Research centers in the College of Health and Human Development are dedicated to improving human health through innovative research. This is the story of the Center for Childhood Obesity Research (CCOR).
The mission of CCOR is to conduct interdisciplinary research that informs successful childhood obesity prevention programs, which can then be shared with public health and clinical practice professionals. Research at CCOR ranges from observational studies to randomized controlled trials, to dissemination and implementation research with community partners.
“Successful childhood obesity prevention will require preventive interventions that can produce changes at multiple levels: individuals, families, schools, health care providers, communities, and government policy,” said Jennifer Savage Williams, interim director and assistant professor of nutritional sciences.
One project being led in the center is a randomized clinical trial to test the effect of coordinating care and responsive parenting messaging between health care clinics and Women, Infant, and Children (WIC) clinics on obesity risk among infants from low-income households.
The project was funded in 2015 and is led by Savage Williams in collaboration with Pennsylvania WIC, the American Academy of Pediatrics, and Lisa Bailey-Davis, associate director of maternal and pediatric research, the Obesity Institute, and Institute for Advanced Application, at Geisinger Health Systems.
One of the main driving factors behind this study is that new parents tend to receive conflicting parenting guidance from different sources. The goal of this project is to coordinate care and messaging on responsive parenting between doctors and WIC nutritionists, so that the families receive the same consistent, evidence-based information about feeding and parenting.
For the first time in Pennsylvania, using health information technologies, pediatricians and WIC nutritionists will also be able to share information, so that the doctor can know what topics were discussed at the WIC visit and vice versa, which might help both the doctors and nutritionists identify and target those areas where parents might need extra help.
The project allows CCOR to translate evidence-based research and incorporate it into the pre-existing infrastructure of health care.
“Children from low-income households who live in poverty are at increased risk for obesity,” Savage Williams said. “We are excited about this project because it translates findings from our clinical trials to real life settings to develop a sustainable program to prevent obesity. Most children attend well child visits and WIC serves over 50 percent of all infants born in the United States, so we have a lot of reach.”
CCOR is also working on the Intervention Nurses Start Infants Growing on Healthy Trajectories, or INSIGHT study. This is a randomized, controlled trial of a responsive parenting intervention for mothers of newborns.
Mothers in the intervention group receive instruction from nurses on responsive parenting in the areas of feeding, sleep, emotional regulation, and active play over their child's first three years, while mothers in the control group receive child safety information.
The project is a collaboration between CCOR, Ian Paul, professor of pediatrics and public health sciences, and his team at Penn State College of Medicine, and Leann Birch, Professor of Foods and Nutrition at University of Georgia.
The center is also working with Danielle Downs, professor of kinesiology and obstetrics and gynecology; and professor in charge of the undergraduate program in the Department of Kinesiology. Downs is conducting an intervention to help overweight and obese women manage their gestational weight gain, using a personalized, adaptive approach to physical activity and healthy eating.
Savage Williams is a co-investigator on this project. She received funding to track fetal growth in the women participating in the study using ultrasounds
The goal of this project is to understand how different factors (such as stress, dietary intake, physical activity, sleep, weight gain) impact fetal growth and birth weight often referred to as “Fetal Programming,” which can have implications for obesity risk later.
With funding from the Pennsylvania Nutrition Education TRACKS program, the center also offers Supplemental Nutrition Assistance Program Education (SNAP-Ed) to low-income preschoolers and their parents or caregivers in Central Pennsylvania. The center is one of several SNAP-Ed partners in the state that delivers this service. Savage-Williams is a local partner project director for PA Tracks SNAP-Ed program.
“We are also reaching out to new areas, including Tioga and Bradford counties, and forming partnerships with community organizations and agencies where we can make an impact on those families most at-risk for obesity by delivering research-based interventions, or testing innovative interventions that we create here at CCOR,” said Angela Tzilkowski, research technologist at CCOR.
Last year, CCOR served 515 children and their caregivers from 491 families enrolled in Blair County Head Start.
“This year we are covering both Blair and Huntingdon Head Start preschools, with more than 750 children enrolled,” Tzilkowski said. “We are providing nutrition education to the children in the classrooms, plus testing a variety of innovative ways to reach low-income caregivers in an effort to connect the classroom education to what's happening in the home.”
Tzilkowski said there are many barriers—lack of time, transportation, and childcare—for low-income caregivers to participate in educational events in person. The center is addressing those barriers by examining whether it can effectively engage low-income caregivers and improve program outcomes through the use of mobile and online technologies, such as text and email messaging, online forum groups, and online educational modules.
With funding from PA Tracks, the center is also working closely with Pennsylvania WIC (Special Supplemental Nutrition Program for Women, Infants and Children) to develop and evaluate its online education modules for low-income parents.
The modules provide evidence-based information and recommendations to foster healthy infant and toddler feeding practices in a fun online format that can be accessed when it is convenient for mothers who might not otherwise have the opportunity to participate in a nutrition education session, Tzilkowski said.
Once the modules are developed and tested with WIC moms, they can eventually be used with other SNAP-Ed-eligible caregiver audiences statewide.