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Implementation and Effectiveness of the Healthy Weight Clinic Type III Hybrid Trial: Massachusetts CORD 3.0

Ines Castro1, Cara F Ruggiero1, Man Luo1

  • 1Division of General Academic Pediatrics Mass General Brigham for Children, Boston, Massachusetts, USA.

Childhood Obesity (Print)
|October 29, 2025
PubMed

Insights

The Healthy Weight Clinic (HWC) effectively reduced BMI in children with obesity. This primary care program was successfully implemented and sustained across multiple clinics.

Area of Science:

  • Pediatric Health
  • Public Health Interventions
  • Implementation Science

Background:

  • Childhood obesity is a significant public health concern requiring evidence-based interventions.
  • The Healthy Weight Clinic (HWC) is a primary care-based Family Healthy Weight Program (FHWP) designed for intensive health behavior and lifestyle treatment.
  • Implementing such programs in primary care settings presents unique challenges and opportunities.

Purpose of the Study:

  • To implement and evaluate the effectiveness and implementation of a packaged HWC program.
  • To assess the HWC's impact on children's Body Mass Index (BMI) and related metrics.
  • To identify facilitators and barriers to HWC adoption and maintenance in primary care.

Main Methods:

  • A Type III hybrid effectiveness-implementation study was conducted across eight primary care clinics.
  • Quantitative and qualitative methods were employed, utilizing the Consolidated Framework for Implementation Research (CFIR) and RE-AIM frameworks.
  • A comparison group of children with BMI ≥ 95th percentile not enrolled in the HWC was used.

Main Results:

  • The HWC reached 191 children and demonstrated effectiveness in reducing BMI (-0.26), percentage of median BMI (-1.87), and %BMIp95 (-1.05).
  • Seven out of eight sites adopted most program components and sustained the program for 18 months post-training.
  • Qualitative data provided context on implementation barriers and facilitators.

Conclusions:

  • The HWC is a promising FHWP for improving health outcomes in children with overweight and obesity.
  • The implementation package supports the adoption of the HWC across diverse primary care settings in the U.S.
  • Primary care settings can successfully implement and sustain intensive lifestyle interventions for pediatric obesity.
Abstract

Keywords:
Family Healthy Weight ProgramImplementation ScienceIntensive Health Behavior and Lifestyle TreatmentMixed Methods

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