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Protocol for the Rhode Island CORD 3.0 Study: Adapting, Testing, and Packaging the JOIN for ME Family-Based Childhood
Elissa Jelalian1,2, Whitney Evans1,2, Katherine E Darling1,2
1Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.
Insights
This study adapted a pediatric weight management intervention (PWMI) for low-income families, aiming to improve accessibility and effectiveness. The adapted program showed promise for scalable dissemination in diverse communities.
Area of Science:
- Public Health
- Pediatric Health
- Intervention Science
Background:
- Childhood obesity is a significant public health issue in the US.
- Access to evidence-based pediatric weight management interventions (PWMIs) is limited, especially for low-income and diverse populations.
- The CDC Childhood Obesity Research Demonstration (CORD) projects aim to disseminate PWMIs to these underserved communities.
Purpose of the Study:
- To adapt the evidence-based "JOIN for ME" PWMI for low-income families.
- To test the adapted intervention's effectiveness and implementation in a hybrid trial.
- To examine implementation outcomes (acceptability, adoption, feasibility, fidelity, reach) and patient-centered outcomes.
Main Methods:
- Recruitment of child-caregiver dyads (ages 6-12, BMI ≥85th percentile) from a federally qualified health center and low-income housing.
- Delivery of a 10-month, remotely-delivered, group-based intervention with phased session frequency.
- Assessment of child/caregiver weight status and child quality of life at baseline, 4, and 10 months; collection of implementation outcomes.
Main Results:
- The study is designed to assess the effectiveness and implementation of an adapted PWMI.
- Key outcomes include changes in weight status, quality of life, and intervention feasibility.
- Implementation outcomes will guide future scalability and dissemination efforts.
Conclusions:
- Successful adaptation and implementation of "JOIN for ME" could offer a scalable model for pediatric weight management.
- This project addresses critical needs in delivering effective interventions to diverse, low-income families.
- Findings will inform broader strategies for tackling childhood obesity in vulnerable populations.
Abstract:
Background: Overweight and obesity in children is a public health crisis in the United States. Although evidence-based interventions have been developed, such programs are difficult to access. Dissemination of evidence-based pediatric weight management interventions (PWMIs) to families from diverse low-income communities is the primary objective of the CDC Childhood Obesity Research Demonstration (CORD) projects. Methods: The goal of the Rhode Island CORD 3.0 project is to adapt the evidence-based PWMI, JOIN for ME, for delivery among diverse families from low-income backgrounds and to test it in a hybrid effectiveness-implementation trial design in which the aims are to examine implementation and patient-centered outcomes. Children between the ages of 6 and 12 years with BMI ≥85th percentile and a caregiver will be recruited through two settings, a federally qualified health center, which serves as a patient-centered medical home, or low-income housing. Dyads will receive a remotely delivered group-based intervention that is 10 months in duration and includes 16 weekly sessions, followed by 4 biweekly and 4 monthly meetings. Assessments of child and caregiver weight status and child health-related quality of life will be conducted at baseline, and at 4 and 10 months after the start of intervention. Implementation outcomes assessing intervention acceptability, adoption, feasibility, fidelity, and penetration/reach will be collected to inform subsequent dissemination. Conclusions: If the adapted version of the JOIN for ME intervention can be successfully implemented and is shown to be effective, this project will provide a model for a scalable PWMI for families from low-income backgrounds. ClinicalTrials.gov no. NCT04647760.
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