NR503 Week 1 Assignment: The Relationship between Obesity and Cancer

NR503 Week 1 Assignment: The Relationship between Obesity and Cancer – Step-by-Step Guide

The first step before starting to write the NR503 Week 1 Assignment: The Relationship between Obesity and Cancer, it is essential to understand the requirements of the assignment. The first step is to read the assignment prompt carefully to identify the topic, the length and format requirements. You should go through the rubric provided so that you can understand what is needed to score the maximum points for each part of the assignment. 

It is also important to identify the audience of the paper and its purpose so that it can help you determine the tone and style to use throughout. You can then create a timeline to help you complete each stage of the paper, such as conducting research, writing the paper, and revising it to avoid last-minute stress before the deadline. After identifying the formatting style to be applied to the paper, such as APA, you should review its use, such as writing citations and referencing the resources used. You should also review how to format the title page and the headings in the paper.

How to Research and Prepare for NR503 Week 1 Assignment: The Relationship between Obesity and Cancer

The next step in preparing for your paper is to conduct research and identify the best sources to use to support your arguments. Identify the list of keywords from your topic using different combinations. The first step is to visit the university library and search through its database using the important keywords related to your topic. You can also find books, peer-reviewed articles, and credible sources for your topic from PubMed, JSTOR, ScienceDirect, SpringerLink, and Google Scholar. Ensure that you select the references that have been published in the last words and go through each to check for credibility. Ensure that you obtain the references in the required format, for example, in APA, so that you can save time when creating the final reference list. 

You can also group the references according to their themes that align with the outline of the paper. Go through each reference for its content and summarize the key concepts, arguments and findings for each source. You can write down your reflections on how each reference connects to the topic you are researching about. After the above steps, you can develop a strong thesis that is clear, concise and arguable. Next you should create a detailed outline of the paper so that it can help you to create headings and subheadings to be used in the paper. Ensure that you plan what point will go into each paragraph.

How to Write the Introduction for NR503 Week 1 Assignment: The Relationship between Obesity and Cancer

The introduction of the paper is the most crucial part as it helps to provide the context of your work, and will determine if the reader will be interested to read through to the end. You should start with a hook, which will help capture the reader’s attention. You should contextualize the topic by offering the reader a concise overview of the topic you are writing about so that they may understand its importance. You should state what you aim to achieve with the paper. The last part of the introduction should be your thesis statement, which provides the main argument of the paper.

How to Write the Body for NR503 Week 1 Assignment: The Relationship between Obesity and Cancer

The body of the paper helps you to present your arguments and evidence to support your claims. You can use headings and subheadings developed in the paper’s outline to guide you on how to organize the body. Start each paragraph with a topic sentence to help the reader know what point you will be discussing in that paragraph. Support your claims using the evidence conducted from the research, ensure that you cite each source properly using in-text citations. You should analyze the evidence presented and explain its significance and how it connects to the thesis statement. You should maintain a logical flow between each paragraph by using transition words and a flow of ideas.

How to Write the In-text Citations for NR503 Week 1 Assignment: The Relationship between Obesity and Cancer

In-text citations help the reader to give credit to the authors of the references they have used in their works. All ideas that have been borrowed from references, any statistics and direct quotes must be referenced properly. The name and date of publication of the paper should be included when writing an in-text citation. For example, in APA, after stating the information, you can put an in-text citation after the end of the sentence, such as (Smith, 2021). If you are quoting directly from a source, include the page number in the citation, for example (Smith, 2021, p. 15). Remember to also include a corresponding reference list at the end of your paper that provides full details of each source cited in your text. An example paragraph highlighting the use of in-text citations is as below:

The integration of technology in nursing practice has significantly transformed patient care and improved health outcomes. According to Smith (2021), the use of electronic health records (EHRs) has streamlined communication among healthcare providers, allowing for more coordinated and efficient care delivery. Furthermore, Johnson and Brown (2020) highlight that telehealth services have expanded access to care, particularly for patients in rural areas, thereby reducing barriers to treatment.

How to Write the Conclusion for NR503 Week 1 Assignment: The Relationship between Obesity and Cancer

When writing the conclusion of the paper, start by restarting your thesis, which helps remind the reader what your paper is about. Summarize the key points of the paper, by restating them. Discuss the implications of your findings and your arguments. End with a call to action that leaves a lasting impact on the reader or recommendations.

How to Format the Reference List for NR503 Week 1 Assignment: The Relationship between Obesity and Cancer

The reference helps provide the reader with the complete details of the sources you cited in the paper. The reference list should start with the title “References” on a new page. It should be aligned center and bolded. The references should be organized in an ascending order alphabetically and each should have a hanging indent. If a source has no author, it should be alphabetized by the title of the work, ignoring any initial articles such as “A,” “An,” or “The.” If you have multiple works by the same author, list them in chronological order, starting with the earliest publication. 

Each reference entry should include specific elements depending on the type of source. For books, include the author’s last name, first initial, publication year in parentheses, the title of the book in italics, the edition (if applicable), and the publisher’s name. For journal articles, include the author’s last name, first initial, publication year in parentheses, the title of the article (not italicized), the title of the journal in italics, the volume number in italics, the issue number in parentheses (if applicable), and the page range of the article. For online sources, include the DOI (Digital Object Identifier) or the URL at the end of the reference. An example reference list is as follows:

References

Johnson, L. M., & Brown, R. T. (2020). The role of telehealth in improving patient outcomes. Journal of Nursing Care Quality, 35(2), 123-130. https://doi.org/10.1097/NCQ.0000000000000456

Smith, J. A. (2021). The impact of technology on nursing practice. Health Press.

NR503 Week 1 Assignment: The Relationship between Obesity and Cancer Instructions

NR503 Week 1 Assignment Requirements  

• Chapter 1, Exercise 1.5

Exercise 1.5 The relationship between obesity and cancer is described and discussed in this chapter. Conduct a search to answer the following questions. Have a look at NR503 Week 2 Healthy People 2020 Impact Paper.

The incidence rates for six cancers associated with obesity are increasing in young Americans. Identify them.

What is the prevalence rate of obesity in people younger than 18 in the state of Virginia? Which children are at the highest risk for obesity in the state of Virginia? Are there any prevention programs in your state that address this issue? Are they effective? Has your state passed and enacted any laws designed to decrease obesity? Are they effective? If they are not effective, explain why you believe they are not working.

Respond with a minimum of two (2) paragraphs of 4-5 sentences each.   

1. You should address each bullet point in the exercise you select.  
2. Your work should have in-text citations integrating at a minimum one scholarly article from this week’s readings and course textbook.  
3. APA format should be utilized to include a reference list.  
4. Correct grammar, spelling, and APA should be adhered to when writing, work should be scholarly without personalization or first person use. 
5. Respond to a minimum of two (2) individuals, peer and/or faculty, with a scholarly and reflective post of a minimum of two (2) paragraphs of 4-5 sentences. A minimum of one (1) scholarly article should be utilized to support the post in addition to your textbook. 

Population-Based Nursing, Third Edition

Ann L. Curley, PhD, RN

Obesity

In 2009, researchers published their analysis of the cost of obesity in the United States, taking into account separate categories for inpatient, outpatient, and prescription drug spending. They estimated that the medical costs of obesity may have been as high as $147 billion/year by 2008 (including $7 billion in Medicare prescription drug costs). According to their findings, the annual medical costs for people who are obese were $1,429 higher than those for normal-weight people (Finkelstein, Trogdon, Cohen, & Dietz, 2009).

10As part of Healthy People 2020, the United States set an objective to decrease the proportion of obese adult Americans (20 years of age or older) to 30.5%. Healthy People 2020 use the baseline of 33.9%, which was the percentage of persons aged 20 years and older who were obese in 2005 to 2008. The target objective for children (aged 2 to 19 years) is 14.5%. The baseline data for this objective is 16.1%, which was the percentage of children who were considered obese in 2005 to 2008 (HealthyPeople.gov, 2019).

For the years 2015–2016 the prevalence of obesity among adults in the U.S. was 39.8%. This represents an increase from the Healthy People baseline. The highest rates were found among Hispanics (47.0%) and non-Hispanic Blacks (46.8%) followed by non-Hispanic Whites (37.9%) and non-Hispanic Asians (12.7%). Young adults had the lowest prevalence rate (35.7%) and middle-aged adults had the highest (42.8%; CDC, 2018c).

The CDC (2018d) reports that the prevalence of obesity among children (aged 2–19) in the United States is 18.5% (an increase over the Healthy People baseline data). The prevalence rate is lowest for children aged 2 to 5 (13.9%) and highest for children aged 12 to 19 (20.6%). It is most common for Hispanic (25.8%) and non-Hispanic Blacks (22.0%). It is lowest for non-Hispanic Whites (14.1%) and non-Hispanic Asians (11.0%).

Obesity is associated with increased morbidity and mortality rates. Abdelaal, le Roux, and Docherty (2017) have summarized the most important comorbidities of obesity. They point out that obesity can cause both psychosocial (depression) and metabolic (diabetes) dysfunction and identified 13 specific domains that account for morbidity and mortality in obesity. Cardiovascular disease (CVD) and cancer account for the greatest mortality risk associated with obesity even when controlling for demographic and behavioral characteristics.

Although people are familiar with the association between heart disease and obesity, many are just learning about the relationship between obesity and cancer. Obesity is associated with an increased risk for many cancers, including esophageal, pancreatic, colon and rectal, breast (after menopause), endometrial, kidney, thyroid, and gallbladder. It has been estimated that the percentage of cases attributed to obesity (although it varies) may be as high as 54% for some cancers (National Cancer Institute, 2017).

Jacobs et al. (2010) published a study that helps to illustrate the complexity of understanding risk factors and their relationship to the development of poor health. They studied the association between waist circumference and mortality among 48,500 men and 56,343 women 50 years or older. They determined that waist circumference as a measure of abdominal obesity is associated with higher mortality independent of body mass index (BMI).

They note that waist circumference is associated with higher circulating levels of inflammatory markers, insulin resistance, type 2 diabetes, dyslipidemia, and coronary heart disease. In recent years, the constellation of these factors has been described as the metabolic syndrome. Metabolic syndrome is a complex syndrome that encompasses many conditions and risk factors, particularly abdominal obesity, high blood pressure, abnormal cholesterol and triglyceride levels, and insulin resistance, and is known to be associated with an increased risk of stroke, heart disease, and type 2 diabetes (Grundy, 2016).

The increasing prevalence of metabolic syndrome is becoming a tremendous public health concern, and more evidence is appearing in the literature to better define the 11treatment as well as preventive measures needed to reduce the incidence. Although it is ill defined in children and adolescents, it is clear that early interventions to reduce obesity and sedentary behavior and to improve nutrition can have long-term effects and can improve overall life expectancy. Metabolic syndrome, similar to many conditions, demonstrates the complexity of interactions that occur in disease development and that no one factor in and of itself can be targeted alone.

Our understanding of obesity is also becoming more complex, as new studies have identified independent associations between sitting time/sedentary behaviors and increasing all-cause and cardiovascular disease mortality risk. This phenomenon highlights the importance of exercising and avoiding prolonged, uninterrupted periods of sitting time (Patel, Maliniak, Rees-Punia, Matthews, & Gapstur, 2018). The APRN needs to take into consideration the many facets of health and disease, genetics and environment, including human attitudes, attributes, and behavior when determining how to implement a population-based intervention.

Smoking

Life expectancy for smokers is at least 10 years shorter than for nonsmokers. It is a leading cause of preventable morbidity and mortality, causing nearly one of every five deaths annually in the United States. This figure includes heart attack deaths and lung cancer 8deaths among nonsmokers who are exposed to secondhand smoke. It is estimated that smoking contributes $170 billion to healthcare costs in the United States (CDC, 2019a).

The CDC used the 2017 National Health Interview Survey (NHIS) to estimate adult smoking prevalence rates in the United States. The findings indicate that 19.3% of U.S. adults use a tobacco product every day or some days. Smoking rates are higher among men, younger adults, non-Hispanic adults, those living in the Midwest and South, those with less education and income, and LGBT (lesbian, gay, bisexual, and transgender) adults (CDC, 2019b).

Although higher rates are seen in younger adults, a reduction in smoking by school-age children should result in reductions in tobacco-related deaths in the future, but new data reveal that tobacco rates among American youth are increasing (CDC, 2019c). This is particularly bad news coming on the heels of the 2012‒2013 National Adult Tobacco Survey, which had revealed the lowest smoking rates for high school students since 1991. The current rise in smoking use among school age children is attributed to an increase in E-cigarette use (CDC, 2014, 2019c).

Technology has contributed to many positive advances in healthcare. E-cigarettes are not one of them. E-cigarettes are metal tubes that heat liquid into an inhalable vapor that contains nicotine. Between 2017 and 2018, E-cigarette use increased from 11.7% to 20.8% among high school students and from 3.3% to 4.9% among middle school students. During the same time period, no change was found in the use of other tobacco products (including cigarettes) (CDC, 2019d). As of December 2018, 50 states have enacted laws that restrict the use of E-cigarettes by youth.

The minimum legal age to purchase E-cigarettes in these 50 states varies but falls within a narrow range (19 to 21). Go to publichealthlawcenter.org/sites/default/files/States-with-Laws-Restricting-Youth-Access-to-ECigarettes-Dec2018.pdf for specific information about youth access to E-cigarettes in the United States (Public Health Law Center, n.d.). Canada passed the Tobacco and Vaping Products Act in May, 2018. This act regulates the manufacture, sale, labeling and promotion of tobacco products and vaping products sold in Canada and includes restrictions on the sale of tobacco products to youth (Government of Canada, 2018).

For more information on this Act go to www.canada.ca/en/health-canada/services/health-concerns/tobacco/legislation/federal-laws/tobacco-act.html. APRNs need to keep abreast of new behaviors that can impact health. Being informed about risky behaviors is of primary importance for APRNs to be effective in planning and delivering evidence-based education and in lobbying for changes to protect the public’s health.

Another very popular trend is the use of hookahs. Hookahs are water pipes used to smoke specially flavored tobaccos. Youth are drawn toward this social trend in which groups of people share a hookah usually in a café setting. Although hookahs have been around for hundreds of years, they are not a safe alternative to smoking. Hookah use rates among youth remained relatively constant from 2011 to 2018. In 2018 1.2% of middle schoolers (1% in 2011) and 4.1% of high school students (4.1% in 2011) reported that they had used a hookah within the past 30 days (CDC, 2018a).

The tobacco and smoke from hookahs have toxic properties and have been linked to various cancers, including lung and oral cancers. Many of the same effects of cigarette smoking are found with smoking hookahs. As with any potential threat to health, education of our youth and 9adult populations regarding the deleterious effects of hookahs is paramount to reducing the potential morbidity and mortality of long-term exposure to these flavored tobaccos.

More recently, newer electronic forms of hookahs have been introduced, and little research has been conducted to determine the long-term health effects of these products. Regardless, the use of hookahs is another health behavior that an APRN can attempt to modify by evidence-based prevention education. For more on the effects of hookahs, refer to the CDC’s site (www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/hookahs/index.htm#overview).

There is huge potential for cost savings by preventing smoking-related illnesses, and one cannot overlook the effects of secondhand smoke on the health of family members and coworkers. It is well known that secondhand smoke has long-lasting effects on the unborn fetus, infant, and child. These effects can manifest as preterm births (Been et al., 2014), increased respiratory infections and higher risk of asthma exacerbations (Abreo, Gebretsadik, Stone, & Hartert, 2018), sudden infant death (CDC, 2018b), and a lower intelligence quotient (Ling & Heffernan, 2016).

Thus, it is important to recognize not only the direct effects of smoking on health but also the indirect effects on fetuses, infants, children, and family members. The effects of secondhand smoke are not specific to smoking cigarettes. Exposure to hookah smoke is also associated with very similar effects on fetuses, infants, and family members. Education of pregnant mothers is just as important as with other family members as they may not realize the negative effects of secondhand exposure to hookah or cigarette smoke.

As with other smoking-related diseases, the cessation of smoking early on can reverse or ameliorate the potential long-term harmful effects of secondhand smoke exposure. These data provide a starting point for targeting specific high-risk groups for intervention based on parameters such as age, education, income, and geographical location. Another pertinent fact is that many insurance companies are now charging higher premiums for smokers than for nonsmokers.

This has led to increasing interest in cessation programs, but whether this will have a long-term impact on smoking rates is unknown. The recent increase in tobacco use by youth in the United States (largely attributed to the use of E-cigarettes) represents a troubling trend. Smoking cessation and smoking prevention programs are areas that offer opportunities for improving the health of people in the United States and for saving money. Other health problems, such as obesity, are also significant public health concerns.

Many additional studies have been conducted that demonstrate the destructive effects of exposure to toxic stress. Smyth, Heron, Wonderlich, Crosby, and Thompson (2008) completed a study of students entering college directly from high school to investigate the association between adverse events in childhood and eating disturbances. They found that childhood adverse events predicted eating disturbances in college. Childhood adverse events have also been linked to drug abuse and dependence 13 (Messina et al., 2008) and greater use of healthcare and mental health services (Cannon, Bonomi, Anderson, Rivara, & Thompson, 2010).

Building on earlier studies that linked smoking in adulthood with ACEs, Brown et al. (2010) discovered a relationship between a history of ACEs and the risk of dying from lung cancer. Researchers have identified similar outcomes in studies carried out with populations in other countries. A study conducted in Saudi Arabia, where beating and insults are often an acceptable parenting style, identified a correlation between beating and insults (once or more per month) and an increased risk for cancer, cardiac disease, and asthma (Hyland, Alkhalaf, & Whalley, 2012).

Scott, Smith, and Ellis (2012) completed a study in New Zealand, which found that adults who had a history of child protection involvement had increased odds of a diagnosis of asthma. McKelvey, Saccente, and Swindle (2019) examined the associations between ACEs in infancy and toddlerhood and obesity and related health indicators in middle childhood. Across all outcomes examined, children with four or more ACEs had the poorest health and were more likely to be obese when compared to children with no ACE exposure.

The problem of chronic diseases is not restricted to the United States. The World Health Organization (WHO) has published a report that documents the global problem of NCDs. NCDs now account for more deaths than infectious diseases even in poor countries. Director-General Dr. Margaret Chan of WHO is quoted as saying, “[F]or some countries, it is no exaggeration to describe the situation is an impending disaster; a disaster for health, society, most of all for national economies” (WHO, 2011, p. ii).

Chronic diseases, such as heart disease, stroke, cancer, chronic respiratory diseases, and diabetes, are the leading causes of global mortality. WHO estimates that NCDs kill 40 million people each year and account for 70% of deaths worldwide. Nearly 40% of these deaths occur in people younger than 70 (WHO, 2019). Millions of people die each year as a result of modifiable risk factors that underlie the major NCDs. The writers of a report by WHO contend that 8% of premature heart disease, stroke, and diabetes can be prevented. Ten action points, including banning smoking in public places, enforcing tobacco advertising bans, restricting access to alcohol, and reducing salt in food, are listed. All of these actions require a population approach to be effective (WHO, 2019).

A survey conducted by the AHA lends an interesting perspective to this argument. They surveyed 1,000 people in the United States. The AHA found that only 30% of respondents knew the AHA’s recommended limits for daily wine consumption. Drinking too much alcohol of any kind can increase blood pressure and lead to heart failure. The survey results also found that most respondents do not know the source of sodium content in their diets and are confused by low-sodium food choices. A majority of the respondents (61%) believe that sea salt is a low-sodium alternative to table salt when in fact it is chemically the same (AHA, 2011).

A poll conducted in 2017 by the American Society of Clinical Oncology (ASCO) revealed that only 31% of Americans are aware that obesity is a risk factor for cancer and just 30% recognize alcohol consumption as a risk factor (ASCO, 2017). These surveys reinforce the idea that people require more understanding of nutrition and the relationship between nutrition and health. It also reinforces the argument that interventions to improve health must be addressed at the community or population level.

NR503 Week 1 Assignment: The Relationship between Obesity and Cancer Example

Obesity in Virginia

Obesity is a rising health concern in the US. The rate of obesity has increased gradually over the last two decades leading to significant healthcare problems such as diabetes, stroke, and coronary heart disease. The problem develops primarily from unhealthy feeding practices and variations in physical activity. The problem affects populations and states differently, and assessing the health status of one’s state will help determine the state’s performance relative to other states in preventing the problem. Understanding the burden of obesity will also help in planning for its management and prevention. This essay analyzes obesity in Virginia.  

Cancers Associated with Obesity

Obesity is associated with an increased risk for 8% of all cancers and is among the leading modifiable risk factors for cancer, and only second after tobacco (Lee, 2022). The association between cancer and obesity and cancer is complex, and the most common etiologies are high insulin, hormone levels, and chronic inflammation secondary to cancer leading to cell hyperproliferation in response to the hormones or to replace the lost cells. Some of these cancers associated with obesity are rare. Lee (2022) notes that the common cancers associated with obesity include breast, colorectal, renal, endometrial, thyroid, and pancreatic cancers. These cancers are rising due to the increase in obesity prevalence nationwide.

Childhood Obesity Rates and Risk in Virginia

Obesity is a national problem, and the rates have been increasing gradually over the years despite the national and international efforts in this age of technology. The national prevalence of obesity lies at 41.9% and has increased gradually over the last two decades from 30.5%. The rate of severe obesity has doubled in the same period (4.7%-9.2%) (CDC, 2022). The CDCD (2022) also notes that national obesity among children below 18 years lies at 19.5%, which is highly alarming. These values vary depending on the body producing the numbers and the years of production.

The state of Virginia’s rate of childhood obesity has increased over the last decade from about 23.4% in 2007 to about 18% in 2020 (Brito et al., 2019). Obesity is highest among high-scholars and children between 10-17 years (14.9% and 21.9%, respectively) (State of Childhood Obesity, 2020). Children in high school-adolescents are at the highest risk for obesity. At this age, they have a high appetite, and their bodies require a lot of activity; poor physical activity is the most important factor in obesity among high-schoolers. Obesity among children in Virginia is moderate due to rigorous activity, but much attention is still required for childhood obesity.

Policies, Laws, and Policies Related to Childhood Obesity in Virginia

Virginia’s Obesity, Health, and Nutrition programs exist, and their primary goal is to prevent obesity among children. Policies affecting child obesity include those that regulate the hours of physical activity required for children and the availability of healthy foods. The Virginia Foundation for Healthy Youth is a program that provides grants to Healthy Community Action teams, which increase children’s activity through interventions such as purchasing activity gear and tools (like bicycles), promoting physical activity, and preventing obesity. This and similar programs also fund structures and infrastructure, such as parks and running trails, that facilitate the activities of the younger population. The Virginia Department of Health supports these programs. Hagedorn et al. (2018) note that teen-led interventions and youth mobilization have also been a leading strategy in programs preventing obesity.

The Virginia state government requires children in primary and secondary schools to be physically active and strictly adhere to physical activity lessons, which are included in the curriculum (State of Childhood Obesity, 2020). The state stipulates the minimum hours children should be active in elementary school but lacks self-updating standards related to the Child and Adult Care Food Program (CACFP) (State of Childhood Obesity, 2020). The government also provides grants to schools to support obesity management programs, such as purchasing play items like balls and uniforms to promote physical exercise, a major intervention in reducing and preventing obesity.

These laws, policies, and programs effectively manage obesity but face resistance in many areas. A major hindrance to implementing these policies is the lack of legal backing (Murphy et al., 2020). Most of these policies are not backed up by laws, or these laws are not strong enough to propel their undisputed implementation. Physical activity and purchasing healthy foods lie basically on the preferences of young individuals and their parents.

Fulfilling these laws thus requires persuading young men to engage in physical activities and encouraging parents and schools to allocate time for play and provide healthy food options. Another major challenge facing these policies is the inconsistencies in determining the major objectives (Murphy et al., 2020). These policies can target prevention or treatment, and they override each other. The lack of clear objectives for obesity makes their implementation and evaluation difficult, hence a lack of data to support their continuity.

Conclusion

Virginia state has a rising obesity statistic, but rigorous governmental and non-governmental efforts have helped reduce the prevalence of childhood obesity compared to other US states. Childhood obesity is a predictor of a child’s overall health; preventing obesity will help prevent many chronic illnesses and improve the health of the younger population. The state should also develop clear policies with legal implications on managing childhood obesity to help improve these efforts.

References

Brito, F. A., Zoellner, J. M., Hill, J., You, W., Alexander, R., Hou, X., & Estabrooks, P. A. (2019). From Bright Bodies to I Choose: Using a CBPR Approach to Develop Childhood Obesity Intervention Materials for Rural Virginia. SAGE Open, 9(1), 2158244019837313. https://doi.org/10.1177/2158244019837313

Center for Disease Control and Prevention (2022). Overweight and Obesity. Adult Obesity Facts. https://www.cdc.gov/obesity/data/adult.html

Hagedorn, R. L., White, J. A., Franzen-Castle, L., Colby, S. E., Kattelmann, K. K., White, A. A., & Olfert, M. D. (2018). Teens implementing a childhood obesity prevention program in the community: feasibility and perceptions of a partnership with HSTA and iCook 4-H. International Journal Of Environmental Research And Public Health, 15(5), 934. https://doi.org/10.3390/ijerph15050934

Lee, H. (2022). Obesity-Associated Cancers: Evidence from Studies in Mouse Models. Cells, 11(9), 1472. https://doi.org/10.3390/cells11091472

Murphy, E., Bowen, E., O’Hara-Tompkins, N., Crum, G., Fincham, H., & Burkhart-Polk, M. E. (2020). Early Childhood Obesity Prevention in Rural West Virginia Extension’s Role and Lessons Learned. Journal of Human Sciences and Extension, 8(1), 10. https://doi.org/10.54718/TPIC6446 

State of Childhood Obesity (2020). State Obesity Data Ranked by Highest Obesity Rate: 10-17 yr-olds (2019-2020). https://stateofchildhoodobesity.org/states/

Virginia Foundation for Healthy Youth (VFHY), (n.d.). Childhood Obesity Prevention. https://www.vfhy.org/programs/obesity/