RWJF Health & Society Scholar:
Pediatrics, Public Health
Area(s) of Expertise:
Pediatric Obesity, Built Environment, Food Environment
Dr. Tester has a clinical and research focus on childhood obesity, with board certification in both pediatrics as well as obesity medicine. She is a co-director of Healthy Hearts, which is a multidisciplinary weight management clinic within the Department of Cardiology at Children’s Hospital & Research Center Oakland. Her research has focused on the influence of children’s environments on their ability to be physically active and have a healthy diet.
Food insecurity and obesity in children
Her current research, funded by NICHD, focuses on the experience of food insecurity among obese children. She is examining how food insecurity influences dietary behaviors and metabolic risk among low-income obese children, conducting analyses with NHANES data as well as with patients in her clinic population. She plans to test an intervention for improving their diet and metabolic profile with the use of a supermarket incentive voucher that is based on SNAP (“food stamps”) benefits. The central hypothesis is that household food insecurity, through its influence on dietary quality and eating behaviors, leads to a higher level of cardiometabolic risk than is seen with obesity alone. The rationale behind studying food insecurity within the context of pediatric obesity is that it offers a clinically sensitive window into the downstream health effects of this condition of poverty. A disproportionately high metabolic risk in food-insecure children warrants implementing targeted interventions that integrate clinical, behavioral, and policy responses.
Mobile street vendors / urban food environment
Dr. Tester has studied urban food access with a particular interest in availability of foods in the after-school setting. She was funded by Healthy Eating Research, a program of the Robert Wood Johnson Foundation, to examine mobile food vendors in Oakland, California. Her team conducted qualitative interviews with stakeholders (city officials, school staff, and vendors) and observations of transactions occurring in the after-school environment in order to inform two pilot interventions to increase schoolchildren’s access to healthy snack foods. She facilitated the permitted location of a fruit vendor immediately in front of a school, and piloted a “healthy snacks menu” on an ice cream truck. This ice cream truck intervention was replicated on multiple trucks, using price manipulations to investigate how to best optimize sales in this venue. She also collaborated with public health lawyers to work towards establishing recommendations for healthy vending ordinances. She also participated in a research working group regarding food access in urban corner stores, and conducted a healthy foods audit in food outlets around low and high income schools in Oakland.
Neighborhoods and parks
Dr. Tester was the principal investigator on a community-based study before and after revitalization of two public playlots in Richmond, California. This study was funded by Active Living Research, which is a national program of the Robert Wood Johnson Foundation. Child visitors to the playlots were invited to wear accelerometers to measure physical activity associated with their visit, and In-person household surveys with nearby residents examined perceptions of safety and social capital measures such as neighborhood cohesion.