Phillip J. Brantley - US grants

behavior therapy; human therapy evaluation; obesity; weight control; Internet; weight loss; social facilitation; computer assisted instruction; computer assisted patient care; telemedicine; clinical trials; cooperative study; patient oriented research; behavioral /social science research tag; human subject; clinical research;

Overweight/obesity is the second leading cause of death in the US, and is growing in prevalence at an alarming rate. Control of overweight/obesity is increasingly recognized as a high national priority because of its contribution to cardiovascular (CVD) risk factors and ultimately to CVD itself. The short-term success of behavioral interventions for weight loss has been repeatedly documented. Unfortunately, because weight re- gain is extremely common, a disappointingly small proportion of individuals achieve long-term weight control. Of the factors that are associated with sustained weight loss, one of the most important is continued intervention with frequent contacts. We propose a multi-center, randomized, controlled trial [Weight Loss Maintenance Trial (MAINTENANCE)] to determine the effects of two innovative behavioral interventions, each designed to maintain frequent contacts, compared to a usual care control group. Overweight and obese individuals (-60% women, -40% African Americans) who are taking medication for hypertension, dyslipidemia and/or type 2 diabetes will enter a 6 month weight loss program. Those individuals who lose at least 4 kg (N = 800) will then be randomized into one of three groups: a Personal Contact (PC) Intervention that provides monthly personal contacts with a trained interventionist, primarily via telephone; an Interactive Technology (IT) Intervention that provides frequent contacts through a state-of-the-art interactive web-based program supplemented by other communication technologies; or Usual Care (UC). The primary outcome will be weight change from the end of the initial weight loss program to the end of the 30-month weight maintenance intervention period. Other outcomes will include weight change in subgroups, prevalence of CVD risk factors, measures of behavior change, and cost of implementation. For each outcome, the PC and IT interventions will be compared to UC, and if different from UC, to each other. To successfully combat the obesity epidemic, clinicians and health care systems must have options that are effective and feasible, and that can be provided to large numbers of individuals. The purpose of this proposal is to develop and test two such interventions, which, if effective, should complement ongoing efforts to stem the obesity epidemic and ultimately prevent obesity-related CVD.

DESCRIPTION (provided by applicant): Obesity/overweight is rampant in the United States and has been acknowledged as the second leading cause of death, behind smoking. Obesity has been linked to diabetes, hypertension, cardiovascular disease and cancer. Efforts to understand and manage this complex disease have met with modest success such that obesity continues to grow in prevalence at an alarming rate in both adults and children. It is likely that research which transcends traditional boundaries of research and focuses on cross-disciplinary approaches to research questions may provide the answers needed to conquer this grave threat to the health of individuals in developed countries. A research Training Program entitled, "Obesity: From Genes to Man," is proposed for the Pennington Biomedical Research Center, Louisiana State University. The objective of this program is to train Ph.D. postdoctoral fellows to become productive research scientists capable of establishing scientific careers that further the efforts of the NIH to understand the complex interactions between genetic, molecular, physiological and behavioral aspects of obesity. Many molecular biologists/geneticists have been attracted into the obesity research field but lack the physiological/metabolic/behavioral expertise to fully exploit their discoveries. Conversely, physiological /metabolic and behavioral studies need to be complemented by molecular and genetic approaches for a fuller understanding. We aim to bridge the divide between the molecular/genetic approaches and the physiological/behavioral studies of the functions of specific genes by providing training in these areas and by selecting research projects for the postdoctoral fellows that are particularly appropriate to this approach. Each postdoctoral fellow will be encouraged to develop these transdisciplinary research efforts to understand an aspect of the obesity disease. The program will take advantage of the cutting-edge technologies and the wide range of research efforts related to obesity that are available at the Pennington Center.

DESCRIPTION (provided by applicant): Obesity/overweight is rampant in the U.S. and has been acknowledged as the second leading cause of death. Obesity has been linked to diabetes, hypertension, cardiovascular disease, and cancer. Efforts to understand and manage this complex disease have met with modest success such that obesity continues to grow in prevalence at an alarming rate in both adults and children. It is likely that research which transcends traditional boundaries of research and focuses on cross-disciplinary approaches to research questions may provide the answers needed to conquer this grave threat to the health. This application is a request for renewal funding for the Pennington Biomedical Research Center (Louisiana State University System) training program Obesity: From Genes to Man. This program was funded originally in 2003, and renewed successfully in 2007. One of the aims of this grant is to train postdoctoral fellows in the complex interactions between genetic, molecular, physiological, and behavioral aspects of obesity. The objective of this program is to train Ph.D. and M.D. postdoctoral fellows to become productive research scientists capable of establishing scientific careers in academia, academic medicine, governmental agencies, and in the private sector. These junior scientists will further the efforts of the NIH to understand the complex interactions between genetic, molecular, physiological, and behavioral aspects of obesity. Many molecular biologists/geneticists are interested in obesity-related research, but lack the physiological/metabolic/behavioral expertise to maximize their research discoveries. Conversely, physiological /metabolic/behavioral studies need molecular and genetic approaches for a fuller understanding. We aim to bridge the divide between the molecular/genetic approaches and the physiological/behavioral studies of the functions of specific genes by providing training in these areas. Each postdoctoral fellow will be encouraged to develop these transdisciplinary research efforts to understand multiple aspects of obesity and obesity-related disease. The program will take advantage of the cutting-edge technologies and the wide range of research efforts related to obesity available at Pennington Biomedical. This broad-based, training program will enable trainees to acquire transdisciplinary research skills and write competitive grant proposals addressing important questions which will move our science forward. The faculty of Pennington Biomedical are committed to postdoctoral research training and see this as inseparable from their goal of excellence in research. This application is requesting five additional years of funding for six (6) trainee positions per year. We will recruit M.D.s and Ph.D.s from the basic, clinical, and population science disciplines including biology, physiology, kinesiology, neuroscience, public health, and psychology. The majority of trainees will enter into the program with no prior postdoctoral training. However, for the first year of funding, we have requested three slots for individuals with prior training in order to accommodate those fellows currently in the program who remain eligible to continue. Trainees will be supported for two to three years.

DESCRIPTION (provided by applicant): Today's researchers need to understand the applications of molecular and genetic approaches as well as the methods for investigating the function of target genes and the effect specific botanicals may have on these processes. Postdoctoral training will be directed toward evaluating the interactions between botanical characterization and molecular/genetic/physiologic approaches at both the basic science and clinical research areas to achieve the ultimate goal of understanding how botanicals can contribute to health maintenance. Thus, a resubmission of a renewal application titled, Training in Botanical Approaches to Combat Metabolic Syndrome is proposed. The continued objective of this training program is to train both Ph.D. and M.D. postdoctoral fellows to become productive research scientists capable of establishing scientific careers that further the efforts o understand the role of botanicals on the complex interactions between genetic, molecular and physiological aspects of the metabolic syndrome and for maintaining human health. Specifically, we will continually aim to bridge the divide between the plant discovery and characterization approach and the molecular biology/physiological approach. We are requesting 16 full-time postdoctoral trainee stipends across the five-year grant period. Trainees will be supported for two to three years. Each postdoctoral fellow will be encouraged to develop interdisciplinary research efforts to understand the effect and action of botanicals on components of the metabolic syndrome. The program will take advantage of the synergy and the cutting-edge technologies of an NCCAM sponsored Botanical Research Center composed of the wide range of research approaches to metabolic syndrome that are available at the Pennington Biomedical and the plant science expertise of the Rutgers Department of Plant Biology and Pathology. This broad-based training program will enable trainees to establish successful research careers in academia, academic medicine, government agencies and in the private sector in the study of botanicals and metabolic disease.

DESCRIPTION (provided by applicant): In order to effectively address the need for physician scientists who are trained to conduct biomedical research, we propose an innovative, short-term research training program for pre-matriculating and matriculated medical students at LSUHSC-New Orleans. This Summer Internship Program (SIP) will support twelve students to work with researchers at the Pennington Biomedical Research Center (PBRC) and is designed to cultivate their interest in research careers. We have identified over40 faculty mentors who are working in the areas of diabetes, obesity and metabolic disorders. Students will conduct intensive hands-on clinical or basic science research for 10 weeks in the summer, working with PBRC faculty. Those students who participate for a second summer (pre-matriculated students) will act as peer mentors to incoming students, thus providing an important mentoring component to the program. The goals of this program include: 1) to provide medical students with research experiences; 2) to provide students with strong career and research mentoring; 3) to increase the participation in research by women and minority students; 4) to provide summer interns with the career skills they will need to succeed in academic medicine. In addition to their research experience, students will attend a didactic training series on: lab safety, responsible conduct of research, HIPPA, writing abstracts and presenting research results (oral and poster presentations). At the end of the summer, students will give an oral presentation at the Summer Research Symposium; they will also be supported to present their data at national or regional meetings as well. We will work to recruit at least 20% underrepresented minority participants, reflecting the demographics of the LSU medical school class. In order to determine the impact the program has on individual participants, summer interns will complete Goals Attainment Scales (GAS) as well as Research Self Efficacy (RSE) surveys. GAS has been shown to be a valuable and flexible technique for the evaluation of summer research training programs. RSE is a major predictor of career choice and performance. We will also conduct formative and summative evaluations concerning the entire program, in order to determine what programmatic changes may be needed and to tailor the program to better meet the needs of the students. Lastly, working with the Office of Student Affairs, we will implement a career tracking system which will measure the long-term impact of their summer experience on career choices and research participation, thus quantifying the long-term impact of this program. This program will help to create the next generation of physician researchers who are prepared to address the underlying causes of and treatment for some of the most common, chronic, and costly diseases affecting people in this country. PUBLIC HEALTH RELEVANCE: We propose an innovative, short-term research training program for medical students in Pennington Biomedical Research Center clinical trials and research labs. The LSU-NIDDK Medical Student Research Program is designed to cultivate students' interest in research careers by having them work on research projects on obesity, diabetes and metabolic diseases. This program will help to create the next generation of physician researchers who are prepared to conduct the translational research that quickly transforms basic science discoveries into new clinical therapies.

F. Abstract (Enrichment Program) The Enrichment Program conducts activities that support the mission of the NORC and are designed ?to facilitate and promote collaborative and multidisciplinary interactions that will foster new research ideas and enhance the translation of basic nutritional research findings into the clinical arena and ultimately into clinical application?. It provides opportunities to foster multidisciplinary approaches to nutrition/obesity research and to attract new investigators or investigators with relevant expertise to the field. The program accomplishes this by 1) improving communication among NORC researchers, 2) monitoring the activities of investigators associated with the NORC grant, 3) promoting awareness of the NORC and disseminating information about its research findings to other scientists, health care professionals and the community, and 4) coordinating events that attract distinguished nutritional scientists to Pennington Biomedical. The Program teams with other NIH sponsored research and training groups in Louisiana (The Louisiana Clinical and Translational Science Center, Pennington Biomedical's Center of Biomedical Research Excellence, two T32 Training Grants, one T35 training grant) to maximize resources for training and enrichment. The program is directed by Dr. Phillip Brantley who has extensive experience in scientific education and has served in his current position since the inception of the NORC. A variety of vehicles will be used to deliver the enrichment opportunities including formal coursework, hands on laboratory mentoring, seminars, workshops, scientific retreats, web based training, newsletters and community health fairs. Efforts will be made to reach out across the state and to provide enrichment opportunities for current and future nutrition/obesity researchers at multiple career levels including NORC member scientists, faculty from Louisiana universities and medical schools, postdoctoral fellows, graduate and undergraduate students, and medical students. Future plans include expansion of activities to include clinical investigators across Louisiana involved in the recently funded PCORI trial to reduce obesity in primary care and with the state wide expansion of the HEADS UP study examining insurance sponsored surgical and nonsurgical weight management.

PROJECT SUMMARY Obesity is rampant in the U.S. and has been acknowledged as a leading cause of death. Obesity has been linked to diabetes, hypertension, cardiovascular disease, dementia, and cancer. Efforts to understand and manage this complex disease have met with modest success such that obesity and particularly severe obesity continues to grow in prevalence at an alarming rate in both adults and children. It is likely that research which transcends traditional boundaries of research and focuses on transdisciplinary approaches to research questions may provide the answers needed to conquer this grave threat to public health. This application is a request for renewal funding for the Pennington Biomedical Research Center-LSU training program originally titled ?Obesity: From Genes to Man?. This T32 program which trains postdoctoral fellows was first funded in 2003, and successfully renewed in 2007 and 2012. The aim of this application, now titled ?Training in Obesity Research? is to train postdoctoral fellows in the complex interactions between genetic, molecular, physiological, behavioral and population aspects of obesity. The objective of the Training in Obesity Research T32 program is to prepare postdoctoral fellows to become productive research scientists capable of establishing independent scientific careers in academia, governmental agencies, and in the private sector. These junior scientists will further the efforts of the NIH to understand obesity and attenuate its impact on public health. During their 2-3 years of training, the postdocs will be exposed to the model of team science and will receive instruction in scientific writing, grant writing, methods to assure rigor and reproducibility of research, and the use of big data and bioinformatics. The program will take advantage of the cutting-edge technologies and the wide range of research efforts related to obesity available at Pennington Biomedical. This broad- based, training program will enable trainees to acquire transdisciplinary research skills and write papers and competitive grant proposals addressing important questions, which will move our science forward and help them to develop into independent researchers. Pennington Biomedical is committed to postdoctoral research training and sees this as inseparable from their goal of excellence in research. This application is requesting five (5) additional years of funding for five (5) trainee positions per year.

Project Summary This application requests a second renewal for our Ruth L. Kirschstein National Research Service Award (NRSA) Institutional Research Training Grant (T32) entitled ?Training in Botanical Approaches to Combat Metabolic Syndrome.? This training program is a collaborative effort between the Pennington Biomedical Research Center of Louisiana State University and the Departments of Plant Biology and Food Science at Rutgers University. The objective of this program is to train the highest caliber of postdoctoral fellows to become productive scientists integrating biomedical research methods and botanical discovery research with the capability of establishing successful scientific careers in academia, academic medicine, governmental agencies, and in the private sector. Metabolic syndrome is prevalent, poses a significant threat to public health, and it is characterized by the presence of co-existing traditional risk factors for cardiovascular disease (e.g. hypertension, dyslipidemia, glucose intolerance, obesity and insulin resistance). Preventative approaches for metabolic syndrome often primarily focus on lifestyle interventions. However, maintenance of lifestyle changes over time is poor. Thus, nutritional supplementation with botanicals that effectively address pathogenic mechanisms, combined with the acceptance and widespread use of supplements by the general public, present an attractive, novel and potentially effective approach to combat metabolic syndrome. Therefore, research training provided by this T32 will be directed toward evaluating the interactions between botanical characterization and the molecular, genetic, and physiologic approaches to achieve the ultimate goal of understanding how botanicals can contribute to health and normal tissue function. The program emphasizes hands on research training in an environment that encourages and facilitates transdisciplinary research and team science. The program will also benefit from the synergy and cutting-edge technologies of the NCCIH-sponsored Botanical Dietary Supplements Research Center (BDSRC) also focused on botanical supplements and metabolic syndrome. This integration between the T32 and the BDSRC provides trainees the opportunity to pursue studies with investigators whose interest span all organ systems impacted by obesity and metabolic syndrome. Since it began in 2009, this T32 program has graduated 15 postdocs who have remained in research-oriented careers and have acquired 30 grants (8 from NIH). Eleven graduates are now in academia and four are in industry. Seven postdocs are still in training. In total, this program?s 22 trainees have published 124 papers on their T32 projects including 66 first author papers. We are requesting 7 full-time postdoctoral trainee positions per year (5 at Pennington Biomedical and 2 at Rutgers) for the next five-year grant cycle (2020-2025). Trainees will be supported for two to three years. Each postdoctoral fellow will be encouraged to develop interdisciplinary research efforts to understand the effects of botanicals on components of metabolic syndrome.