Document text
Principal Investigator: Michelle Weiss Katzow
Organization: FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH
Fiscal Year: 2023
Award: $192,266
Funding agency: National Heart Lung and Blood Institute
PROJECT SUMMARY/ABSTRACT
This Mentored Patient-Oriented Research Career Development Award (K23) proposal will address an urgent
need to advance the science of child obesity prevention in low-income, minority communities, a priority of the
National Heart, Lung, and Blood Institute. Simultaneously, it will prepare the applicant, Michelle Katzow, MD,
MS, to become an independent investigator specializing in interventions that begin in pregnancy to prevent
child obesity using innovative and scalable delivery platforms. Risk factors for lifelong cardiometabolic
morbidity and mortality related to obesity are identifiable in pregnancy and early infancy, with the highest
prevalence in low-income, Latinx communities. Few interventions have improved child obesity related
outcomes in this high-risk group. The Starting Early Program (StEP) was designed to fill this gap. The program
delivers nutrition and parenting support sessions in the primary care setting and has significant positive
impacts on child obesity-related outcomes. These impacts are dose dependent, such that families who attend
more sessions have significantly better outcomes than families who attend fewer sessions. Many families cite
geographic distance as a major barrier to program engagement. Though the original program was delivered in
person, a second cohort receiving the program in 2020 experienced a rapid conversion to remote,
videoconference delivery due to the global pandemic. Despite many challenges posed by the pandemic,
attendance among participants in this ongoing cohort has been higher than among participants in the original,
in-person cohort. In addition to improving attendance, remote delivery has created opportunities for more
frequent sessions than would be typical in contexts outside of primary care that are otherwise well-suited for
obesity prevention programs, such as the Special Supplemental Nutrition Program for Women, Infants, &
Children (WIC). WIC reaches more than half of all infants in the nation and has a high concentration of children
at risk of obesity. However, no studies have examined videoconference-based, longitudinal interventions for
child obesity prevention in WIC. This K23 proposes to develop and test Starting Early to Prevent Obesity Using
Telehealth (StEP OUT), an adapted version of StEP optimized for remote, virtual delivery through WIC. Aim 1
will identify knowledge and attitudes of key stakeholders likely to impact engagement and outcomes of StEP
OUT; Aim 2 will iteratively adapt and test StEP OUT in sequential small cohorts; and Aim 3 will conduct a pilot
randomized controlled trial (RCT) to evaluate acceptability and feasibility of StEP OUT. In the process, the
candidate will obtain essential career development skills in four domains: 1) qualitative methods; 2) CBPR; 3)
iterative intervention adaptation; and 4) conduct of clinical trials in vulnerable populations. The resources of
Northwell Health and an expert team of interdisciplinary mentors and advisors will provide an outstanding
context to launch Dr. Katzow’s career. This project will provide the necessary data for Dr. Katzow’s future R01
submission of a large-scale RCT testing the efficacy of StEP OUT.
Terms: <0-11 years old><2 year old><2 years of age><2019 novel corona virus><2019 novel coronavirus><2019-nCoV><21+ years old><Address><Adult><Adult Human><Adverse Experience><Adverse event><Articulation><Attitude><Belief><Bottle feeding><Bottlefeeding><Breast Feeding><Breast fed><Breastfed><Breastfeeding><COVID-19><COVID-19 virus><COVID19><COVID19 virus><CV-19><CV19><Cardiometabolic Disease><Cardiometabolic Disorder><Child><Child Rearing><Child Youth><Childhood><Children (0-21)><Clinical Trials><CoV-2><CoV2><Communities><Conduct Clinical Trials><Coupled><Cues><Data><Development><Disparities><Disparity><Dose><Enrollment><Epidemic><Exposure to><Family><Food><Frequencies><Funding><Future><Geography><Gestation><Health><High Prevalence><Infant><Interruption><Intervention><Intervention Strategies><Investigators><K23 Award><K23 Mechanism><K23 Program><Knowledge><Latina><Latine><Latinx><Low income><Measures><Mentored Patient-Oriented Research Career Development Award><Mentored Patient-Oriented Research Career Development Award (K23)><Mentors><Methods><Morbidity><Morbidity - disease rate><Mothers><NHLBI><National Heart, Lung, and Blood Institute><Obesity><Outcome><Over weight><Overweight><Parenting><Parenting behavior><Parents><Participant><Persons><Postpartum Period><Predisposition><Pregnancy><Preventative intervention><Prevention program><Preventive><Primary Care><Process><Psychosocial Stress><Qualitative Methods><Randomized><Randomized, Controlled Trials><Research Personnel><Research Resources><Researchers><Resources><Risk Factors><SARS corona virus 2><SARS-CO-V2><SARS-COVID-2><SARS-CoV-2><SARS-CoV2><SARS-associated corona virus 2><SARS-associated coronavirus 2><SARS-coronavirus-2><SARS-related corona virus 2><SARS-related coronavirus 2><SARSCoV2><SES disparity><Sample Size><Sampling><Science><Severe Acute Respiratory Coronavirus 2><Severe Acute Respiratory Distress Syndrome CoV 2><Severe Acute Respiratory Distress Syndrome Corona Virus 2><Severe Acute Respiratory Distress Syndrome Coronavirus 2><Severe Acute Respiratory Syndrome CoV 2><Severe Acute Respiratory Syndrome-associated coronavirus 2><Severe Acute Respiratory Syndrome-related coronavirus 2><Severe acute respiratory syndrome associated corona virus 2><Severe acute respiratory syndrome coronavirus 2><Severe acute respiratory syndrome related corona virus 2><Social Conditions><Societal Conditions><Special Supplemental Nutrition Program for Women, Infants, and Children><Susceptibility><Technology><Testing><Vulnerable Populations><WIC><WIC program><Weight><Woman><Women, Infants and Children (WIC)><Wuhan coronavirus><acceptability and feasibility><adiposity><adulthood><age 2 years><aged 2 years><aged two years><bottle fed><bottlefed><cardiometabolic><cardiometabolism><career><career development><child adiposity><child obesity><childhood adiposity><childhood obesity><childrearing><cohort><community based participatory research><community led research><community participatory research><community research><compare to control><comparison control><conference><convention><corona virus disease 2019><coronavirus disease 2019><coronavirus disease 2019 virus><coronavirus disease-19><coronavirus disease-19 virus><coronavirus infectious disease-19><corpulence><delivered remotely><delivered virtually><design><designing><developmental><diet education><disease disparity><disparity elimination><disparity in ethnic><early childhood><efficacy testing><efficacy trial><eliminate disparities><eliminating disparities><enroll><ethnic based disparity><ethnic disadvantage><ethnic disparity><ethnic inequality><ethnic inequity><ethnicity disparity><evidence base><experience><feeding><hCoV19><high risk><high risk group><high risk individual><high risk people><high risk population><improved><infancy><infant adiposity><infant obesity><infantile><infantile obesity><innovate><innovation><innovative><insight><intervention for prevention><interventional strategy><kids><lower income families><minority communities><mortality><nCoV2><nutrition><nutrition education><obese children><obesity among infants><obesity during childhood><obesity in children><obesity in infants><obesity prevention><obesity risk><pandemic><pandemic disease><parent><participatory action research><pediatric><pediatric obesity><pilot test><post-doctoral training><post-partum><postdoctoral training><power analysis><pregnant><prenatal><prevent><prevent obesity><preventing><prevention intervention><preventional intervention strategy><preventive intervention><primary care setting><primary care visit><programs><qualitative reasoning><randomisation><randomization><randomized control trial><randomly assigned><recruit><remote delivery><response><risk for obesity><risk of obesity><skill acquisition><skill development><skills><social health determinants><socio-economic disparity><socio-economic inequality><socio-economic inequity><socioeconomic disparity><socioeconomic inequality><socioeconomic inequity><stem><sugar><summit><sweetened beverage><symposia><symposium><telehealth><two year old><two years of age><unborn><usability><videoconference><videoconferences><virtual delivery><vulnerable group><vulnerable individual><vulnerable people><weights><youngster>