Grant Number:	3R01CA268034-04S1 Interpret this number
Primary Investigator:	Befort, Christie
Organization:	University Of Kansas Medical Center
Project Title:	Building Capacity to Address Obesity in the State of Kansas in Collaboration with Community Organizations
Fiscal Year:	2025

Project Summary/Abstract This application is being submitted in response to the Notice of Special Interest (NOSI) identified as NOT-CA-25-004. Obesity increases risk for 13 types of cancer and now affects over 40% of the U.S. adult population, with even higher prevalence among rural Americans. Across states, Kansas ranks near the top of national rankings for obesity, contributing to cancer and a range of health problems, placing considerable burden on the state’s healthcare system, workforce, and overall quality of life. While obesity rates have increased for all population groups, some groups face systematic barriers contributing to worse obesity prevalence, including rural residents and certain racial/ethnic minority groups. In Kansas, 26% of the population live in designated rural counties, and the rural population is spread out over 99% of the land area. The high prevalence of obesity in Kansas calls for an integrated approach that spans multiple sectors of society across both rural and urban areas. The parent clinical trial for this supplement, called RETOOL (Rural Engagement in TelemedTeam for Options in Obesity Treatment Solutions) is testing the implementation of a novel team-based approach to treating obesity in rural primary care clinics throughout the state of Kansas. In RETOOL and our previous trials, we have engaged a Patient Advisory Board and Community Advisory Board, trained over 200 local clinicians, and collaborated with local partners to link patients with local community resources. We have observed significant and clinically meaningful changes in weight, nutrition, physical activity, and quality of life, but we have also learned first-hand how individual level outcomes are deeply influenced by a complex system in which individuals live. This supplement will allow us to expand beyond intervention at the individual, medical provider, and clinic or community setting and address broader policy, systems, and environmental changes within a complex system. This supplement coincides with a statewide endeavor supported by the Kansas Department of Health and Environment (KDHE) to develop an Obesity Plan that addresses priorities for both rural and urban areas. With this supplement, we will utilize expertise and resources from the RETOOL parent grant and KU Cancer Center. The objectives are to 1) describe and visualize the prevalence of obesity and its behavioral determinants in the state of Kansas overall and by subgroups (age, sex, race/ethnicity, rural-urban continuum, regions, social disadvantage), 2) convene key collaborators across multiple sectors to conduct systems mapping and an environmental scan, and develop an Obesity Plan for the State of Kansas, and 3) identify the most promising policy, systems, and environmental initiatives across rural and urban areas toward a significant whole of systems effort to address obesity in Kansas. The overall goal is to develop shared knowledge and collaborations across sectors that will lead to future studies addressing whole of systems approaches.





None. See parent grant details.