Project Summary
Overweight affects over one-third of children in the United States and is more common among racial and ethnic minorities and those living in disadvantaged communities. Overweight children often suffer from chronic medical problems like diabetes and also from conditions that are often unseen, such as poor quality of life. Programs within healthcare settings, such as primary care offices, can help children who are overweight because families often have a long-standing, trusting relationship with their primary care clinicians.
However, clinical programs do not always pay close attention to the many non-medical issues that can interfere with families trying their best to follow their doctors’ recommendations. Many things can get in the way, such as financial trouble leading to inability to buy healthy foods, not recognizing which foods are contributing to their child’s weight gain, or not knowing about the availability of low-cost resources in their communities to help their children exercise. Therefore, it is unlikely that the primary care setting can address the vexing problem of childhood overweight without understanding and addressing social issues that influence weight.
The goal of this study is to work with parents and children to develop a new program for the management of childhood overweight. The program will build on the resources available in primary care and provide linkages to community resources to support behavior change. This program is intended to improve children’s weight, body mass index, quality of life, and parents’ experiences with their child’s care. We will conduct this study in Massachusetts primary care offices that care for a large number of children at high risk for being overweight.
This study has two parts. First, we will work with pediatricians to identify children from disadvantaged communities who have achieved a healthier weight. We call these children and their families “positive outliers” because they stand apart from their peers by managing to succeed under conditions where many fail. Learning from these families by using interviews and group discussions will help us determine what worked and how we can incorporate their strategies into a new program.
Next, we will design and test a new clinical program to improve the care of overweight children 2–12 years old. The program will involve health coaches who will assist children in improving their health behaviors and will link children and families to existing resources in their community. Health coaches will study communities by using cutting-edge technology that can tell them where families can shop for healthy foods, find safe places for children to play, and use public transportation to get there. In addition, health coaches will use text messages and other mobile technology to reach families. By creating clinical-community linkages and attending to the social issues that influence weight, this program can have a significant impact on childhood overweight.
Taveras EM, Marshall R, Sharifi M, et al. Comparative Effectiveness of Clinical-Community Childhood Obesity Interventions: A Randomized Clinical Trial, JAMA Pediatrics (June 2017).
Lim J, Davison KK, Jurkowski JM, et al. Correlates of Resource Empowerment among Parents of Children with Overweight or Obesity, Child Obesity (November 2016).
Sharifi M, Marshall G, Goldman RE et al.,Engaging Children in the Development of Obesity Interventions: Exploring Outcomes that Matter Most among Obesity Positive Outliers, Patient Education and Counseling (November 2015).
Taveras EM, Marshall R, Sharifi M et al., Connect for Health: Design of a Clinical-Community Childhood Obesity Intervention Testing Best Practices of Positive Outliers, Contemporary Clinical Trials (September 2015).
Sequist TD and Taveras EM, Clinic–Community Linkages for High-Value Care, The New England Journal of Medicine (December 2014).
Sharifi M, Marshall G, Goldman R et al., Exploring Innovative Approaches and Patient-Centered Outcomes From Positive Outliers in Childhood Obesity, Academic Pediatrics (2014).
Learning from the Success Stories
A narrative about researchers who are looking to families for help with improving health care of children who are overweight.
Project Details
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