Interventions for Health-promotion in Oncology and Obesity in Pediatrics (I-HOPE)

Research Activity

Student Research Posters

黑料社 in the I-Hope lab are made up of undergraduates, post-Bacs, masters鈥 and doctoral students and Moffitt Cancer Center T-32 and USF postdoctoral fellows.

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The I-HOPE research lab, led by Dr. Marilyn Stern, maintains an overarching focus on addressing pediatric psychosocial oncology, rural Latino health and obesity and has several ongoing funded projects, including several from the National Institutes of Health (NIH). We are excited to offer students the opportunity to engage in critically important research which seeks to promote resilience and overall good health among the pediatric as well as adolescent and young adult populations. We run a bilingual lab as much of our work entails providing interventions in both English and in Spanish.

Current Research

ADAPT

ADAPT+: Optimizing an Intervention to Promote Healthy Behaviors in Rural, Latino Youth with Obesity and their Parents, using Mindfulness Strategies (R34AT010661-01, Stern and Redwine, MPI) aims to refine and test the acceptability and feasibility of a culturally competent, evidence-based, community-centered obesity intervention to address obesity in Latino youth living in rural communities. We completed this project and are now awaiting word for our follow-up projects to test the efficacy and dissemination of our intervention across the state of Florida. 

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ADAPT+ project focuses on Latino families living in rural communities with a child between[MS1]  8-12 years old who is overweight or obese (BMI over 85%). The purpose of this study is to optimize an obesity intervention with rural underserved Latino children and their parents that combines a standard family-based behavioral approach, the 鈥済old standard鈥 for pediatric obesity treatment, with a mindfulness approach focusing on stress reduction. Long work hours, common among rural/agricultural families, can reduce parent involvement, including uninvolved feeding style, which can increase risk of obesity in youths. Specifically, parent stress is associated with decreased physical activity, overeating and higher body weight in both children and parents. We conducted a pilot RCT and found strong feasibility and acceptability of our intervention approach (see Stern et al., 2023, Journal of Pediatric Psychology, 2023. 48(8): p. 666鈥675. ).  In line with our hypotheses, compared to enhanced usual care (EUC), our active control, ADAPT+ parents reported decreased stress and increased mindful eating  from a baseline to 3-months post-intervention.

鈥淧royecto de Promoci贸n de Salud para disminuir el riesgo de c谩ncer鈥 (ProSalud or 鈥淗ealth Promotion Project to reduce cancer risk鈥).

Our newest project in this area is ProSalud. ProSalud is funded by a Moffitt Catchment Area Research Enhancement Support (M-CARES).  We partner with RCMA and are looking at the prevention of cancer risk.  Our plan for this project is to conduct a series of workshops with follow-up WhatsApp messaging to maintain engagement over 8 weeks with groups of 6-10 Latino parents of 6- to 12-year-olds. For a target of 50 parent participants, baseline and 2-month follow-up assessments we will solicit information on (i) acceptability and (ii) key modifiable health behaviors associated with cancer risk reduction. A series of follow-up focus groups with a subgroup of ~15 parents will be conducted to further refine and evaluate optimization of our manualized workshop.

To implement this project, we partner with RCMA, rcma.org  to deliver the workshop sessions with parents living in the target rural/agricultural communities.

ADAPT Project Mindfulness Videos (en enpanol)

RCMA, has served low-income working families across Florida (21 counties) for over 60 years. Residents in these communities are primarily of Latino heritage. RCMA is a leader in their communities, with established charter schools and child development centers. RCMA鈥檚 primary mission is to improve the quality of life of low-income families living in Florida, serving > 6500 children and their families, through social programs and education.

RCMA鈥檚 slogan, 鈥淗ealth for you now, is your children鈥檚 health in the future!鈥 is consistent with ADAPT+鈥檚 aims.

Sample

(R01CA240319-01A1, Stern, PI) is a multisite randomized clinical control trial targeting parents of pediatric cancer survivors to support the development and maintenance of healthy lifestyle behaviors and mitigate the late effects associated with obesity.

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Pediatric/adolescents and young adult patients treated for cancer are at higher risk than the general population for obesity, diminished exercise capacity, hypertension and metabolic syndrome features related to cardiovascular disease. Rates of overweight and obesity for pediatric survivors have been found to be high five years after cancer treatment (from 40 to 50%). In line with recent calls emphasizing the importance of promoting healthy lifestyle behaviors in youth treated for cancer, we focus on key eating and exercise behaviors that can be targeted through parent education efforts to foster better overall health among youth with cancer transitioning off active treatment to survivorship. Our prior work supported by funding from the NCI found that our NOURISH-T intervention was both acceptable, feasible and showed preliminary efficacy. In NOURISH-T+ (NOURISH for Healthy Transitions) we now test the efficacy of this intervention in both English and Spanish across four diverse pediatric oncology clinics in a multi-site randomized control trial (RCT). Jocelyn Jarvis serves as project coordinator.

Hispanic Services Council

Social, Ethical, and Behavioral Implications (SEBI) Research on COVID-19 Testing among Rural Latino Migrants in Southwest Florida. (3R34AT010661-02S1, Redwine and Stern, MPI) aims to assess COVID-19 testing and vaccine uptake attitudes and behaviors among rural Latino migrants in Southwest Florida.

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Latinos in Florida account for over 30% of all COVID-19 cases and hospitalizations. Most Latinos live in rural areas, work as migrant farmworkers, and have higher rates of underlying medical conditions, limited access to health care, and live in circumstances that interfere with implementation of community mitigation measures, all potentially leading to increased risk of COVID-19 exposure, morbidity, and mortality. Our community partner, the trains local promotoras de salud (community health workers), and in the past two years has reached 5,900 underserved Latino immigrant families in SW Florida. Recently, HSC promotoras reached over 300 Latino families to ask about the impact of COVID-19 on their health and wellbeing. We build on our ongoing partnership (R34At010661-01) with HSC and the promotoras to collect data using mixed methods to assess healthcare, social, economic, and contextual factors that influence the ability and willingness to get tested for COVID-19 and/or vaccinated. Our findings will guide products, including community education and population-specific marketing strategies, to improve testing and vaccination uptake. In partnering with and sharing information with other NOSI recipients we hope to increase testing for COVID-19 across diverse communities in the USA and to inform targeted implementation of COVID-19 vaccines.

Pediatric Oncology and Obesity

Dr. Stern is also involved in several other ongoing grant projects, all related to pediatric oncology and obesity, including several supported by the AYA committee, Moffitt Cancer Center.

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  • Mindfulness in AYA patients undergoing hematopoietic stem cell transplantation: A Pilot Project.
  • The PAWN-Q Study: An exploratory analysis of perceived needs regarding Physical activity, Appearance, Weight, Nutrition, and Quality of life in adolescent and young adult cancer survivors. (Dr. Sylvia Crowder, PI)
  • Health Literacy, Home Environmental Influence and Ethnicity and its Association to Adherence to Nutrition and Physical Exercise Guidelines in Adolescents and Young Adults Cancer Patients and Survivors: An Exploratory Study. (Sandra Soca Lozano, PI)
  • An Exploratory Study of Perceived Stress and Reported Health Behaviors in Adolescent and Young Adult Cancer Survivors  (Dr. Acadia Buro, PI)


Post-Doctoral Research

Ana Paula Dos Santos

Nutrition, obesity, and psycho-oncology


Graduate Student Research

Sandra Soca Lozano

Pediatric Psychology, Pediatric Health, Behavioral Health, Cancer Treatment and Survivorship, Obesity, Healthy Lifestyles, Health Disparities, Social Determinants of Health, Psychological Wellbeing

Jocelyn Jarvis

Health promotion, food insecurity, behavioral health, cultural factors, adolescent and young adult health outcomes

Mina Davari

Metabolic Health, Indicators of Obesity, Eating Disorders, Food Insecurity, and Maternal & Child Health

Sahar Heydari

Food insecurity, global health, implementation science, HIV, health policy, and Health Outcomes & Behavior

 


Our multi-site research collaborators include:

  •  Johns Hopkins Medicine in Baltimore, MD (Site PI: ) 
  • Children's National Hospital in Washington, DC (Site PI: ) 
  • Emory University/Children鈥檚 Hospital of Atlanta in Atlanta, GA (Site PI: ) 
  • University of Florida Health Systems in Gainesville, FL (Site PI: ) 
  • Hackensack Meridian Health in Hackensack, NJ (Site PI: ) 
  • University of Miami Health System/Sylvester Comprehensive Cancer Center in Miami, FL (Site PI: ) 
  • Children鈥檚 Minnesota in Minneapolis, MN (Site PI: ) 

Honors and Awards

Nashira Brown, PhD

Nashira Brown, PhD awarded Karen Calfas Physical Activity Student Research Excellence Award at the 44th Society of Behavioral Medicine's Annual Meeting.

Marilyn Stern, PhD

Honored as Fellow of the American Association for the Advancement of Science (AAAS), recognizing her contributions to the field of psychology, particularly for the development of parent-involved interventions.

Sandra Soca Lozano, MS

: Facilitates members of Society of Pediatric Psychology (SPP) to visit an international research or clinical program for a minimum of one week and up to one month. With this award Sandra will stay for a month in Australia initiating the collaboration of our lab with the Behavioral Science Unit at Sydney Children鈥檚 hospital and their REBOOT project with pediatric cancer survivors.

Diversity supplement grant: A mixed methods approach to evaluating the Role of individual differences: Impact on fruit and vegetable intake outcomes in NOURISH-T+ parents of pediatric cancer survivors.

Karen Calfas Physical Activity Student Research Excellence Award