Success in Health: Impacting Families Together
Condition: Childhood Obesity
MeSH terms: Pediatric Obesity
Study type: Interventional

Summary: 
      This study evaluates and compares the efficacy of professional versus peer-based delivery of
      family-based treatment for childhood overweight and obesity in elementary school aged
      children. Families will be randomized to receive treatment from professionals or to receive
      treatment from professionally-trained peer interventionists. Some parents will then be
      invited to serve as peer interventionists for the next group of families.
    

Detailed description: 
      The high prevalence of pediatric overweight and obesity in the U.S. necessitates the
      development of efficacious, but cost-effective and easily disseminable interventions that
      improve and sustain better pediatric weight outcomes. Accumulated evidence finds initial and
      long-term efficacy of moderate-to-high intensity (>25 contact hours) family-based treatment
      (FBT) for elementary school-aged children, but such treatment is prohibitively expensive
      because of high personnel costs (delivery by behavioral health professionals) and therefore
      limited in availability, reach, and impact. Very few overweight/obese children receive
      evidence-based treatment to improve their weight status or health.

      The pilot data suggest a new model, peer-based delivery FBT with FBT-treated parents trained
      and subsequently delivering FBT to other families, is feasible and demonstrates initial
      efficacy. This delivery model could dramatically reduce FBT costs and increase FBT
      availability. Preliminary data also suggest that serving as a peer interventionist may also
      benefit the peers themselves and their children in better sustaining their own weight
      outcomes. The present study aims to provide a more definitive test of the short- and
      long-term efficacy of peer- versus professionally-delivered FBT on child weight outcomes.
      Embedded in this comparison is an examination of the feasibility of peer-based FBT delivery,
      investigating the impact of serving as a peer interventionist on the peers' own and their
      child's long- term weight status, and a more comprehensive examination of differential costs
      of professional- versus peer- based FBT delivery.

      The present study will also test potential dissemination and sustainability by examining the
      efficacy of peer-delivered FBT among peer interventionists who themselves received FBT from
      other peers and not from professional interventionists. Moderation of treatment outcome is
      also examined, focusing on peer interventionist and child characteristics. This multi-phase
      trial will enroll 304 families with 7-11 year old overweight/obese children in multiple sites
      throughout the region, and include short-term (post-treatment) and long-term (up through 1
      year after treatment cessation) assessments. This investigation of an innovative approach
      that could significantly reduce FBT delivery costs, while also improving the maintenance of
      treatment effects, is critical to improving the health of the many already overweight
      children at risk for chronic disease.
    

Intervention name(s): FBT for Pediatric Weight Management by Professionals; FBT for Pediatric Weight Management by Peers; Peer Interventionists
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): This behavioral treatment includes behavioral skills training and accountability, including food and activity self-monitoring, goal setting, and home environment change. This 20 week treatment is adapted from our existing evidence-based interventions and is delivered by PROFESSIONAL interventionists.; This behavioral treatment includes behavioral skills training and accountability, including food and activity self-monitoring, goal setting, and home environment change. This 20 week treatment is adapted from our existing evidence-based interventions and is provided by PEER interventionists.; Parents who receive FBT complete 6 weeks of training and then serve as peer interventionists to a new group of families.
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment