OBESITY IS A PREVALENT CONDITION IN THE UNITED STATES AND IT CONTRIBUTES TO THE HIGH COSTS OF HEALTHCARE AND EARLY MORTALITY. THE RISKS OF BECOMING OBESE AS AN ADULT OCCUR IN CHILDHOOD. THEREFORE, EFFORTS TO PREVENT OBESITY MUST BEGIN EARLY IN THE CHILD'S LIFE. INTERVENTIONS TO PREVENT OBESITY IN EARLY CHILDHOOD NEED TO INVOLVE THE CHILD'S FAMILY MEMBERS, PARTICULARLY THE PARENTS, AND TARGET HEALTHY LIFESTYLE AND DIETARY BEHAVIORS. DIETS THAT ARE HIGH IN FRUITS AND VEGETABLES AND LOW IN SUGARS AND CALORICALLY-DENSE FOODS HELP CHILDREN MAINTAIN A HEALTHY WEIGHT. INCREASING PHYSICAL ACTIVITY, LIMITING SEDENTARY TIME, AND IMPROVING SLEEP ARE RELATED BEHAVIORS THAT INTERVENTIONS NEED TO ADDRESS. THE PLACE MOST CHILDREN AND FAMILIES RECEIVE ADVICE AND RECOMMENDATIONS ABOUT THESE BEHAVIORS IS THEIR PEDIATRICIAN. UNFORTUNATELY, MANY PARENTS ARE UNABLE TO ENACT THE RECOMMENDATIONS OF THE PEDIATRICIAN TO IMPROVE THE CHILD'S DIET AND INCREASE PHYSICAL ACTIVITY DUE TO INEFFECTIVE PARENTING SKILLS AND OTHER FAMILY FUNCTIONING ISSUES. FAMILY-BASED BEHAVIORAL INTERVENTIONS THAT FOCUS ON BUILDING PARENTING SKILLS TO SUPPORT HEALTHY BEHAVIORS ARE OFTEN NEEDED FOR RECOMMENDATIONS TO BE FOLLOWED BUT THESE KINDS OF INTERVENTIONS HAVE NOT YET BEEN INTEGRATED INTO PEDIATRIC CARE IN THE UNITED STATES. EMBEDDING THESE PROGRAMS WITHIN AND IN COORDINATION WITH PRIMARY HEALTH CARE HAS THE POTENTIAL TO SIGNIFICANTLY IMPACT THE OBESITY EPIDEMIC AND IMPROVE SOCIETY, CHILD AND ADULT HEALTH, AND WIDE-RANGING ECONOMIC OUTCOMES.FOR THIS STUDY, WE ARE USING A GROUP RANDOMIZED TRIAL DESIGN. WE WILL RECRUIT AND ENROLL 180 FAMILIES WITH CHILDREN AGES 2 TO 8 YEARS WHO HAVE ELEVATED RISK FOR OBESITY DUE TO POOR DIETARY HABITS AND BEING LOW-INCOME--BOTH ARE RELATED TO RISK FOR EXCESS WEIGHT GAIN. AFTER ASSESSING THE FAMILY, 117 WILL BE ASSIGNED TO A GROUP THAT WILL BE OFFERED AN EVIDENCE-BASED PARENTING INTERVENTION CALLED THE FAMILY CHECK-UP FOR HEALTH IN ADDITION TO THE HEALTH CARE SERVICES THROUGH THEIR PEDIATRICIAN'S OFFICE. THE REMAINING 63 WILL CONTINUE IN PEDIATRIC CARE AS USUAL. FAMILIES IN THE FAMILY CHECK-UP FOR HEALTH GROUP WILL RECEIVE THE INTERVENTION EACH YEAR FOR 3 YEARS COINCIDING WITH THE CHILD'S ANNUAL WELL VISIT. THE PROGRAM INVOLVES AN ASSESSMENT OF FAMILY STRENGTHS AND CHALLENGES, A MOTIVATIONAL SESSION TO ENCOURAGE ENGAGEMENT IN ADDITIONAL PARENTING SUPPORT SESSIONS AND RESOURCES IN THE LARGER COMMUNITY, SUCH AS COOKING CLASSES, EMPLOYMENT SUPPORT, AND OTHER RESOURCES TO SUPPORT CHILD AND FAMILY HEALTH. EACH YEAR, WE WILL COLLECT DATA THROUGH SURVEYS, OBSERVATION, AND MEDICAL RECORDS ON THE CHILD AND FAMILY TO EVALUATE THE EFFECTS OF THE PROGRAM. WE WILL TEST THE EFFECTS OF RANDOM ASSIGNMENT TO THE FAMILY CHECK-UP FOR HEALTH VERSUS USUAL CARE AND EXPLORE WHAT CONTRIBUTED TO THE OBSERVED CHANGES IN HEALTH BEHAVIORS AND FAMILY FUNCTIONING AND WHETHER THESE EFFECTS DIFFER BASED ON CHARACTERISTICS OF THE FAMILIES.THIS STUDY HAS THE POTENTIAL TO RED,UCE CHILDHOOD OBESITY AND IMPROVE CHILDREN'S HEALTH. IF SUCCESSFUL, THIS STUDY WILL PROVIDE A MODEL FOR HOW TO COORDINATE PREVENTIVE FAMILY-BASED INTERVENTION WITH THE PEDIATRIC PRIMARY CARE SYSTEM, ESTABLISH THAT THE FAMILY CHECK-UP FOR HEALTH IS AN EFFECTIVE PROGRAM FOR IMPROVING HEALTH OUTCOMES, AND WE WILL HAVE DEVELOPED A PLATFORM TO TRAIN HEALTHCARE STUDENTS AND PROFESSIONALS IN THESE EFFECTIVE PRACTICES. OVER TIME AND WITH WIDE-SCALE IMPLEMENTATION OF FAMILY CHECK-UP FOR HEALTH, SOCIETAL BENEFITS WOULD INCLUDE A HEALTHIER GENERATION WITH LOWER HEALTH CARE COSTS AND LONGER MORE FULFILLING LIVES.