Researchers Target Disparities in Childhood Obesity

Richard White, M.D., Community Internal Medicine, wants to improve the odds for inner-city adolescents in Jacksonville, Florida, to live long and healthy lives.

“Some reports have suggested this may be the first generation that doesn’t necessarily outlive their parents," says Dr. White. "That’s a very concerning and provoking thought.”

In research funded by the Mayo Clinic Office of Health Disparities Research, Dr. White’s team recruited 20 pairs of adolescents and their adult caregivers in Health Zones 1 and 6 — primarily African-American neighborhoods that are among the poorest in Jacksonville.

In the study, Dr. White’s team determined that more than half of the adolescents were obese or severely obese, and their adult caregivers also had high obesity rates. The team found that both groups responded better to positive messages about healthy choices than to negative messages that highlight barriers.

Through targeted interventions, the researchers aim to help adolescents overcome obesity and the risk of future health problems like diabetes and cardiovascular disease.

Obesity prevalence in adolescents is high in urban, low-income neighborhoods and tied to a complex array of factors, such as poor diet and exercise, targeted marketing of unhealthy foods, and the behaviors of adult caregivers.

“I think that people in these communities understand that they face a lot of significant barriers, but they may not have many people coming and encouraging them to focus on … things that they can do to improve their health,” says Dr. White.

To leverage community strengths and improve the research, Dr. White’s team collaborates with a Mayo-sponsored community advisory board. The advisory board helped develop study recruitment strategies and suggested changes in the research protocol, like using the term "healthy weight" instead of "obesity."

This collaboration is an example of community-based participatory research, in which communities are equal partners in every step of the research process — from conception to communication of results.

In a second phase of the study, the team is conducting focus groups with the adolescent-adult pairs to identify the motivators and barriers that contribute to obesity.

This work starts with building trust, according to Dr. White. “In general, people are not going to be willing to participate with you until they know that you care about them and that you have their best interests at heart,” he says.

“I think that, for Mayo Clinic, addressing disparities very much falls in line with our mission and who we are as an organization, as the needs of our patients come first ... We owe it to our values and morals to make a concerted effort to ensuring that members of our society have equal access to quality health care,” says Dr. White.

— Kris Schanilec, Public Affairs