There is little disagreement that the origins of the obesity epidemic are multifactorial and progress toward a solution has been stubbornly slow. In a recent call to action for improved health care training and prevention of obesity, Dietz et al. noted that medical education and health professional training lags behind in understanding stigma associated with obesity, working on interdisciplinary teams, and modifying lifestyles (1). Others have noted that medical students have somewhat unidimensional views of the causes of obesity with over one quarter endorsing purely physiological causes and close to a quarter not endorsing causes outside of overeating and physical activity (2). Most expert panels recommend multi-pronged approaches to prevention and intervention that involve multiple disciplines working as a team and across sectors (e.g., healthcare, education, government) in order to effect the most long lasting change at a population level (3–5).

Although the call for more comprehensive and interdisciplinary approaches has been made for over a decade, educational programming has not kept pace with scientific thinking on the topic, and most public health professionals are not trained in transdisciplinary approaches (6). Currently, most educational efforts in obesity prevention and treatment occurs at the postdoctoral level in specialty programs such as those offered through Nutrition Obesity Research Centers (NORC) funded by the National Institute of Diabetes and Digestive and Kidney Diseases. There are a few doctoral level programs such as the Illinois Transdisciplinary Obesity Prevention Program (I-TOPP) (7) and the Pennsylvania State University Childhood Obesity Prevention Graduate Training Program funded by the United States Department of Agriculture, National Institute of Food and Agriculture. Rarer yet are interdisciplinary programs at the undergraduate level. A program that exposes undergraduate students to the complexities of obesity has the potential to increase the scientific workforce as well as raise awareness of the next generation of parents and public health professionals. Adding obesity as topic at the undergraduate level also has the potential to effect career choices and practice in the future.

There is increasing interest in promoting transdisciplinary education as a means to address major public health issues. Lawlor et al. describe a MPH program organized around the tenets of transdisciplinarity, including an applied problem driven approach that recognizes the multiple factors that contribute to a public health problem (8). A key component of transdisciplinary team science is the ability to work collaboratively in an integrative process across disciplines to address a common research problem (9, 10). To date, the majority of efforts to train scientists in this approach have been directed toward graduate and post-graduate level students (11). There are however, exceptions at the undergraduate level (12). In this report we describe an undergraduate transdisciplinary curriculum addressing the complexity of obesity. We provide evidence that the curriculum and its hands-on problem-solving format increased knowledge about the complexity of the causes and consequences of obesity as well as research skills.

There was a significant increase in content knowledge in Year 1 in seven of the 10 modules (see Figure 2). Students gained knowledge about the neighborhood influences, the role of the built environment and physical activity, sleep, childcare, and feeding practices, media, culturally relevant interventions, and family mealtimes. There were no significant gains in understanding of food advertising, picky eating, or food policy from before the class to after the completion of the course.

In year two, the students evidenced significant gains in knowledge in 14 of the 20 modules (see Figure 3). There were significant increases in knowledge about bone health, the gut to brain axis, pediatric nutrition and breastfeeding, picky eating, sleep, food policy, genetic influences, culturally relevant interventions, brain health, cancer, the 6 C framework, and child care and feeding practices from before the class until after the class ended.

Students gained significantly in their understanding of research and their research skills. Student self-assessment of their understanding of “nature of the job as a researcher” (t (71) = 8.225, p = .000) and their understanding of the “research process” (t (71) = 6.255, p = .000) displayed significant gains. At the beginning of the course, the majority of students reported a “weak” or “average” understanding of the research process (70.3%) and the nature of the job as a researcher (78.4%). By the end of the course, an overwhelming majority of the students reported having a “Strong” or “Very Strong” understanding of the research process (69.4%), and the nature of the job as a researcher (70.8%).

Obesity is a complex public health concern that requires transdisciplinary approaches for solutions. However, few scientists are explicitly trained in team science approaches. Rarer yet are programs at the undergraduate level that expose students to interdisciplinary and transdisciplinary methods. In this report, we documented knowledge gains and increased confidence in research skills in an undergraduate course delivered across three different sites. Overall, students gained content knowledge about the complex causes, consequences, and correlates of obesity. Further, they gained appreciation of the research process and their own confidence as researchers. In this discussion, we highlight some of the lessons learned from this evaluation and future directions for course development.

Across two evaluation points (Years 1 and 2) we were able to demonstrate that students gained content knowledge about the role that sleep, childcare and feeding practices, neighborhood influences, and culturally relevant interventions might play in obesity. Modules only evaluated once (Year 2) also showed significant gains in knowledge in the 6 C Framework, Cancer, Pediatric Nutrition and Breastfeeding, and Gut to Brain. Modules that evidenced significant gains in knowledge 1 year but not on another included Food Policy, Picky Eating, Family Mealtimes & Nutrition, and the Changing Food & Media Environment. We can only speculate about the different pattern of results. For those modules that evidenced consistent significant gains, our impression is that these are areas that students had little baseline knowledge and stood to gain the most information. Anecdotally, students were fascinated with the role that sleep played in risk for obesity. They also tended to personalize this factor in relation to their own health. In addition, they had little exposure to factors such as child care and the potential role that feeding practices in child care might play in health.

Even though we were able to show gains in some content areas- the overall purpose of the course is also to expose the students to the research process. Using valuable class time and a hands-on approach actively engaged students in critical thinking about how to develop research questions and the limits of scientific evidence. The students gained not only content knowledge about the causes and consequences of obesity but also the research process and the role of a researcher. Because they were assigned to work on teams, they also gained valuable experience from diverse backgrounds as to how the research process unfolds and how to consider multiple perspectives.

Some of the challenges to teaching the TOPRs course included students feeling that the course and research projects (for the two classes that included direct research experiences) were too separate and needed better integration. In Krettek and Thorpenberg's review of transdisiciplinary higher education, one of their suggestions for effective transdisciplinary teaching is that instructors across varied disciplines work together to design their lectures (6). The TOPRS curriculum does this in the micro-lectures, but future courses may take this a step further by having the researchers that are working directly with students on research projects come to a class and get the entire class involved in a discussion around the specific research project. Setting aside time for students to discuss their specific research projects as well as allocating time for practicing research poster presentations might also help students to see the intersection of the course content and direct research experiences. We encourage interested instructors to visit the website to determine the suitability and usefulness of the materials for their own instructional needs https://stemedhub.org/groups/toprs.

A report commissioned by the National Academy of Medicine Roundtable on Population Health Improvement recommends that interdisciplinary training be provided at multiple levels, beginning with an investment at the high school and undergraduate levels as a way of building a foundation of basic skills, competencies, and knowledge of population health concepts (9). The 2015 report lists three categories of competencies for training in population health science: knowledge, interdisciplinary skills, and knowledge exchange, and that these competencies can be achieved through immersion in an interdisciplinary environment, mentoring, and being part of an interdisciplinary team. The TOPRS undergraduate curriculum aims to provide a basic foundation for this type of training, as a central goal of the program is to actively teach interdisciplinarity. The three classes that participated in this program experienced the interdisciplinary environment, mentoring, and experience on an interdisciplinary team in varying degrees.

In two of the courses, the students participated in a hands-on research experience working on interdisciplinary teams. In the other course, students did not participate in research directly but engaged in exercises, and class activities on interdisciplinary teams designed to simulate working on research teams to solve problems related to obesity. The mentoring aspect also varied as the students working on research projects with faculty had more access to mentors in this capacity, but the instructor in the other course served as a mentor as well, but to a lesser degree. Students have fewer opportunities to get involved in research at the teaching university than at the research university, and this was the first intensive exposure to research for many of the students. As such, many of the students used the instructor as a mentor, asking questions about research and several later signed up to work on a research project with the instructor.

We recognize that this report is not without limitations. The students enrolled in the courses across sites were primarily female. Thus, further work needs to be done to consider whether the format and topic of the course appeals equally to men and women.

In conclusion, although each class experience was different, all resulted in gains in knowledge content as well as appreciation for the research process. These results are promising because the curriculum can be replicated and adapted to fit the needs of particular types of schools and students can be expected to leave the course with a basic foundation in interdisciplinary and transdisciplinary methods as applied to an important and urgent public health problem. Programs such as TOPRS can provide students exposure at the undergraduate level to transdisciplinary concepts and methodology as well as give them team building experience, which is a first step in effective collaborative science.

The evaluation data is available upon reasonable request from the authors.

BF, AH, DT, and BK originally developed the curriculum. LP and GG designed the measurement protocols. GG conducted the evaluation. All authors contributed to the writing and review of the manuscript. GG conducted the analyses presented in the manuscript.

Portions of these findings were presented at The Obesity Society as a poster in 2016. This manuscript is not currently under review at any other source.