My experience to date has provided a solid foundation in early childhood obesity prevention, particularly in childcare settings, that will sere as a natural launching point for expansion into cancer prevention interventions designed to reach low-income preschool children with a family history of obesity-related cancers. My long-term career goal is to become a successful, independent, externally-funded research investigator, specializing in designing and implementing family-based interventions for the prevention of obesity in childhood that can reduce the lifetime risk for obesity-related cancers, particularly among at-risk and underserved populations. My short-term goals are to: 1) develop scientific and technical skills in: mechanisms linking nutrition, physical activity, and obesity to cancer;and developing and implementing family-based behavioral interventions to prevent obesity in childhood to reduce the incidence of obesity-related cancers in later life among low-income children with a 1st or 2nd degree family history of obesity-related cancers;2) develop skills for writing grants to become an independent investigator and compete for peer-reviewed funding;and 3) enhance my communication skills through presentations at scientific meetings, writing for peer-reviewed journals, and teaching students. To acquire these skills, I have proposed to take graduate-level courses, participate in workshops, including a research working group and seminars, and develop and pilot-test a behavioral intervention, under the mentorship of a team of accomplished senior researchers at the University of North Carolina-Chapel Hill (UNC-Chapel Hill). RESEARCH Purpose: Obesity contributes to about one-third of all cancer deaths. Having a family history of obesity-related cancers further elevates one's risk for obesity-related cancers. Interventions to prevent the onset of obesity early in life are critical for preventing/reducing the risk of obesity-related cancers in adulthood. Few interventions have focused on preventing obesity in preschool children, particularly those from low-income families, who have a family history of obesity-related cancers. The purpose of the proposed study is to develop and pilot-test a 16-week, family-based intervention that uses the life skills approach to promote healthy weight gain in low-income preschool children (3-5 years old) who have a 1st or 2nd degree family history of obesity- related cancers, to prevent/reduce their risk for obesity-related cancers in adulthood. Methods: Formative research data will be collected to develop the intervention. The intervention will be pilot-tested in a randomized controlled trial among 106 low-income families/parent-child dyads, with change in children's weight status as the primary study outcome. Secondary outcomes include change in: a) children's dietary intakes and physical activity levels;b) parental psychosocial characteristics, and parenting practices related to diet and physical activity;and c), parental dietary intakes, physical activity and weight status. Study outcomes will be assessed at baseline, 16-weeks post-intervention, and at a 2-month follow-up. Statistical Analysis: Multiple regression analyses will be conducted to assess change in child and parent outcomes, respectively, between the intervention and control arm over the16-week intervention, and at the 2-month follow-up, controlling for demographic characteristics. Structural equation modeling will be used to determine whether the effects of the intervention on children's diet and physical activity are mediated by changes in the targeted parental psychosocial variables and parenting practices related to diet and physical activity. ExpectedOutcomes/Hypothesis: At the end of the16-week intervention, children in the intervention arm will have: a) healthier weight gain;b) healthier dietary intakes, as measured by higher Healthy Eating Index-2005 (HEI-2005) scores;and c) higher levels of physical activity, compared to children in the control arm. Parents in the intervention arm will also have: a) improved psychosocial well-being;b) improved parenting practices;c) higher HEI-2005 scores;d) higher physical activity levels;and e) healthier weight gain than parents in the control arm. Study findings will provide information that will be useful in testing the efficacy of the intervenion in a larger sample of low-income families with preschool children. THE ENVIRONMENT UNC-Chapel Hill is a leading educational and research university in the United States with ample resources to support the candidate in acquiring all of the skills proposed for the career development award.
Obesity contributes to about one-third of all cancer deaths in the US. Obesity that develops in childhood tends to persist into adulthood, increasing the risk for certain cancers. The proposed intervention tests the effectiveness of an innovative life-skills based family intervention in promoting healthy weight gain and reducing the risk for obesity-related cancers in adulthood among low-income children who have a first or second degree family history of obesity-related cancers. The written critiques of individual reviewers are provided in essentially unedited form in this section. Please note that these critiques and criteria scores were prepared prior to the meeting and may not have been revised subsequent to any discussions at the review meeting. The Resume and Summary of Discussion section above summarizes the final opinions of the committee.