An individually tailored family-centered intervention for pediatric obesity in primary care

Study protocol of a randomized type II hybrid effectiveness-implementation trial (Raising Healthy Children study)

Justin D. Smith, Cady Berkel, Neil Jordan, David C. Atkins, Shrikanth S. Narayanan, Carlos Gallo, Kevin Grimm, Thomas J. Dishion, Anne Mauricio, Jenna Rudo-Stern, Mariah K. Meachum, Emily Winslow, Meredith Bruening

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Pediatric obesity is a multi-faceted public health concern that can lead to cardiovascular diseases, cancers, and early mortality. Small changes in diet, physical activity, or BMI can significantly reduce the possibility of developing cardiometabolic risk factors. Family-based behavioral interventions are an underutilized, evidence-based approach that have been found to significantly prevent excess weight gain and obesity in children and adolescents. Poor program availability, low participation rates, and non-adherence are noted barriers to positive outcomes. Effective interventions for pediatric obesity in primary care are hampered by low family functioning, motivation, and adherence to recommendations. Methods: This (type II) hybrid effectiveness-implementation randomized trial tests the Family Check-Up 4 Health (FCU4Health) program, which was designed to target health behavior change in children by improving family management practices and parenting skills, with the goal of preventing obesity and excess weight gain. The FCU4Health is assessment driven to tailor services and increase parent motivation. A sample of 350 families with children aged 6 to 12 years who are identified as overweight or obese (BMI ≥ 85th percentile for age and gender) will be enrolled at three primary care clinics [two Federally Qualified Healthcare Centers (FQHCs) and a children's hospital]. All clinics serve predominantly Medicaid patients and a large ethnic minority population, including Latinos, African Americans, and American Indians who face disparities in obesity, cardiometabolic risk, and access to care. The FCU4Health will be coordinated with usual care, using two different delivery strategies: an embedded approach for the two FQHCs and a referral model for the hospital-based clinic. To assess program effectiveness (BMI, body composition, child health behaviors, parenting, and utilization of support services) and implementation outcomes (such outcomes as acceptability, adoption, feasibility, appropriateness, fidelity, and cost), we use a multi-method and multi-informant assessment strategy including electronic health record data, behavioral observation, questionnaires, interviews, and cost capture methods. Discussion: This study has the potential to prevent excess weight gain, obesity, and health disparities in children by establishing the effectiveness of the FCU4Health and collecting information critical for healthcare decision makers to support sustainable implementation of family-based programs in primary care. Trial registration:NCT03013309ClinicalTrials.gov.

Original languageEnglish (US)
Article number11
JournalImplementation Science
Volume13
Issue number1
DOIs
StatePublished - Jan 15 2018

Fingerprint

Pediatric Obesity
Primary Health Care
Health
Weight Gain
Obesity
Health Behavior
Parenting
Delivery of Health Care
Motivation
Costs and Cost Analysis
North American Indians
Family Practice
Electronic Health Records
Medicaid
Program Evaluation
Child Behavior
Body Composition
Hispanic Americans
African Americans
Cardiovascular Diseases

Keywords

  • Coordinated care
  • Family Check-Up 4 Health
  • Hybrid effectiveness-implementation trial
  • Integrated care
  • Pediatric obesity
  • Primary care

ASJC Scopus subject areas

  • Health Policy
  • Health Informatics
  • Public Health, Environmental and Occupational Health

Cite this

An individually tailored family-centered intervention for pediatric obesity in primary care : Study protocol of a randomized type II hybrid effectiveness-implementation trial (Raising Healthy Children study). / Smith, Justin D.; Berkel, Cady; Jordan, Neil; Atkins, David C.; Narayanan, Shrikanth S.; Gallo, Carlos; Grimm, Kevin; Dishion, Thomas J.; Mauricio, Anne; Rudo-Stern, Jenna; Meachum, Mariah K.; Winslow, Emily; Bruening, Meredith.

In: Implementation Science, Vol. 13, No. 1, 11, 15.01.2018.

Research output: Contribution to journalArticle

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