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Primary care child obesity intervention targeting parents

$213,750R15FY2009HDNIH

East Tennessee State University, Johnson City TN

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Abstract

DESCRIPTION (provided by investigator): Child overweight has become one of today's most important public health concerns. Engaged and skilled parenting that models, values, and encourages healthy eating habits and a physically active lifestyle can play a key role in childhood overweight prevention and reduction. Primary care providers are well positioned to intervene with children and their parents, but they encounter many barriers in addressing child overweight. A child overweight treatment approach is thus proposed for the primary care setting to facilitate parents'active involvement and self-efficacy in promoting healthy eating habits and physical activity for their children. Specific aims are: 1) to establish a primary care based and parent-mediated childhood overweight intervention program in the primary care setting, 2) to explore the efficacy of this intervention in promoting the weight status of children, 3) to examine the acceptability and feasibility of the approach among primary care providers and parents. The children that will be recruited for this study are from a predominantly low socioeconomic status population residing in the Southeastern United States with a particularly high prevalence of overweight in which few interventions have been tested. Eighty children five to eleven years old who are overweight or at risk for overweight will be recruited from two pediatric and two family practice clinics. Children will be randomly assigned to intervention and control groups based on clinic affiliation. Parents of children in the intervention group will participate in six clinic-based group sessions moderated by a trained clinic provider or nutritionist, two visits with their clinic provider, and six follow-up phone calls. The intervention is designed to facilitate efficient communication of advice about behavior change, nutrition, and physical activity to parents. Individualized action plans, completed by parents during each of the group meetings, will be placed in each child's clinic chart to facilitate continued therapy and monitoring by their clinic provider. Changes in provider and parent attitudes and perceptions about this treatment approach, adherence to the program, and estimates of associated time will be measured. Parenting behaviors and attitudes, and family eating and activity habits will be assessed at baseline and at the completion of intervention, while children's weight status will be assessed at baseline, at the completion of the intervention, and at six months after the intervention. Changes in the assessments will be compared between treatment and control groups. Partnership of primary care providers with parents and use of brief intervention techniques and group visits can be a practical approach. If proven to be effective, this approach can serve as an exportable model to other primary care practices and will reach a large proportion of the population and have far-reaching effects. PUBLIC HEALTH RELEVANCE: Child obesity has become one of today's most important public health concerns. Primary care providers can reach millions of children and their families and, therefore, can assist in establishing and encouraging parents'active involvement in promoting healthy eating habits and physical activity for their children. The partnership of primary care providers with parents can be a practical and powerful approach toward reducing child obesity and, if successful, will have a significant impact on this public health issue.

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