Results Summary

What was the research about?

Childhood obesity is common in the United States. Weight problems during childhood can lead to long-term health problems, such as high blood pressure, type 2 diabetes, and high cholesterol. Children who have obesity are also at risk of having low self-esteem and depression.

In this study, the research team looked at possible ways to help children and their parents manage children’s weight. The team assigned children whose weight was higher than the healthy range to one of two groups. In both groups, children and their parents took part in a healthy weight program that included

  • Information about how to manage children’s weight
  • A neighborhood resource guide
  • Monthly text messages

One group also got two extra weekly text messages and had six sessions with trained health coaches. Health coaches worked with children and their families to improve children’s diets, physical activity levels, and motivation.

What were the results?

After one year, children in both groups had lower body mass index (BMI) scores compared with their BMI scores at the start of the study. BMI is a measure of a person’s body fat based on their height and weight. Adding health coaching and extra texts was no more effective than the basic program alone in helping children get to a healthier weight.

Neither program changed the number of children who were in the highest weight category. This group included about 20 percent of the children in the study.

In both groups, parents reported that they had better access to resources to help with their children’s weight than before the study. These resources included farmers’ markets, recreation centers, and community support groups. Only the parents of children who received health coaching reported a better quality of life for their children.

Who was in the study?

The study included 721 children, ages 2 to 12 years, and their parents. The children had BMI scores that were higher than the scores of 85 percent of children of the same age and gender. The children were patients in a large healthcare system in Massachusetts.

What did the research team do?

The study team assigned the children and their parents to one of two groups by chance. One group received materials to help manage children’s weight, a neighborhood resource guide, and monthly text messages about healthy behaviors. The materials urged parents to help their children cut back on sugary drinks, exercise more, limit screen time, and improve sleep habits. The second group received the same materials as the first group plus two extra weekly text messages and six sessions with a trained health coach. The health coaches helped families set goals for managing weight, find local places to exercise, learn to shop for and eat healthy foods, and improve sleep habits.

The research team used the heights and weights from children’s medical records to figure out the children’s BMIs at the start of the study and one year later. In telephone interviews at the beginning and end of the study, parents answered questions about their ability to help their children manage their weight. Parents also reported their feelings about their children’s quality of life related to their weight.

What were the limits of the study?

The study included children who were patients in a large Massachusetts healthcare system. The results may differ for patients who live in other places or receive care in different kinds of medical offices.

These programs didn’t decrease the number of children who were in the highest weight category. Future research could look at how best to help these children.

How can people use the results?

Doctors’ offices and clinics could consider using similar weight-management programs to help children achieve a healthy weight.

Final Research Report

View this project's final research report.

More About This Research

PCORI Stories

Learning from the Success Stories
A feature story about researchers who are looking to families for help with improving health care of children who are overweight.

Engaging with Families Is Key to Addressing Childhood Obesity
An update to the feature story about how researchers discovered that tailored coaching and educational text messages for families, as well as clinical decision support tools for pediatric providers, seemed to help children with obesity and those who are overweight lower their body mass indexes.

Study Protocol

View this project's study protocol.

Related PCORI Dissemination and Implementation Project

Peer-Review Summary

Peer review of PCORI-funded research helps make sure the report presents complete, balanced, and useful information about the research. It also assesses how the project addressed PCORI’s Methodology Standards. During peer review, experts read a draft report of the research and provide comments about the report. These experts may include a scientist focused on the research topic, a specialist in research methods, a patient or caregiver, and a healthcare professional. These reviewers cannot have conflicts of interest with the study.

The peer reviewers point out where the draft report may need revision. For example, they may suggest ways to improve descriptions of the conduct of the study or to clarify the connection between results and conclusions. Sometimes, awardees revise their draft reports twice or more to address all of the reviewers’ comments. 

Reviewers’ comments and the investigator’s changes in response included the following: The awardee revised the conclusions to clarify that there were no differences between children in the two study groups (enhanced primary care and health coaching plus enhanced primary care) regarding body mass index (BMI) or family-centered outcomes. Both groups improved over time in these areas.

  • The awardee added a thorough description of the role that patients and stakeholders played in the study design, execution, and interpretation. It also described its website, which provided examples of all patient and stakeholder intervention materials.
  • Responding to reviewer comments that the report did not put the changes in outcome measures into a clinical context, the awardee added to the statistical analysis section a description of accepted clinically meaningful changes in BMI, a main outcome measure. The investigator noted that it was unable to add similar values for quality of life, the other major outcome, because any improvement is usually considered clinically meaningful.
  • Addressing the patient reviewer’s request to better understand the areas of children’s lives that could be improved by the research, the investigator presented information about family-centered outcomes for childhood obesity that both interventions improved.
  • The awardee addressed reviewer questions about blinding. It included a section in the methods describing the procedures for blinding study staff, participants, and clinicians to specific study hypotheses and to intervention assignment.

Conflict of Interest Disclosures

Project Information

Elsie Mireya Taveras, MD, MPH
Massachusetts General Hospital
$2,153,815
10.25302/3.2018.IH.13046739
Improving Childhood Obesity Outcomes: Testing Best Practices of Positive Outliers

Key Dates

September 2013
October 2017
2013
2018

Study Registration Information

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Last updated: January 12, 2022