PROJECT ABSTRACT
The overall goal of this K01 award is to provide Gina Tripicchio, PhD, MSEd, with the training and mentorship
to establish an independent program of research focused on innovative behavioral interventions to improve
dietary intake in high-risk adolescents. Added sugar (AS) is a prime target for dietary intervention in
adolescents; it contributes excess calories with no nutritional benefits, and adolescents consume more AS than
any other age group. High-risk adolescents (e.g., racial/ethnic minorities from low-income communities),
experience disproportionately higher rates of obesity and diet-related chronic diseases yet remain
understudied. A key limitation in developing efficacious trials for this high-risk group is the dearth of information
about key factors associated with AS intake. To address this gap, this project aims to characterize key drivers
of AS intake in high-risk adolescents using ecological momentary assessment (EMA). EMA allows for the
examination of contextually specific dietary influences in real-time, while reducing recall bias and participant
burden. This rich information can be used to guide the development of a tailored, salient behavioral
intervention. Additionally, an objective carbon stable isotope ratio (CIR) biomarker of AS has recently emerged
and can be used to address key limitations of self-reported outcomes in dietary interventions. Two studies will
be employed to meet the aims of this project. Study 1 (years 1-2), will collect EMA from 40 adolescents and
examine the feasibility and acceptability of the CIR biomarker in the target sample. Study 2 (years 3-5), will
implement a pilot RCT to test a contextually tailored, technology-enriched intervention in a sample of 70
adolescents, 12-16 years of age, from a low-income community in north Philadelphia. A 3-month behavioral
intervention, including group-based sessions, interactive text messaging and parent support, will aim to reduce
AS intake compared to an educational comparison group. Changes in AS, as measured by the CIR biomarker,
will be assessed as the primary outcome and total changes in diet quality will be examined as a secondary
outcome. A rigorous training plan complements the proposed research and is facilitated by mentors who are
experts in nutrition, eating behavior, digital interventions, statistics, and behavioral trials in pediatric
populations. Specific training objectives include: 1) ecological momentary assessment, 2) multi-level statistical
modeling, 3) assessment of objective nutritional biomarkers and 4) designing and implementing behavioral
interventions to address disparities. Temple University's Center for Obesity Research and Education is an ideal
setting for this work as it provides extensive research resources and access to a population of diverse, high-
risk youth. This award holds significant potential for public health impact and will enable Dr. Tripicchio to
establish a rigorous program of research to improve dietary intake and reduce diet-related chronic disease risk
in vulnerable adolescents. This K01 Administrative Supplement will ensure Dr. Tripicchio's progress to date is
not disrupted due to a critical life event and will facilitate her clear trajectory towards research independence.