Rationale and design of the Clinic and Community Approaches to Healthy Weight Randomized Trial

Area of Science:

• Pediatric Health
• Obesity Research
• Public Health Interventions

Background:

• Childhood obesity is a growing concern, particularly among low-income populations.
• Family-centered pediatric weight management programs show promise but require optimization for underserved communities.
• There is a need for scalable interventions to address obesity in low-income children.

Purpose of the Study:

• To compare the effectiveness of two distinct pediatric weight management programs.
• To evaluate interventions delivered in clinical versus community settings.
• To inform care strategies for millions of children with obesity covered by public insurance.

Main Methods:

• A randomized trial comparing a clinic-based program (Federally Qualified Health Centers) with a community-based program (YMCAs).
• Inclusion of children aged 6-12 years with a body mass index (BMI) at or above the 85th percentile.
• One-year program duration with at least 30 contact hours, with outcomes measured at baseline, 6 months, and 1 year.

Main Results:

• The primary outcome is the change in BMI (kg/m²) and percent change of the 95th percentile (%BMIp95) at 1 year.
• Data collection includes baseline, 6-month, and 1-year follow-ups.
• Comparative effectiveness of clinic-based versus community-based interventions will be analyzed.

Conclusions:

• The study will determine the comparative effects of clinical and community-based interventions for childhood obesity.
• Findings will guide the care of over 7 million children with obesity insured by Medicaid or the Children's Health Insurance Program.
• This research contributes to developing effective and scalable solutions for pediatric weight management in vulnerable populations.