylvania senior Sarah Schulte spends her summer hours in the Puentes de Salud clinic in South Philadelphia, investigating nutrition and exercise trends.

Puentes de Salud, or Bridges of Health, was started ten years ago by Steven Larson, assistant dean for global health programs and associate professor in emergency medicine at the Hospital of the University of Pennsylvania, and Matthew O’Brien, assistant professor of medicine and public health at Temple University.

The nonprofit offers low-cost health services to local Latino communities, regardless of their documentation, and also looks to establish partnerships with nearby universities to develop better treatments and practices.

“Patients use the clinic for routine check-ups but will also come in when they experience acute problems,” Schulte explains.

A pre-med major in health and societies, Schulte began volunteering at the clinic during her freshman year. She was assigned to do standard intake and vitals but soon became involved in Puentes’ after-school tutoring program run out of Southwark Elementary School.

“We assist students with homework, which is helpful because many of their parents have limited education and very few speak English,” Schulte says.

Schulte enjoyed her time volunteering, but desired an opportunity to become more integrated in the clinic. As a result, she chose to base her honors thesis research on Puentes de Salud. She is supervised by Jason Schnittker, professor of sociology, and a College Alumni Society Research Grant funds her work this summer.

“I wanted to choose a research area that would be useful or meaningful for the patients, an area where there is a pressing need for information,” Schulte says.

With the advice of Puentes co-founder O’Brien, Schulte decided to concentrate on nutrition and obesity, issues that are often prevalent in Hispanic communities.

She explains that there is a troubling phenomenon for Latino immigrants: they arrive healthier than most Americans, but, as they spend more time in the United States, their nutrition -– and consequent wellness -– deteriorates. 

“Sarah has done a very good job of identifying a problem, the obesity of Hispanic immigrants, but she’s also identified correctly that we don’t really know what’s going on,” Schnittker says.

To research the cause, Schulte surveys patients of the clinic as well as relatives and friends in order to learn about diet and exercise habits.

She’s also taking into account personal levels of acculturation. For this, she uses the standard Marin scale, which includes questions concerning language preferences and intercultural friendships.

“I want to understand how patients think about nutrition or exercise and if these thought processes vary at different levels of acculturation,” Schulte says.

Schulte, who conducts the surveys in Spanish, says her next step will be longer, more extensive interviews with a select number of Puentes attendees. 

“It’s one small sample, in one town, but Sarah is uncovering insights that have not been covered before in survey research,” Schnittker says.

Schulte will not be able to draw conclusions until she has completed the interview process and further reviewed literature on the subject; however, she already has a sense of the factors that might be at play in the development of obesity and other health issues.

“I think it might be a combination of eating fatty foods that are readily available here as well as the move from rural areas to an urban setting like Philadelphia,” Schulte says.

She notes that Latino communities tend to move away from a fruit-and-vegetable-based diet upon relocation to the U.S. and often do not include exercise in their daily routines.

Schnittker agrees, noting that American culture is likely to play a role.

“Once you’re in the United States and you start to acculturate, you do what other Americans do in terms of diet, and, unfortunately, Americans have a diet that includes enriched and fatty foods,” Schnittker says.

Schulte hopes to put her thesis into practice and improve the nutrition of those served by the clinic.

“I want to get a sense of what impedes people from making good nutritional choices and then use the information to help them make better decisions,” Schulte says.

Schulte suggests that students should not lose focus on the true importance of thesis work: enjoying the learning experience and applying the product to a real-world situation.

“I am constantly thinking about how I can turn this research around and make it helpful to the community I’m serving,” Schulte says.