Intervening in Food Insecurity to Reduce and Mitigate (InFoRM) Childhood Obesity - PROJECT SUMMARY Childhood obesity and food insecurity are escalating and intersecting public health threats. Childhood obesity prevalence has been rising in the U.S. and tracks into adulthood, increasing the risks of chronic diseases such as type 2 diabetes. Food insecurity is associated with poorer dietary quality, including higher energy-dense food intake, and a higher prevalence of obesity and diabetes in adults; however, data are inconsistent and less known regarding longitudinal health effects in children. Further, there is evidence that the neighborhood food environment, including limited access to sources of healthy food, is associated with elevated body mass index in children. Because food insecurity and childhood obesity tend to co-occur in Black, Hispanic, and lower- income populations, there is an urgent need to examine the multilevel contributions of household food insecurity and neighborhood food access to rising childhood obesity prevalence. Dr. Allison Wu, a pediatric gastroenterology and nutrition specialist with advanced training in epidemiology and health services research, is well-suited to address this need. Dr. Wu seeks to expand on her research in the determinants, risks, and disparities in childhood obesity to develop and test interventions to support food and nutrition security in children and families. Specifically, her proposal aims to examine the extent to which household food insecurity and neighborhood food access contribute to increasing childhood obesity prevalence (Aim 1), test a meal kit delivery intervention in families and children with food insecurity and obesity (Aim 2), and explore the facilitators and barriers associated with the intervention’s implementation (Aim 3). These are the critical next steps toward achieving her long-term goal to develop evidence-based interventions and policies ensuring nutrition security for children and families. This career development award will provide Dr. Wu with the necessary mentored training and research opportunities to 1) develop expertise in multilevel and longitudinal analyses, 2) conduct a phase II clinical trial, and 3) obtain a foundation in implementation science and training in qualitative methods to translate interventions into routine practice. She is supported by outstanding mentorship provided by experts in obesity epidemiology, health services, and health equity (Dr. Elsie Taveras), food insecurity and implementation science (Dr. Lauren Fiechtner), social and behavioral epidemiology (Drs. Henning Tiemeier and Izzuddin Aris), clinical trials in pediatric nutrition (Drs. Christopher Duggan and Enju Liu), and qualitative research in child health (Dr. Karen Kuhlthau). Her training and research activities will be conducted in the unparalleled academic environments at Boston Children’s Hospital and Harvard Medical School, which are firmly committed to Dr. Wu’s successful transition to independence as a physician-scientist.
