| LITTLE ROCK — The University of Arkansas for Medical Sciences (UAMS) is leading a major new effort to reduce cancer by addressing eating habits in early childcare and education settings.
The project, led by UAMS’ Taren Swindle, Ph.D., will reach about 5,000 children and 500 teachers across Arkansas and Louisiana. It is supported by a five-year, $3.1 million grant from the National Cancer Institute (NCI) at the National Institutes of Health (NIH). The NCI upgraded the grant to an R37 MERIT Award, giving Swindle the option to extend the project another two years.
Approximately one in five children in the United States are obese by their fifth birthday, and the link between obesity and cancer is now well established.
“The numbers are pretty staggering because it’s setting children up for lifelong health risks that range from cancer to diabetes to cardiovascular disease, just to name a few,” said Swindle, an associate professor in the College of Medicine Department of Family and Preventive Medicine. “Excess weight will have lifelong impacts, so early prevention is critical.”
An Arkansas native and former early childhood educator, Swindle has spent the past decade developing, studying and refining approaches to improve the diets of children in early care settings. The centerpiece of her work is the intervention, “Together, We Inspire Smart Eating” (WISE), which she developed with Leanne Whiteside-Mansell, Ed.D., a professor in the Department Family and Preventive Medicine and co-investigator on the study as well as early education stakeholders. The WISE program aims to serve families at or below the federal poverty line.
WISE includes four key evidence-based practices:
- Hands-on exposures to fruits and vegetables
- Role modeling by educators
- Positive feeding practices
- A mascot – Windy WISE the owl – associated with fruits and vegetables
Swindle’s research leading up to the NCI grant has found that not all early care settings are equal in their capacity to adopt the WISE practices. She and her collaborators will now test strategies to find the right levels of support for each site. The idea is to optimize resources, which is a tenet of implementation science.
“Basically we’re looking for the Goldilocks approach, testing how we can adapt implementation strategies to give early care and education sites the exact dose of implementation support that they need,” Swindle said. “Because the sites have different challenges and resources, we want to be able to tailor our strategies so that our resources are used most efficiently.”
Ultimately, she hopes the study will lead to broader implementation of the WISE program without need of grant funding.
“At the end of this grant, I want us to have a proven model that’s ready for implementation by a state or federal agency,” she said.
Swindle’s co-investigators include Julie Rutledge, Ph.D., an associate professor at Louisiana Tech University in Ruston, the project site lead in Louisiana and a longtime collaborator on the WISE Program.
Other co-investigators are:
- Geoffrey Curran, Ph.D., director, UAMS Center for Implementation Research, and professor, UAMS College of Pharmacy
- Jacob Painter, Pharm.D., Ph.D., associate professor, UAMS College of Pharmacy
- James Selig, Ph.D., associate professor, UAMS Department of Biostatistics
- Susan Johnson, Ph.D., professor, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Denver.
The project will also receive consultation from Daniel Almirall, Ph.D., a research associate professor and expert in adaptive designs at the University of Michigan; and Tracey Barnett McElwee, Ph.D., a professor in the Department of Social Work at the University of Arkansas at Little Rock. She is an expert in the intersection of health equity and qualitative research.
Key community partners include the UAMS Head Start Program, Save the Children Head Start, Lincoln Parish (La.) Head Start and the Lincoln Health Foundation.
“We have had community and stakeholder partners with us at every step in the process of developing our plans,” Swindle said. “This grant also has a stakeholder advisory component.”
Kristina Smith, a registered dietitian at UAMS Head Start/Early Head Start, has been a key partner with Swindle in her research and is excited to see it expanding.
“I believe our work with Dr. Swindle and the WISE Program could be a significant benefit to children in other early care and education programs such as Head Start,” Smith said. “We’ve demonstrated that the WISE program can be successful in the UAMS Head Start Program, and now I am looking forward to this next phase of implementation research.”
Swindle’s research has been supported by the UAMS Translational Research Institute, which is funded by a Clinical and Translational Science Award from the NIH National Center for Advancing Translational Sciences. The UAMS institute awarded Swindle a two-year KL2 Mentored Research Career Development Award that aided her early research in the WISE Program.