Development and Pilot Testing of a Childhood Obesity Treatment Program
Condition: Childhood Obesity
MeSH terms: Obesity; Pediatric Obesity
Study type: Interventional

Summary: 
      The primary aims were to assess community capacity to develop, implement, and sustain a
      childhood obesity reduction initiative in the health-disparate Dan River Region as well as to
      pilot test iChoose to determine the potential reach (i.e., proportion of target population &
      representativeness), effectiveness (i.e., changes in child BMI z-scores over a 6 month
      period), feasibility (i.e., the degree to which the intervention can be adopted, implemented,
      and sustained as intended) and cost (i.e., resource and staffing costs) of the newly
      developed intervention.
    

Detailed description: 
      The Dan River Region (DRR) is a federally designated medically under-served area/population
      with high rates of obesity. In response to 3 comprehensive community needs assessments The
      Dan River Partnership for a Healthy Community (DRPHC) was established in 2010 'to foster
      community partnership to combat obesity in the Dan River Region through healthy lifestyle
      initiatives' (DRPHC mission statement). To date the DRPHC (1) tested a successful adult
      weight control intervention, (2) initiated youth-focus community garden and instant recess
      initiatives, and (3) continues to complete a comprehensive audit of the food and physical
      activity environment across the DRR. This RFA provided an opportunity to address an
      additional and complimentary area of need for the DRPHC-childhood obesity. A newly formed
      subcommittee and community advisory board (CAB) of the DRPHC, Partnering for Obesity Planning
      and Sustainability (POPS), met in preparation of this proposal and discussed the need to
      engage systems where high need families received services and could participate in childhood
      obesity treatment. The POPS-CAB came to consensus that using a systems-based approach, within
      the existing CBPR partnership would allow for the development of a contextually relevant
      intervention with the potential for long-term sustainability. Systems-based approaches
      include, but also move beyond, a focus on initiative effectiveness and address broader
      contextual issues such as initiative adoption, implementation, and maintenance across
      settings and delivery staff as well as reach and maintenance of effects at the individual
      level. The general goal of this proposal is to engage multiple systems through the DRPHC
      POPS-CAB and design and test prototype childhood obesity interventions. The current
      membership of the POPS-CAB include Danville Pittsylvania Health District, Children's
      Healthcare Center, Danville Parks Recreation & Tourism, and Boys & Girls Club, along with an
      interdisciplinary team of academic investigators. The first aim is to assess community
      capacity to develop, implement, and sustain a childhood obesity reduction initiative in the
      DRR. To accomplish this aim a concurrent mixed-method study design will be used and guided
      dimensions of community capacity and organizational level dimensions of the RE-AIM framework
      (i.e., adoption, implementation, and maintenance). The second aim is to determine the
      potential reach, effectiveness, feasibility and cost of the newly developed interventions.
      Three stages of iterative intervention testing/formative feedback loops in a public health
      and healthcare system will be used to achieve this aim. The partnership members will meet in
      an ongoing basis to discuss the qualitative & quantitative results and make adaptations to
      improve the strategies. Indicators of success include reduced child BMI z-scores, the
      engagement of multiple systems, and regional capacity to evaluate research evidence and
      integrate this evidence into sustainable practices. The end goal is a childhood obesity
      intervention that is ready for large scale testing across these systems in the DRR.
    

Intervention name(s): iChoose
Intervention type(s): Behavioral
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: evidence-based programs; community-based participatory research; program adoption