Primary Care Child Obesity Intervention Targeting Parents
Condition: Overweight; Obesity
MeSH terms: Obesity; Overweight; Pediatric Obesity
Study type: Interventional

Summary: 
      Child overweight has become one of today's most important public health concerns. Engaged and
      skilled parenting that models, values, and encourages healthy eating habits and a physically
      active lifestyle can play a key role in childhood overweight prevention and reduction.
      Primary care providers are well positioned to intervene with children and their parents, but
      face many barriers in addressing child overweight. A child overweight treatment approach is
      proposed for the primary care setting to facilitate parents' active involvement and
      self-efficacy in promoting healthy eating habits and physical activity for their children. We
      will test the following hypotheses: Hypothesis I (primary hypothesis): Children assigned to
      the intervention group will improve more in weight status (measured by BMI percentile) than
      children in the control group. Hypothesis II: Primary care providers assigned to the
      intervention group will improve more in their competence in addressing child overweight than
      the providers in the control group. Hypothesis III: After the intervention, parents in the
      intervention group will have more involvement and self-efficacy in promoting healthy weight
      for their children than parents in the control group. Hypothesis IV: Compared to the control
      group, the intervention group will improve more in family diet and eating, physical activity
      behaviors, as well as parental attitude and beliefs. Eighty children five to eleven years old
      who are overweight or obese will be recruited from two pediatric and two family practice
      clinics in southern Appalachia. Children will be randomly assigned to intervention and
      control groups based on clinic affiliation. Parents of children in the intervention group
      will participate in four clinic-based group sessions using the NIH We Can! curriculum
      moderated by a trained clinic provider, two individual brief motivational interviewing visits
      with their clinic provider, and four follow-up phone calls with the project coordinator or
      registered dietician. Parenting behaviors and attitudes, and family eating and activity
      habits, and children's weight status will be assessed at baseline, at the completion of the
      intervention, and at six months after the intervention. Changes in the assessments will be
      compared between treatment and control groups. Changes in provider and parent attitudes and
      perceptions about this treatment approach,adherence to the program, and estimates of
      associated time will be measured.
    

Detailed description: 
      Specific aims of this project are: 1) to establish a primary care based and parent-mediated
      childhood overweight intervention program based on the Chronic Care Model in the primary care
      setting, 2) to explore the efficacy of this intervention in improving the weight status of
      children, 3) to examine the acceptability and feasibility of the approach among primary care
      providers and parents. Clinic providers and study personnel will be trained in the use of
      brief motivational interviewing (brief MI) for the visits and phone calls. The American
      Academy of Pediatrics 15-Minute Obesity Prevention Protocol will be used for individual
      visits while the NIH We Can! curriculum and materials will be used for group visits. Parents
      in the control group will receive the We Can! Parent Handbook and usual care. The
      intervention is designed to facilitate efficient communication of advice about behavior
      change, nutrition, and physical activity to parents. Partnership of primary care providers
      with parents and use of brief intervention techniques and group visits can be a practical
      approach. If proven to be effective, this approach can serve as an exportable model to other
      primary care practices and will reach a large proportion of the population and have
      far-reaching effects.
    

Intervention name(s): Parent education / behavioral counseling; Usual Care
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Providers and study personnel will be trained in the use of the NIH We Can! curriculum for group visits and brief motivational interviewing for individual visits and follow-up phone calls. Training will be conducted by the PI and Co-Investigators using a combination of online, self-study, and face-to-face formats totally at least/approximately 8 hours. At least one project team member will attend each group visit. Specifically, the American Academy of Pediatrics 15-minute Obesity Prevention Protocol will be utilized during individual visits. The intervention is designed to take place over a period of 10-12 weeks in the primary care office.; Parents of children in the control group will receive usual care from their primary care provider as well as a copy of the NIH We Can! Parent Handbook.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: overweight; obesity; rural; primary care