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Published on: May 9, 2017
A comparative effectiveness trial of two family-based childhood obesity treatment programs in a medically underserved
Jamie M Zoellner1, Wen You2, Jennie L Hill3
1University of Virginia (UVA), Department of Public Health Sciences, UVA Cancer Center Research and Outreach Office, 16 East Main Street, Christiansburg, VA 24073, USA.
Insights
This study tested two family-based childhood obesity (FBCO) treatments in a medically underserved region, aiming to bridge the gap between intervention efficacy and real-world practice for better child health outcomes.
Area of Science:
- Public Health
- Pediatric Obesity
- Implementation Science
Background:
- Family-based childhood obesity (FBCO) interventions show efficacy but lack real-world translation, especially in health disparate areas.
- A research-practice gap exists in implementing effective FBCO treatments into routine care.
- Medically underserved communities face unique challenges in accessing and sustaining obesity interventions.
Purpose of the Study:
- To address the research-practice gap by evaluating FBCO interventions in a medically underserved region.
- To assess the feasibility and effectiveness of two distinct FBCO programs (iChoose and Family Connections).
- To examine factors influencing intervention adoption, implementation, and sustainability within community settings.
Main Methods:
- Community-based participatory research approach guided by a Community Advisory Board (CAB) and the RE-AIM framework.
- Randomized controlled trial assigning families with overweight/obese children (5-12 years) to either iChoose or Family Connections.
- Recruitment integrated into a regional healthcare organization, with outcomes measured at 3, 6, and 12 months.
Main Results:
- Primary outcome: child BMI z-scores at 6 months.
- Secondary outcomes: reach, effectiveness on other child/parent metrics, adoption, fidelity, cost, capacity, and maintenance.
- Data collection focused on individual changes and organizational sustainability for scalable implementation.
Conclusions:
- This research identifies critical features for improving child weight status and facilitating FBCO intervention translation in underserved communities.
- Findings aim to inform strategies for integrating effective obesity treatments into typical clinical and community practice.
- The study addresses literature gaps concerning implementation and sustainability of FBCO interventions in diverse settings.
Abstract:
While there is a large body of literature documenting the efficacy of family-based childhood obesity (FBCO) treatment interventions, there is little evidence that these interventions have been systematically translated into regular practice - particularly in health disparate regions. To address this research-practice gap, this project was guided by a community advisory board (CAB) and the RE-AIM planning and evaluation framework within a systems-based and community-based participatory research approach. Families with overweight or obese children between 5 and 12 years old, in the medically-underserved Dan River Region, were randomly assigned to one of two FBCO treatment programs (iChoose vs. Family Connections) delivered by local Parks & Recreation staff. Both programs have previously demonstrated clinically meaningful child BMI z-score reductions, but vary in intensity, structure, and implementation demands. Two clinical CAB partners embedded recruitment methods into their regional healthcare organization, using procedures representative to what could be used if either program was taken to scale. The primary effectiveness outcome is child BMI z-scores at 6-months, with additional assessments at 3-months and at 12-months. Secondary goals are to determine: (1) reach into the intended audience; (2) effectiveness on secondary child and parent outcomes; (3) intervention adoption by organizations and staff; (4) fidelity, cost, and capacity for intervention implementation; and (5) maintenance of individual-level changes and organizational-level sustainability. This research addresses literature gaps related to the features within clinical and community settings that could improve both child weight status and the translation of FBCO interventions into typical practice in medically-underserved communities. IDENTIFIERS: Clincialtrials.gov: NCT03245775.
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