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Topics: Child Health, Clinical & Translational Research, Community Engagement, Five Questions

Five Questions With … Elsie Taveras

Our co-faculty lead for child health discusses her research on obesity as part of our Community Engagement program.

Elsie M. Taveras, MD, MPH, a faculty leader of our Community Engagement program, is executive director of the Kraft Center for Community Health at Massachusetts General Hospital, where she is chief of the Division of General Academic Pediatrics. The Conrad Taff Professor of Nutrition in Pediatrics at Harvard Medical School, she is also professor in the Department of Nutrition at the Harvard T.H. Chan School of Public Health.

You grew up in a working-class American immigrant family in the Bronx. What inspired you to go into pediatrics and research?

I was inspired by a desire to improve health outcomes for children and their families. I was particularly interested in pediatrics because there is so much opportunity for influencing health trajectories through prevention and adoption of early healthy behaviors, as opposed to working to change those practices and outcomes once they’re established.

During my residency, I started thinking about how I could make a broader impact beyond one-on-one patient care through public health and population health. That’s why I got my master’s in public health and started focusing my research on a health condition that disproportionately affects racial, ethnic, minority, and low-income populations — obesity.

Describe some of your work on the origins of childhood obesity. Why is it so important to study in the context of community?

The research that I do has several different components and spans the spectrum of epidemiology, exploring risk factors in early life and throughout childhood that increase the risk for obesity and chronic diseases. My research is also translational, bringing research innovation to the community health market. I’ve used some of the epidemiology to develop interventions to prevent and manage obesity in early life and throughout childhood.

And some of that translational work has taken me to community-based settings as well as clinical settings. Particularly for childhood obesity, I think that’s important. The community is where children and their families spend most of their time. How do we influence those settings to improve their health and health behaviors?

“The community is where children and their families spend most of their time. How do we influence those settings to improve their health and health behaviors?”

From your translational work, what strategies are rising to the top as best for encouraging healthy child weight?

That’s a challenging question because the influences are multifactorial. There are obviously genetics and inheritance influences on obesity. There is also a large influence from environmental and psychosocial conditions. Our research indicates that there are social determinants of obesity that can be mitigated by social support and systematic efforts.

But our research has also shown that there are health behaviors and habits that can be adopted early in life about which we can counsel and teach families. For example, we can focus on early life feeding.

That includes encouraging breastfeeding and delaying the introduction of solid food, not introducing sugary beverages, planning meals to prepare at home instead of fast food, and adopting healthy behaviors around sleep, ensuring good sleep quality and quantity. It also includes following a nutrition plan that promotes the healthy microbiome.

How does the Harvard Catalyst Community Engagement program aim to improve child health?

A lot of the work that we and other researchers do is focused on a clinical setting. We seek to expand the bi-directional relationship and engagement between our clinicians-researchers and researchers in community-based organizations to look for solutions in those settings.

We want to increase the collective impact of the work that we are doing around obesity. In follow-up to our symposium in 2018 on Advancing Uptake of Evidence and Community Engagement for Healthy Child Weight, we funded two projects. We’re excited about the work these grantees are doing to link Harvard Catalyst researchers with community-based organizations and to really catalyze what was happening before in isolation.

What is the appeal for you of the new Implementation Science Center for Cancer Control Equity that you and Karen Emmons, PhD, are heading?

Much of my research is around the prevention of chronic diseases and we know that obesity is responsible for a number of chronic diseases, including some cancers. But the main appeal is that I feel very strongly that we need to do more to take already proven, effective programs and innovations and increase their adoption and implementation in settings that care for low-income families. There are so many health disparities among vulnerable populations.

The Implementation Science Center, funded recently by the National Cancer Institute, is going to allow that. It’s going to increase the adoption of proven cancer control interventions in community health centers. It’s a really great example of the kind of things we want to encourage and expand upon in community engagement.

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