Addressing Obesity to Reduce Cancer Risk and Health Disparities in Underserved Populations

解决肥胖问题以降低癌症风险和服务不足人群的健康差异

基本信息

批准号：
10665298
负责人：
Xiaochen Zhang
金额：
$ 9.1万
依托单位：
FRED HUTCHINSON CANCER CENTER
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-08-01 至 2026-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10665298
关键词：
Address Adherence Adult Appalachian Region Area Attenuated Behavior Therapy Behavioral Risk Factor Surveillance System Biological Biological Markers Body Composition Body Weight Body Weight decreased Breast Characteristics Cholesterol Clinical Colorectal Control Groups Counseling County Data Diabetes Mellitus Diet Dietary intake Dose Endometrial Evidence based intervention Family Goals Health Health Benefit Health Food Health Promotion Health behavior Healthcare Heart Diseases Height Hypertension Incidence Individual Inflammation Inflammatory Insulin Intake Intervention Learning Life Style Life Style Modification Liver Malignant Neoplasms Mediating Mediation Metabolic Modification Obesity Obesity associated cancer Observational Study Ohio Outcome Overweight Pancreas Patient Self-Report Phase Physical activity Physiological Pilot Projects Population Population Heterogeneity Prediabetes syndrome Premature Mortality Preventable cancer cause Randomized Randomized Controlled Trials Recreation Research Research Personnel Research Project Grants Research Training Residencies Resources Risk Risk Factors Role Rural Rural Appalachia Rural Population Self Efficacy Series Social support Techniques Text Messaging Training Translating Translational Research Translations Travel Underserved Population Urban Population Walking Weight acceptability and feasibility base cancer health disparity cancer prevention cancer risk comorbidity design disorder risk evidence base experience good diet health disparity inflammatory marker insight interest intervention effect lifestyle intervention mortality multidisciplinary obese person obesity treatment programs randomized trial response rural disparities rural setting telephone-based therapy design therapy development urban area weight loss intervention weight loss program

项目摘要

PROJECT SUMMARY/ABSTRACT Obesity and poor health behaviors are major modifiable contributors to health disparities in rural and Appalachian populations. Residents in rural and Appalachian areas experience higher rates of obesity, cancer incidence, and mortality, compared to residents in urban or non-Appalachian areas. Obesity increases the risk of 13 cancers due to excessive adiposity accumulation and abnormal metabolic modifications. Weight loss, physical activity, and healthy diet potentially attenuate the negative effects of obesity and reduce cancer risk and premature mortality. Evidence-based weight loss programs have been implemented in clinical settings and showed various health benefits. However, these programs solely focused on health-promoting resources available in urban areas and are not generalizable to rural and Appalachian populations. Therefore, developing effective strategies to provide weight loss programs for rural and Appalachian populations is an important priority. My long-term goal is to reduce cancer risk and disparities through lifestyle modifications among rural and Appalachian populations. To achieve this goal, the F99 phase focuses on understanding characteristics of rural and Appalachian populations that influence health behaviors and obesity-related health outcomes (Aim 1a), identifying targetable factors for intervention (Aim 1b), and translation of an evidence-based weight loss program to rural populations (Aim 1c). To complete Aim 1a, we will utilize 2011-2017 Behavioral Risk Factor Surveillance System data. To complete Aim 1b, we will conduct post-hoc mediation analysis using data from a completed NCI-sponsored group-randomized weight loss trial in Appalachian adults. To complete Aim 1c, I will coordinate a 15-week telephone-based pilot weight loss intervention among rural Ohio residents. This pilot study will translate an evidence-based weight loss intervention with tailored strategies for rural populations to meet their needs. We will determine the feasibility and acceptability of the intervention among rural populations. The results from studies in the F99 phase will guide the design of the intervention in the K00 phase: I will determine the dose-response effect of a weight loss intervention on cancer risk factors in rural and Appalachian populations (Aim 2). To complete this aim, I will design and conduct a pilot weight loss randomized controlled trial among overweight/obese residents in rural and Appalachian areas. The proposed research aligns with an NCI strong interest of behavioral intervention and cancer prevention across diverse populations. The proposed research and training plan will: 1) provide the multidisciplinary training necessary to accelerate the translation of research findings into the design and conduct of lifestyle interventions; 2) facilitate my long-term goal to become a successful independent investigator with a focus on lifestyle modifications and cancer prevention in rural and Appalachian populations; and 3) provide necessary experience to submit a competitive large-scale research grant (R01).

项目摘要/摘要肥胖和健康行为不良是农村和阿巴拉契亚族健康差异的主要贡献者人群。农村和阿巴拉契亚地区的居民的肥胖症，癌症发生率和与城市或非阿帕拉奇地区的居民相比，死亡率。肥胖增加了13个癌症的风险由于肥胖积累过多和异常代谢修饰。体重减轻，体育锻炼，健康的饮食可能会减弱肥胖的负面影响，并降低癌症风险和过早死亡。基于证据的减肥计划已在临床环境中实施，并显示了各种健康益处。但是，这些计划仅着眼于城市地区可用的健康资源并且不能推广到农村和阿巴拉契亚人口。因此，制定有效的策略来为农村和阿巴拉契亚人口提供减肥计划是重要的重点。我的长期目标是通过农村和阿巴拉契亚人口的生活方式改变来减少癌症风险和差异。为了实现这一目标，F99阶段着重于理解农村和阿巴拉契亚的特征影响健康行为和与肥胖相关的健康成果的人群（AIM 1A），确定可目标的干预因素（AIM 1B），以及将基于证据的减肥计划转换为农村人群（AIM 1C）。为了完成AIM 1A，我们将使用2011 - 2017年行为风险因素监视系统数据。到完整的AIM 1B，我们将使用完整的NCI赞助的数据进行事后调解分析阿巴拉契亚成年人的团体随机减肥试验。要完成AIM 1C，我将协调15周俄亥俄州农村居民的基于电话的飞行员减肥干预措施。这项试验研究将翻译基于循证的减肥干预措施采用量身定制的策略来满足他们的需求。我们将确定农村人口中干预的可行性和可接受性。研究结果在F99阶段将指导K00阶段的干预设计：我将确定剂量反应减肥干预对农村和阿巴拉契亚人口中癌症危险因素的影响（AIM 2）。到完成此目标，我将设计并进行飞行员减肥随机对照试验农村和阿巴拉契亚地区的超重/肥胖居民。拟议的研究与NCI强度保持一致行为干预和预防癌症的兴趣。拟议的研究培训计划将：1）提供加速研究翻译所需的多学科培训生活方式干预的设计和行为的发现； 2）促进我的长期目标成为一个成功的独立研究者，重点是农村的生活方式改变和预防癌症阿巴拉契亚人口； 3）提供必要的经验来提交竞争性的大规模研究格兰特（R01）。