This Mentored Patient-Oriented Research Career Development Award (K23) will provide a promising early-stage investigator, Dr. Foster, with the knowledge and skills requisite to become an independent clinician-investigator in the field of childhood obesity. Dr. Foster's interest is in applying the novel, community-based approach of positive deviance to develop effective and sustainable solutions to early childhood obesity. Dr. Foster will actively participate in a variety of training activities in the fields of health disparities, positive deviance, behavioral intervention mapping and statistical analysis of clinical trials. He will apply the knowledge and skills learned to the execution of an innovative research project on early childhood obesity in a Hispanic population at high risk for obesity. The training activities address gaps in Dr. Foster's knowledge and skills, and the research project addresses a significant gap in understanding related to community-based approaches to early childhood obesity. Early childhood obesity tracks into later childhood and even adulthood with associated increased risks of diabetes and cardiovascular disease. Significant disparities exist with Hispanic children experiencing much higher rates of early childhood obesity compared with white children. Very few effective interventions exist for early childhood obesity that can be widely implemented in communities, particularly Hispanic communities. Therefore, the need for research on community-based, sustainable solutions is great. The core idea of positive deviance is that in every community, there are individuals who have found a way to succeed despite an adverse environment and with the same resources as their peers. In other words, this proposal seeks to define the solutions that already exist in communities. Once those solutions are defined and characterized, this project evaluates ways of modeling or coaching other community-members on those effective solutions for childhood obesity, using a model of parent mentors. Parent mentors have been shown to be an effective means of addressing complex behavior change in other problems such as asthma or being uninsured. The hypotheses are 1) positively deviant behaviors and strategies can be defined in a Hispanic community at high risk for early childhood obesity and 2) those strategies and behaviors can be spread in the community using parent mentors. The training will occur in an exceptional research environment for community-based research in San Antonio, and the mentorship for Dr. Foster is provided by highly experienced, senior faculty. Dr. Foster will utilize the training and research aims to develop his career as an independent investigator doing patient-oriented research and make a positive difference in the community he serves.
Developing sustainable, community-based solutions to early childhood obesity is key to reducing the disparities that exist in obesity and reducing the long-term, adverse health consequences of childhood obesity. The studies described will evaluate the novel approach of positive deviance in trying to discover the solutions to obesity that already exist in the community, defining those behaviors and strategies, and then encouraging their spread in the rest of the community at risk.
