Pilot Studies Core

Recipients of Systems-Oriented Pilot Project Grants

The Pilot Studies Core (PSC, formerly known as the Rapid Response Pilot Project Core) supports time-sensitive, innovative pilot projects that use a systems-oriented approach to study impending policy and environmental changes (known as natural experiments) relevant to childhood obesity. So far there have been 10 awardees, covering topics ranging from walking paths to school meals. We are particularly interested in new policies and environmental changes where baseline data can be captured as natural experiments.

Each year, the PSC issues at least two RFAs in January and July. Applicants can request up to $30,000 in total costs (including institutional overhead). One to three awards are made in each round, depending on the funds available and the quality of the proposals received. Investigators worldwide are eligible and the PSC encourages both junior and senior investigators to apply. Research proposals are evaluated by scientific peers based from within and outside of the Gloal Obesity Prevention Center. The Center funds the most competitive proposals each year and provides support via the services and resources of its various units. In the last two years, we received applications from more than 12 countries in Asia, Africa, North America and South America.

Round 5: Rapid Response Pilot Project

RFA Announced January 7, 2014

Evaluating Changes in Food Access as a Result of the Minneapolis Staple Food Ordinance.

Principle Investigator: Melissa N. Laska, PhD, RD, Associate Professor of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minn.

Funding Dates: 5/1/14 – 4/30/16

The Institute of Medicine, Centers for Disease Control and Prevention and others have identified food access as an important issue for local governments to address when trying to prevent obesity, including by increasing healthy food availability and decreasing high-calorie, nutrient-poor products in small food stores.

Although much of the current work in this area involves working one-on-one with stores through “healthy corner store” initiatives, these efforts can be time- and resource-intensive. New policy initiatives may help create mechanisms to broaden programmatic reach and enhance sustainability.

A novel area for policy action involves the implementation of health criteria, such as minimum stocking requirements for healthy foods, as a condition of store licensing. Minneapolis City Council passed a Staple Food Ordinance in 2008 requiring stores with grocery licenses to carry specific staple foods, including fresh fruits and vegetables.

To the best of the researchers’ knowledge, this is the only policy of its kind in the United States. However, it was originally passed as a crime prevention policy (targeting “food stores” that offered little food and served as venues for criminal activity) and contained numerous loopholes. No minimum stocking quantities were specified in the ordinance, the number of varieties mandated for each food type was limited, and the specified foods were not necessarily healthy (i.e., meat, white bread and full-fat dairy).

The City Council is now revising the ordinance, and its approval is expected later this year. Revisions include changes to align the policy with federal health guidelines and stocking requirements for WIC vendors. As a result, stocking requirements for all eligible stores would increase to include an array of nutrient-rich foods that are low in energy density, including fruits, vegetables, 100 percent juices, whole grains and low-fat dairy. To take advantage of this time-sensitive opportunity and evaluate the policy’s impact, this study aims to assess changes in healthy and unhealthy food availability in 120 urban food stores at baseline and 6 months post-policy implementation, and examine changes in store environments that are not directly addressed by the policy, such as promotions and advertising, quality, price and placement of healthy and unhealthy foods. We will use a quasi-experimental, A-B study design with a control community (St. Paul) for comparison.

Round 4: Rapid Response Pilot Project Recipients
RFA Announced: July 8, 2013

Using Systems Thinking Concepts and Processes to Guide Obesity Prevention Practice and Policy Development.

Principal Investigator:Christine Siokou, PhD, Strategic Research Advisor, The Centre of Excellence in Intervention and Prevention Science, and Research and Evaluation Officer, Preventive Health Partnership, City of Whittlesea, Australia.

Funding dates: 1/1/14-12/31/14

The State Government of Victoria (Australia), in partnership with the Australian Federal Government, has made an unprecedented investment in the use of systems science and systems thinking for obesity prevention. This investment is administered through local and state government initially in 14 geographical sites around the state, before a phased roll out across the whole state if the initiative proves successful.

A new preventive health workforce of 150 people is charged with implementing a systems approach to prevention practice and policy development at the local level. The intervention works across schools, workplaces and communities to reduce the incidence and burden of obesity. Now one year into implementation, the workforce is grappling with the groundbreaking task of applying systems theory to obesity prevention practice.

The question this research grant begins to address is: Can the introduction of system dynamic concepts through group model building processes build practitioner capacity to take a systems approach to obesity prevention? The long-term aim, not addressed directly here, is to assess whether this ultimately improves policy and practice.

In partnership with Dr. Peter Hovmand (Founding Director, Social System Design Lab, George Warren Brown School of Social Work, Washington University), we propose to pilot an innovative approach to building systems thinking capacity in two geographical sites, with two sites as comparisons, with the aim of eventually extending this to all 14 sites in the first wave of the Victorian initiative. The pilot will include a one-day workshop that uses scripts, presentations and group model building methods to introduce system dynamic concepts. This provides practitioners with a range of tools and concepts and the language of systems science, to map their local system and to identify leverage points to ascertain what policies and environmental changes are worth pursuing to address childhood obesity. The workshop approach will be evaluated using quantitative methods to determine progression in understanding systems concepts and qualitative evaluation to assess the practicality of model building in assisting practice and its potential in guiding policy and practice.

The research team has multiple existing collaborations and a track record in developing systems science approaches. Notably, they are co-investigators on a U.S. NIH bid on systems thinking in obesity prevention among under 5s, and an Australian National Health and Medical Research Council Centre for Research Excellence in Policy Research for Obesity Prevention in Food Systems. The work proposed here complements these initiatives by investigating how one might develop systems expertise among the prevention workforce, and how this in turn influences practice.

Introduction of Physical Activity Classes in Girls' Private Schools in Saudi Arabia: Evaluation of the New Policy.

Principal Investigator: Hazzaa M. Al-Hazzaa, PhD, FACSM, Professor and Director, Pediatric Exercise Physiology Research Laboratory, College of Education, King Saud University, Riyadh, Saudi Arabia.

Funding dates: 11/1/13-10/31/14

Physical activity level and sedentary behaviors are known to have a major influence on the risk of obesity, yet few studies have examined this effect prospectively, and even fewer in the Middle East, a region undergoing massive lifestyle transition with rapid increases in the prevalence of childhood obesity and its co-morbidities. This proposal takes advantage of a natural experiment about to unfold, wherein girls in private schools in Saudi Arabia will soon be allowed to engage in physical activity and fitness classes for the first time. We propose to study this emerging change, using an integrated, systems science framework. We anticipate that this study will shed light on both the multiple complex factors that influence childhood obesity associated behavioral risks, and the potential value of focused changes in school or public policy that may benefit in battling the epidemic of childhood obesity in the Middle East and other regions.

Therefore, this research aims to evaluate, in a natural setting, the influence of this new policy on lifestyle behaviors of Saudi high school girls. The expected outcomes of this project will be to obtain baseline and end of school-year data on anthropometric, PA, sedentary behaviors and related environmental determinants from the private girls’ schools policy adopters and non-adopters. Students’ knowledge, attitude and practice will also be evaluated. In addition, data will be collected from parents as well as school teachers and principals. The minimal target sample will be 350 pupils from each group: the policy adopters and the non-adopters. The analysis will be conducted at multiple levels comprising the microsystem, exosystem and macrosystem. Both qualitative and quantitative evaluation methods will be employed.

Round 3 Abstracts: Rapid Response Pilot Project Recipients
RFA Announced: January 18, 2013

Using Point of Sale (POS) Systems to Measure Changes in Purchases Before and After Environmental Interventions in Corner Stores.

Principal Investigator: Allison Karpyn, PhD – Director of Research and Evaluation, The Food Trust, Philadelphia, PA USA

Funding Dates: 06/1/13-05/31/15

The Food Trust, through partnership with the Philadelphia Department of Public Health’s―Get Healthy Philly program, has been at the forefront of a growing national movement to increase healthy food access in corner stores in low-income urban areas as an environmental strategy to reduce obesity. In 2012, The Food Trust implemented Point of Sales (POS) systems in five corner stores in Philadelphia to:

1.  Objectively measure product sales in corner stores, particularly at peak times for youth purchases before and after school

2.  Evaluate the efficacy of interventions designed to increase sales of healthier products.

POS systems offer an unprecedented opportunity to analyze stores’ real-time sales. Real-time sales data are considered the gold standard for tracking and analyzing grocery purchases in supermarkets, but are rare in corner stores, which typically use non-computerized cash registers.

The Food Trust has worked with owners at five corner store locations to install POS systems, and provides ongoing, intensive, in-store training on use and maintenance of scanners, touch screens and computerized cash registers to process product sales. The overall goal for this pilot study is to evaluate the efficacy of environmental interventions on corner stores purchases, using the POS system.
The timing for this research project is critical: This spring, The Food Trust will partner with the Philadelphia Department of Public Health to implement a new Healthy Corner Store Certification policy, along with physical renovations to the store environment that will employ marketing and pricing strategies to increase healthier food and beverage sales. The Food Trust will use POS data from corner stores to examine customers’ purchases before and after implementation of policy and environmental interventions. These analyses will add to understanding of the impact of corner stores on shopping patterns, dietary intake and on overweight and obesity, leading to more informed decisions for implementing policies for childhood obesity prevention in underserved areas.

Examining the outcomes of collaborative networks to improve school nutrition environments.

Principal Investigator: Donna B. Johnson, PhD, RD, Associate Professor, Nutrition Sciences, Interim Director, Center for Public Health Nutrition, University of Washington, Seattle Wash.

Funding Dates: 06/1/13-05/31/15

Rigorous and comprehensive school wellness policies are part of systematic recommendations to make it easier for children to choose healthy foods and be physically active. Across the United States, many wellness policies are weak and ineffective, but school districts are mandated to improve those policies.

As part of a Community Transformation Grant (CTG) that is serving diverse low-income communities in King County, Wash., the county health department is funding a School Learning Network (SLN). The SLN will support district nutrition directors as they do the challenging work of bringing together diverse stakeholders to develop new policies that must be approved by local school boards. This project will apply social network analysis to determine

·  The extent to which the SLN fosters the development of ties between directors and the characteristics of those ties

·  The extent to which the position of the directors in the network and the strength of their ties is related to the quality of district wellness policy revisions

·  How best practices are diffused through the network.

The sample for this project will be an intervention group of 19 nutrition directors from King County and a control group of 27 directors from adjacent counties. Baseline data for this project must be collected as soon as possible as the SLN is beginning in the spring of 2013. Data will be collected in the spring and summer of 2013 and one year later in 2014.

This project is a partnership between the University of Washington, the CTG principal investigators and evaluators, and the WA Nutrition Obesity Policy and Evaluation Network. This assures that findings from the study will be disseminated and applied to other collaborative networks that are underway in the state and nationally, and that the research methodologies will be applied to future studies of the policy development process.

Round 2 Abstracts: Rapid Response Pilot Project Recipients

RFA Announced: July 1, 2012

Dynamics between the Community Eligibility Option and Elementary Students’ School Breakfast/Lunch Program Participation.

Principal Investigators: Maryann Mason, PhD, Consortium to Lower Obesity in Chicago Children (CLOCC), Ann & Robert H. Lurie Children’s Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, IL; Soyang Kwon, PhD, Consortium to Lower Obesity in Chicago Children (CLOCC), Ann & Robert H. Lurie Children’s Hospital of Chicago, IL, USA

Funding Dates: 11/1/12-10/31/13

The primary aim of this project is to evaluate dynamics of the Community Eligibility Option (CEO) and elementary students’ participation in school breakfast and lunch programs among six CEO participating schools.

The CEO is a new extension of free breakfast and lunch to all students at low-income schools. We will collect data on school enrollment, monthly school breakfast and lunch counts, estimated meal reimbursement, menus, school food environment and other elements in a hypothesized dynamics model from six predominantly minority, low-income, public schools located in Chicago suburbs during school year (SY) 2012-2013. We will retrospectively collect SY 2011-2012 school breakfast and lunch counts to compare students’ participation in school meal programs before CEO implementation.

The exploratory aim is to qualitatively identify the determinants of schools’ CEO participation among six CEO participating schools and three non-participating schools. The secondary aim is to estimate the potential impact size of changes in nutrition standards for school lunch (e.g. offering fruit daily, vegetables subgroups weekly and only fat-free and low-fat milk) on intake of students’ fruits, vegetables, reduced-fat milk.