Developing a multicomponent lifestyle intervention to address obesity and cardiometabolic risk in Samoan children

About This Grant

PROJECT SUMMARY The goal of the proposed K99/R00 award is to support Dr. Courtney Choy’s development as an independent, community-engaged implementation scientist and epidemiologist focused on the prevention and treatment of noncommunicable, cardiometabolic diseases (CMD). Obesity and cardiometabolic risk are emerging earlier in life than ever before and require urgent preventative interventions. The R00 phase of this award will co-design and pilot test a multicomponent lifestyle intervention to address obesity and CMD risk among children in Samoa, a low-resource population with a large United States (US) diaspora and one of the highest rates of obesity in the world. The K99 phase informed intervention design by identifying several prevention opportunities and demonstrating how modifiable risk factors influence childhood obesity and related CMD risk. Specifically, our data highlight a need for prevention before children reach 9 years old and to encourage healthy dietary behaviors, sufficient sleep, self-efficacy, mental wellness, and positive family relationships. In other settings, routine-based interventions have been effective in addressing these risk behaviors. Therefore, in the R00 phase, we will co-design and test a multicomponent, routine-based intervention to address obesity and CMD risk. The intervention will 1) focus on pre-school aged children, 2) use evidence-based behavior change strategies such as goal setting and positive reinforcement to encourage daily structure and household routines related to healthy eating, physical activity, sleep, and family communication (to support child mental health and parenting self-efficacy), and 3) align with community priorities, needs, and preferences for child health programs. We will assess preliminary efficacy using a hybrid type 1 randomized waitlist-controlled trial among n=40 families. We will evaluate changes in CMD risk behavior and outcomes (glycemic control, weight status, lipids, blood pressure, mental wellness). We will also use an established implementation science framework to examine feasibility, acceptability, and potential for sustainability. We expect to develop a program with the potential for replication in US populations experiencing a high burden of CMDs and comparable low-resource settings. The findings and innovations from this work are applicable to strengthening CMD care in the US.