# StEP OUT

> **NIH NIH K23** · FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH · 2022 · $190,836

## Abstract

PROJECT SUMMARY/ABSTRACT
This Mentored Patient-Oriented Research Career Development Award (K23) proposal will address an urgent
need to advance the science of child obesity prevention in low-income, minority communities, a priority of the
National Heart, Lung, and Blood Institute. Simultaneously, it will prepare the applicant, Michelle Katzow, MD,
MS, to become an independent investigator specializing in interventions that begin in pregnancy to prevent
child obesity using innovative and scalable delivery platforms. Risk factors for lifelong cardiometabolic
morbidity and mortality related to obesity are identifiable in pregnancy and early infancy, with the highest
prevalence in low-income, Latinx communities. Few interventions have improved child obesity related
outcomes in this high-risk group. The Starting Early Program (StEP) was designed to fill this gap. The program
delivers nutrition and parenting support sessions in the primary care setting and has significant positive
impacts on child obesity-related outcomes. These impacts are dose dependent, such that families who attend
more sessions have significantly better outcomes than families who attend fewer sessions. Many families cite
geographic distance as a major barrier to program engagement. Though the original program was delivered in
person, a second cohort receiving the program in 2020 experienced a rapid conversion to remote,
videoconference delivery due to the global pandemic. Despite many challenges posed by the pandemic,
attendance among participants in this ongoing cohort has been higher than among participants in the original,
in-person cohort. In addition to improving attendance, remote delivery has created opportunities for more
frequent sessions than would be typical in contexts outside of primary care that are otherwise well-suited for
obesity prevention programs, such as the Special Supplemental Nutrition Program for Women, Infants, &
Children (WIC). WIC reaches more than half of all infants in the nation and has a high concentration of children
at risk of obesity. However, no studies have examined videoconference-based, longitudinal interventions for
child obesity prevention in WIC. This K23 proposes to develop and test Starting Early to Prevent Obesity Using
Telehealth (StEP OUT), an adapted version of StEP optimized for remote, virtual delivery through WIC. Aim 1
will identify knowledge and attitudes of key stakeholders likely to impact engagement and outcomes of StEP
OUT; Aim 2 will iteratively adapt and test StEP OUT in sequential small cohorts; and Aim 3 will conduct a pilot
randomized controlled trial (RCT) to evaluate acceptability and feasibility of StEP OUT. In the process, the
candidate will obtain essential career development skills in four domains: 1) qualitative methods; 2) CBPR; 3)
iterative intervention adaptation; and 4) conduct of clinical trials in vulnerable populations. The resources of
Northwell Health and an expert team of interdisciplinary mentors and a...

## Key facts

- **NIH application ID:** 10449005
- **Project number:** 1K23HL159326-01A1
- **Recipient organization:** FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH
- **Principal Investigator:** Michelle Weiss Katzow
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $190,836
- **Award type:** 1
- **Project period:** 2022-07-01 → 2027-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10449005

## Citation

> US National Institutes of Health, RePORTER application 10449005, StEP OUT (1K23HL159326-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10449005. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*