Living a long life starts early

MD Anderson will lend its cancer prevention expertise to the Coordinated Approach to Child Health (CATCH) program, which is used in schools and after-school programs across the nation. Initial efforts will focus on preventing skin cancer and tobacco use.

BY Scott Merville

MD Anderson will add a dose of cancer prevention to a research-based program that helps children around the nation exercise more, eat better and learn skills to make healthier decisions in life.

In an agreement reached in February, MD Anderson will lend its expertise to the Coordinated Approach To Child Health (CATCH) program.

Originally developed as a childhood anti-obesity initiative, CATCH has been introduced in 10,000 schools, preschools and after-school programs throughout the nation. It helps students and their families adopt healthy lifestyles through good nutrition and exercise.

With MD Anderson’s participation, the program will expand to include lessons aimed at lowering children’s lifelong risk of developing cancer. The institution will focus its initial CATCH efforts on preventing skin cancer and tobacco use.

“MD Anderson’s affiliation with CATCH greatly accelerates our ability to nationally promote healthy lifestyles in childhood and adolescence,” says Ernest Hawk, M.D., vice president of Cancer Prevention and Population Sciences at MD Anderson.

Up to half of all cancers could be prevented if Americans adopt a healthy lifestyle starting in childhood, Hawk says.

“For example, sunburns in childhood are closely tied to the risk of skin cancer later in life, including melanoma, the most lethal form,” he explains. “So sun safety is an important early lesson.”

Sunbeatable superheroes

To promote sun safety in children, MD Anderson will kick off its participation in CATCH this summer with Ray and the Sunbeatables: A Sun Safety Curriculum for Preschoolers. The program features a band of superheroes led by Ray, who has the superpower of creating shade and wears a magic watch that reminds him to be super-protected from 10 a.m. to 4 p.m., when the sun’s rays are strongest. His band of superheroes have unique superpowers of their own, including Serena, who champions sunscreen; Chloe, who promotes protective clothing; Stefan, who sports protective sunglasses; and Hannah, who covers her head under protective hats.

All are shielded from the sun as they explore the world in their travel ship, the Eclipse.

By participating in these adventures, children learn how and why to be sun safe in their daily lives, and how to find their own “sunbeatable superpowers.”

“It’s important to teach sun protection at an early age so children get into the habit of protecting themselves from the sun’s rays,” says Mary Tripp, Ph.D., a behavioral sciences instructor at MD Anderson.

Sun protection is especially important for children with cancer, because childhood cancer survivors have an increased risk of getting a second cancer such as melanoma later in life.

The MD Anderson Children’s Hospital School — an accredited on-site school (see story "Continuing education") that helps pediatric patients stay on grade-level with schooling during treatment — has added Ray and the Sunbeatables to its curriculum.

The program will launch this summer at a limited number of schools and early childhood education centers.

MD Anderson will lend its cancer prevention expertise to the Coordinated Approach to Child Health (CATCH) program. Initial efforts will focus on preventing skin cancer and tobacco use. Photo: Eric Kayne

Optimum impact

The agreement cementing MD Anderson’s role in CATCH makes the cancer center a founding partner of the CATCH Global Foundation, a public charity established in 2014 to improve children’s health worldwide.

The partnership is an initiative of the institution’s Moon Shots Program, which aims to fast-track scientific discoveries into treatments or advances that improve survival rates for many of the deadliest cancers. MD Anderson’s role in providing skin cancer prevention education for CATCH is part of the Melanoma Moon Shot, and its tobacco-use prevention education falls under the Lung Cancer Moon Shot.

Hawk, along with MD Anderson’s vice president of governmental relations, Mark Moreno, leads the moon shots’ cancer prevention and control platform, which supports prevention efforts through enhanced public policy, public education and the sharing of clinical practices to effectively address community needs and priorities.

The Melanoma and Lung Cancer Moon Shots each have youth cancer prevention education programs underway that build on or extend programs developed by the institution’s Cancer Prevention and Population Sciences faculty.

Another objective of moon shots is to extend MD Anderson’s expertise nationally for maximum impact.

“Effective cancer prevention will play a powerful role in the future health of our country and in our team meeting its moon shots goals,” says MD Anderson President Ron DePinho, M.D.

“It’s important that we deploy MD Anderson’s programs for optimum impact,” he says. “With CATCH, we’re fortunate to combine our expertise with a successful, longstanding program providing a practical, research-based approach to child health that’s already national in scope.”

The four-year agreement calls for MD Anderson to provide $3.3 million in funding for infrastructure and operations, curriculum development and dissemination, and program and technology support.Anticipated projects will:

Transform CATCH curriculum to a digital format
Develop and disseminate new program content, including UV light protection to reduce skin cancer risk, and tobacco use prevention to reduce the risks of at least 15 types of cancer
Promote peer-to-peer student engagement in prevention programs
Educate students and parents about vaccination to prevent cancers associated with the human papillomavirus (HPV)

The start of CATCH

When childhood obesity began to emerge as a serious public health problem in the 1990s, researchers at The University of Texas Health Science Center School of Public Health at Houston (UTHealth) set out to address it with science. They concluded the challenges were so deeply embedded in modern life that efforts focusing on a single aspect — diet alone, for example — wouldn’t get the job done.

Originally developed by a coalition of five research universities, including UTHealth’s School of Public Health, CATCH has expanded through the school’s Michael & Susan Dell Center for Healthy Living.

It includes programs for early childhood education, elementary school, middle school and after-school programs. Each have components for nutrition, physical education, classroom activities and community and family outreach.

Recommendations are specific and practical. For example, the physical education program offers an “activity box” of 250 vigorous but fun games and activities, tailored by age group, with tips on how to devote at least half of physical education class time to moderate-to-vigorous activity.

The nutrition component features healthy menu consultation with cafeteria staff as well as educational materials for children, including a stoplight icon that sorts foods into GO, SLOW and WHOA categories.

The classroom component focuses on nutrition and physical activity. Family and community events reinforce the overall message of healthy living.

From the beginning, research has shown that CATCH programs are working. The initial study revealed it reduced fat consumption and increased physical activity for children and adolescents, and that these changes were maintained for three years after exposure to the program, through the end of eighth grade.

Subsequent studies showed:

Children in El Paso, Texas, who participated in CATCH were 11% less likely to experience the onset of excessive weight and obesity — a significant difference.

In Central Texas’ Travis County, it led to a 9% decrease in excessive weight and obesity among fourth-graders.

Steve Kelder, Ph.D., and Deanna Hoelscher, Ph.D., professors at the UTHealth School of Public Health and founding directors of the Michael & Susan Dell Center for Healthy Living, initiated the CATCH Global Foundation last year to ensure that effective programs are put into broad practice.

“Our goal is to create a public entity dedicated to improving the health of children, in perpetuity, by disseminating programs developed and proven effective at UTHealth and MD Anderson. MD Anderson’s generous support and cancer prevention expertise will greatly accelerate the foundation’s progress in obesity prevention, cancer prevention and population health,” Kelder says.

Duncan Van Dusen, founding executive director of the foundation and a UTHealth graduate, notes: “CATCH is backed by 25 years of scientific evidence proving that it’s the most cost-effective means to prevent childhood obesity. And since obesity is a leading risk factor for cancer, it has really always been an anti-cancer program.”

The mission of the foundation is to improve children’s health worldwide, Van Dusen says, by developing, disseminating and sustaining the program in collaboration with UTHealth researchers.

“The foundation links underserved schools and communities to resources that create and sustain healthy change for future generations,” he says.

Since CATCH began as a program to prevent obesity and the associated long-term risks of developing Type 2 diabetes and heart disease, obesity itself has emerged as a risk factor for cancer. According to the National Cancer Institute, adult obesity is associated with increased risk for at least eight different types of cancer.

“Joining forces with MD Anderson immediately expands the value of CATCH to our partners in schools, YMCAs, Jewish community centers, and other settings around the country, and will power several large initiatives to benefit hundreds of thousands more kids,” Van Dusen says.

The foundation is seeking school and community partners to implement CATCH. For more information, visit CATCH's website.