Reducing Health Disparities in Childhood Obesity

Study Overview
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Brief Summary
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In this study, we will address cost barriers to participating in summer programs and hypothesize this will lead to marked improvements in children's obesogenic behaviors and a reduction in excessive, unhealthy weight gain over summer.

Detailed Description
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For this study, we will rigorously test the impact of providing access to existing community-operated summer programs on weight status (i.e., BMI z-score) and obesogenic behaviors of 1st-3rd grade children from low-income households. Using a pragmatic, Type II hybrid effectiveness-implementation randomized design, we will compare changes in weight status and obesogenic behaviors of children from low-income households randomized to one of two conditions: free summer programming or comparison/control.

Official Title
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Reducing Health Disparities in Childhood Obesity Using Financial Incentives in Low-income Households

Conditions
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Obesity

Intervention / Treatment
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* Behavioral: Free Summer Programming


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 1st through 3rd grade students in the participating schools. Exclusion Criteria: The only exclusion criteria will be the diagnosis of an intellectual disability, such as: Autism Spectrum Disorder Down Syndrome Fragile X Fetal Alcohol and/or a physical disability, such as wheelchair use This decision was made because of the added resources required to evaluate these children, as well as the inability to sample enough of these children to adequately draw conclusions. No other exclusion criteria will be used.

Ages Eligible for Study
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Minimum Age: 6 Years
Maximum Age: 10 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: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: We will compare changes in weight status and obesogenic behaviors of children from low-income households randomized to one of two conditions: free summer programming or comparison/control.
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Summer Programming<br>The summer day camps are not singularly focused, such as sport camps or academic only camps. Rather, the camps provide indoor and outdoor opportunities for children to be physically active each day, provide enrichment and academic programming, as well as provide breakfast, lunch, and snacks. To standardize programming, the schools operate their camps on the same daily schedules which are developed by the same district-level personnel, with identical programmatic content delivered across all schools. The schools also provide the same meals to all children enrolled. The meals adhere to the Summer Food Service Program nutrition guidelines and are reimbursed through existing federal food programs. | Behavioral: Free Summer Programming<br>* The summer day camps are not singularly focused, such as sport camps or academic only camps. Rather, the camps provide indoor and outdoor opportunities for children to be physically active each day, provide enrichment and academic programming, as well as provide breakfast, lunch, and snacks. To standardize programming, the schools operate their camps on the same daily schedules which are developed by the same district-level personnel, with identical programmatic content delivered across all schools. The schools also provide the same meals to all children enrolled. The meals adhere to the Summer Food Service Program nutrition guidelines and are reimbursed through existing federal food programs.<br>|
| No Intervention: Comparison/Control<br>The children in the control group will be children enrolled in the same schools as those randomized to receive summer programming. The comparison/control group will not receive a voucher to attend a summer camp. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| BMI | Change in Body Mass Index - height and weight | Baseline (month 0), 9 months, and 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Physical Activity | Accelerometer-derived physical activity (minutes per day) | 7 months and 10 months | 
| Sleep | Accelerometer-derived sleep (minutes per day) | 7 months and 10 months | 
| Diet | Parent report of child dietary intake (healthy eating index) | 7 months and 10 months | 
| Screen Time | Parent report of screen time usage (minutes per day) | 7 months and 10 months |