The Healthy Families Project
Condition: Childhood Obesity
MeSH terms: Pediatric Obesity
Study type: Interventional

Summary: 
      A primary care approach to obesity prevention will be developed and tested in a randomized
      trial in 4 pediatric primary care practices. Enhanced screening for obesity risks and prompts
      for effective counseling at well visits of 4 to 10 year olds will be developed utilizing hand
      held technology( PDAs). The impact on the content and quality of clinician counseling will be
      assessed in exit survey prior to and after implementation. Among families interested in
      making a change to address nutrition or activity risk reported on the screener a cohort with
      children > BMI 85% will be recruited. They will be randomized to mailed tailored supports to
      level of readiness to change versus a single generic informational mailing. The hypotheses
      are that 1)families that receive the enhanced office visit with screening will be more likely
      to plan to make changes compared to usual care; and 2) families receiving the tailored post
      visit supports will be less likely to gain weight than controls after 6 months.
    

Detailed description: 
      1. Using hand held PDAs, we will develop an obesity risk screening and counseling system
           for 4 through 10 year olds attending primary care well child visits. Screening results
           will be summarized immediately by the PDA and will prompt the clinician to provide brief
           counseling messages tailored to each childís obesity screening results, including the
           familyís and the childís readiness to change behavior

        2. We will evaluate the specific content and quality of clinician obesity counseling
           provided at the well child visit through parent surveys before and after implementation
           of the PDA screening and counseling program.

        3. To support action by families after the office visit, we will develop a post-visit
           intervention package of newsletters and materials that are tailored to child/family
           obesity risk behaviors and parental readiness to change.

        4. We will evaluate the impact of this post visit intervention program in a 6 month trial
           focused on children identified at well child screening to have BMI >85%. 200 Families
           will be randomized to receive either a series of mailed supports over 3 months versus a
           single generic-content mailing. We will determine the respective impact of these two
           levels of post-visit support on stage of change, parental action on key obesity risk
           behaviors, and stabilization of BMI z scores after 6 months.
    

Intervention name(s): Clinician enhanced screening and counseling prompts; Tailored education and motivational materials; basic educational brochure
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): PDA based health risk screening for well child issues and obesity risks; Specific tailoring for those interested in change vs not . Two newsletters over 3 mpn.; Booklet by ADA sent x 1.
Other intervention name(s): All subjects receive screening/counseling; Well child care intervention; Education
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Childhood Obesity; Primary Care; Counseling; Screening