Guided Self-Help Obesity Treatment in the Doctor's Office - GOT Doc
Condition: Pediatric Obesity
MeSH terms: Obesity; Pediatric Obesity
Study type: Interventional

Summary: 
      One-third of our nations' children are overweight or obese (OW/OB). The cornerstone of
      obesity treatment involves intensive family-based behavioral therapy, yet these programs
      often exist in tertiary care academic settings that have long wait lists and are too far away
      for families to access. Primary care providers (PCP) have been called on by several
      organizations to be the front line of obesity management, yet they are limited by a lack of
      time, resources, and skills. Thus, if we are to offer effective obesity management in the
      healthcare setting, other care models need to be developed and tested. The goal of this
      proposal is to deliver Guided Self-Help (GSH) treatment of childhood obesity in the primary
      care setting. This program relies on classic behavioral therapy strategies, self-regulation
      theory, and provides the support needed for patient/family self-management of weight loss.
      Implementing this program in the primary care setting will increase our ability to deliver
      nutrition and weight-related counseling in the primary care office and serve patients closer
      to home, thereby increasing access to effective treatment, improving adherence to recommended
      changes, and meeting the goals of Healthy People 2020.
    

Detailed description: 
      Currently 1/3 of our nation's children are overweight or obese. The goal of Healthy People
      2020 is to reduce the proportion of children who are obese and increase the proportion of
      primary care visits that include nutrition and weight-related counseling. However, there are
      a lack of resources and providers that can offer effective weight-related counseling and
      treatment. Gold-standard family-based weight control programs for children are often provided
      at tertiary care academic centers and can be difficult to access. Furthermore, primary care
      providers (PCPs), who have been identified as key players in the treatment of childhood
      obesity, are not well-equipped to address this issue, engage in behavior
      modification/lifestyle counseling, or provide effective treatment in the primary care
      setting. As a result, new models of care are needed so that a greater proportion of
      overweight/obese (OW/OB) children and their parents can access care and receive quality
      treatment for obesity. The investigators propose to train health coaches in the primary care
      setting to deliver Guided Self-Help (GSH) treatment of childhood obesity. Implementing this
      program in the primary care setting will increase our ability to deliver nutrition and
      weight-related counseling in the primary care office and serve patients closer to home,
      thereby increasing access to effective treatment, improving adherence to recommended changes,
      and meeting the goals of Healthy People 2020.

      The goal of this study is to conduct a pragmatic clinical trial in two large pediatric
      practices in San Diego County (n=200) where 38% and 39% of children are OW/OB. The
      intervention group will receive GSH (14 sessions over 6 months) delivered by a health coach
      in the clinic. The control group will receive usual care, i.e. PCP provides obesity
      management using decision support tools in the electronic health record and refers to a
      tertiary care program (20 sessions over 6 months) at the academic center.
    

Intervention name(s): Guided Self-Help Obesity Treatment; Family-based behavioral obesity treatment
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Guided Self-Help obesity treatment will be provided by a health coach in the clinic. The treatment involves 14 sessions: 1 one-hour session and 13 twenty-minute sessions with the health coach who will provide behavioral obesity treatment.; Traditional family-based, group-based behavioral weight control program. The treatment involves 20 hourly group-based sessions for parents and children separately, which occurs weekly for 16 weeks, then every other week for the last 2 months (4 session).
Other intervention name(s): Guided self-help; FBT
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Obesity treatment; Primary care; Guided Self-Help