An Ecological Approach to Addressing Childhood Obesity Issues in Imperial County

Study Overview
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Brief Summary
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Our Choice is one of three CORD (Childhood Obesity Research Demonstration) studies funded by the Centers for Disease Control and Prevention in 2011 to test multi-sector, multi-level approaches to prevent and control childhood obesity. Our Choice is translating evidence-based approaches for modifying behaviors, policies, systems, and environments to promote fruit and vegetable consumption, physical activity, water consumption, and quality sleep. The ultimate goal is to assist Children's Health Insurance Program-eligible children between 2-12 years old attain a healthy weight. In addition to site-specific intervention and evaluation activities, Our Choice is working with the University of Houston Evaluation Center to conduct a cross-site evaluation on a set of shared measures.

Detailed Description
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Our Choice is a partnership between a university-affiliated research institute, a federally qualified health center, and a county public health department. We used formative research, advisory committee members' recommendations, and previous research to inform the development of the Our Choice project. Our theory-informed multi-sector, multi-level intervention targets improvements in four health behaviors: fruit, vegetable, and water consumption, physical activity, and sleep. Intervention partners include 1200 families, a federally qualified health center (including three clinics), 26 early care and education centers, two elementary school districts (and 20 elementary schools), three community recreation centers, and three restaurants. Intervention components in all sectors target changes in behaviors, policies, systems, and the social and physical environment. Evaluation activities include assessment of the primary outcome, BMI z-score, at baseline, 12- and 18-months post-baseline, and sector evaluations at baseline, 12, and 24-months.

Official Title
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An Ecological Approach to Addressing Childhood Obesity Issues in Imperial County

Conditions
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Childhood Obesity

Intervention / Treatment
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* Behavioral: Family wellness workshops
* Behavioral: Obesity chronic care model
* Behavioral: Physical activity, healthy eating, water drinking, healthy sleep promotion
* Behavioral: Environment, policy, systems changes in clinic setting only
* Behavioral: No intervention
* Behavioral: Environment, policy, and systems changes in schools, early child care education & recreation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: If family had school-age child, child must attend one of the designated Our Choice schools located in one of three designated cities. If family had preschool-age child, family must reside in one of three designated cities. Children ages 2-11 years old Maximum two children per household Children above the 5th percentile body mass index Family agrees to remain in the area throughout the duration of the study Participating parent had to understand English or Spanish Exclusion Criteria: Child has any condition that significantly limits eating or physical activity in a way that interventions would be impacted

Ages Eligible for Study
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Minimum Age: 2 Years
Maximum Age: 11 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Non-Randomized
Intervention Model: Factorial Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Health Care plus Public Health<br>The Health Care intervention involves the implementation of an obesity care model within a Federally Qualified Health Center (FQHC) and includes a Family Wellness Program delivered by Community Health Workers (CHWs). The Public Health intervention involves working with early care and education centers, schools, community recreation organizations, and restaurants to promote four health behaviors: fruit and vegetable consumption, physical activity, water consumption, and quality sleep. | Behavioral: Family wellness workshops<br>* Nine family wellness workshops and eight family physical activity sessions facilitated by community health workers.<br>Behavioral: Obesity chronic care model<br> <br> Behavioral: Physical activity, healthy eating, water drinking, healthy sleep promotion<br> <br> Behavioral: Environment, policy, systems changes in clinic setting only<br> <br> Behavioral: Environment, policy, and systems changes in schools, early child care education & recreation<br> <br> |
| Experimental: Health Care<br>The Health Care intervention involves the implementation of an obesity care model within a Federally Qualified Health Center (FQHC) and includes a Family Wellness Program delivered by Community Health Workers (CHWs). | Behavioral: Family wellness workshops<br>* Nine family wellness workshops and eight family physical activity sessions facilitated by community health workers.<br>Behavioral: Obesity chronic care model<br> <br> Behavioral: Physical activity, healthy eating, water drinking, healthy sleep promotion<br> <br> Behavioral: Environment, policy, systems changes in clinic setting only<br> <br> |
| Experimental: Public Health<br>The Public Health intervention involves working with early care and education centers, schools, community recreation organizations, and restaurants to promote four health behaviors: fruit and vegetable consumption, physical activity, water consumption, and quality sleep. | Behavioral: Physical activity, healthy eating, water drinking, healthy sleep promotion<br> <br> Behavioral: Environment, policy, systems changes in clinic setting only<br> <br> |
| Experimental: Control<br>No intervention. | Behavioral: No intervention<br>* No intervention.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| BMI z-score change in 1184 children, 2-11 years old, assigned to a Health Care plus Public Health intervention, a Health Care intervention only, a Public Health intervention only, or a control condition |  | 12-month and 18-month post baseline evaluation; December 2015 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Child waist circumference |  | 12-month and 18-month post baseline evaluation; December 2015 | 
| Parent waist circumference |  | 12-month and 18-month post baseline evaluation; December 2015 | 
| Parent body mass index | Weight and height | 12-month and 18-month post baseline evaluation; December 2015 | 
| Parent blood pressure |  | 12-month and 18-month post baseline evaluation; December 2015 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Childhood obesity, Latino, Hispanic