UK Research Project to Focus on Lung Cancer, Pediatric Obesity in Appalachia

LEXINGTON, Ky. (May 19, 2014) -- The University of Kentucky Center for Clinical and Translational Science (CCTS), in conjunction with the Appalachian Translational Research Network (ATRN), has awarded funding to two projects to develop sustainable, interdisciplinary, community engaged research in Appalachia.

"Raising Awareness About Lung Cancer Screening: Kentucky Terminate Lung Cancer (TLC) Study," will partner with community-based organizations and focus groups to create an awareness campaign encouraging high risk individuals to obtain lung cancer screenings.  The second project, "Circadian Rhythm Parameters and Metabolic Syndrome Associated Factors in Young Children," will examine circadian rhythm parameters and associated health risks and behavioral factors of children in Clay County.

Each project will receive $100,000 over two years to build partnerships between academic researchers and community stakeholders. It is the first pilot funding opportunity from CCTS to require that projects have a community advisory board and that responsibility for the study is shared between the academic and community partners.

"This is the first time we've called for proposals specifically for sustainable partnership," said Tom Curry, director of the CCTS pilot program.  "The idea is that this infrastructure that will come out of the project will stay in place after the funding period."

Dr. Roberto Cardarelli, chief of community medicine in the Department of Family & Community Medicine at UK and director of the Kentucky Ambulatory Network, is the principle investigator of the lung cancer screening project, which is co-funded by the UK Markey Cancer Center. Cardarelli says that Kentucky's lung cancer rates - the highest in the country for both incidence and mortality - demand collaborative, interdisciplinary action that works with communities to develop the most effective interventions. The project thus involves collaboration between UK doctors and researchers, the UK Center of Excellence in Rural Health at Hazard and Morehead, the University of Pikeville/ Kentucky College of Osteopathic Medicine, the Kentucky Cancer Program, the Kentucky Cancer Consortium, and the Appalachian Osteopathic Postgraduate Training Institute Consortium. 

Using the input of a community advisory board and focus groups comprised of 72 community members in Hazard, Pikeville and Morehead, the research team will develop a population-based awareness campaign to encourage high risk individuals to obtain lung cancer screenings, the guidelines for which changed in December 2013. Cardarelli's team will also work to inform physicians in those counties about the changes in the screening guidelines.

"We're trying to determine the best way to reach this target population," Cardarelli said. "Working with community focus groups will help us focus on what we should do with the awareness campaign, versus just trying to guess what might have a meaningful reach to this high risk population."

The project will also assess the impact of using community health workers from Kentucky Homeplace to promote lung cancer screenings. Kentucky Homeplace is housed at the UK Center for Excellence in Rural Health and works to address the "lifestyle choices, environmental factors, inadequate health insurance and general lack of understanding of the healthcare system" that contribute to health disparities of rural populations. Furthermore, the community health workers will be trained to conduct the focus groups, a skillset that they could use in future projects as well.

"We're not going to be successful if we don't listen to our communities," said Dr. Fran Feltner, director of the UK Center for Excellence in Rural Health.

The second project, "Circadian Rhythm Parameters and Metabolic Syndrome Associated Factors in Young Children," is led by co-principle investigators Dr. Jody Clasey, associate professor in the department of kinesiology and health promotion, and Dr. Karyn Esser, professor in the department of physiology. The project draws on the diverse expertise of UK researchers from public health, kinesiology, and physiology in collaboration students and staff of Clay County public schools. The project will use a new, noninvasive skin temperature monitoring system with activity monitors to analyze the potential impact of circadian rhythm disruption as a contributing risk factor to the development of obesity and metabolic syndrome in school children.

Clasey says that the research team hopes to learn about the relationship between circadian rhythms, feeding and activity behaviors and the incidence of overweight and obesity in children. Previous studies have demonstrated circadian rhythm disruption is associated with increased risk for metabolic disease in adults.  With new findings implicating time of feeding and time of activity as contributors to circadian health there is reason to believe that these lifestyle factors may contribute to metabolic health in children, but to date, very little is known. 

Kentucky has elevated rates of childhood obesity and overweight, but the incidence is particularly high in rural Appalachian areas.

"We have an epidemic of obesity, and there's a fair amount of evidence that there's some sort of relationship between obesity and circadian rhythms, but we don't really understand the direction of that relationship," said Dr. Mark Swanson, associate professor in the UK College of Public Health and a member of the research team. "With nearly half the kids in the Clay county schools being overweight or obese, we need to get a clear understanding of all the factors related to obesity."

The research could also identify potential ways the school systems may work to better align the structure of the school day with children's natural body cycles.

"We're hoping that this will give us information to better structure our school day so that it to matches students' circadian rhythms and they can get the most out of their educational experiences," said Dr. Deann Allen, who works as the instructional supervisor, district assessment coordinator, and district health coordinator for Clay County public schools.  

A particularly unique aspect to the project is that it gives the fourth and fifth grade Clay County students first-hand experience in the research and data collection. The students will wear small monitors, about the size of a watch battery, on their wrist for a week to gather physiological data. The students will also report each day on their sleep and eating activities. In exchange for their participation, the students will be rewarded with a field trip to UK's campus and a bookstore.

"This is a chance for our students to interact with real researchers," said Allen. "And we want to make sure that every child, whether in the city limits or on the banks of the Kentucky River, has the same opportunities."

The project builds upon a partnership that was originally initiated by Dr. Jill Day, a Clay County native turned UK faculty member, who partnered with the Clay County school system to study the relationships between physical activity, body composition, and academic achievement in rural children for her Ed.D dissertation at UK.

Allen describes Day as a local hero who is inspiring a generation in Clay County.

"She has a servant's heart and she wants to give back to her community, and what better way than to influence the next generation of scientist," Allen said of Day.

Day knows that for some of the students, the trip to UK will be the first time that they've left Eastern Kentucky.

"For some of them, it will be a once-in-a-lifetime opportunity that they've never had-- to come here to UK and see that there's more than that what's in their hometown, and get them excited about science and research and their own health."

MEDIA CONTACT: Mallory Powell, mpowell@uky.edu