Results Summary

What was the research about?

Children with obesity may develop health problems that usually affect adults, such as heart disease or high blood pressure. In Virginia’s Dan River Region, childhood obesity is about three times higher than in the rest of the state. This region has limited resources and a shortage of doctors and nurses.

In this study, the research team wanted to improve body mass index, or BMI, in children with obesity or overweight who live in this region. BMI is a measure of body fat. For children, BMI is based on age, height, weight, and sex. The team compared two programs shown to improve BMI:

  • iChoose was for parents and children. Families took 12 classes about healthy eating and 48 exercise classes. Parents received 24 automated phone calls for support, and children received newsletters twice a month.
  • Family Connections was for parents only. It included two classes and 10 phone calls.

The research team looked at BMI and other health outcomes for children and their parents.

What were the results?

After six months, the two programs didn’t improve children’s or parents’:

  • BMI
  • Blood pressure
  • Quality of life
  • Intake of fruit, vegetables, water, or sugary drinks
  • Exercise level

Who was in the study?

The study included 139 children and 128 parents. Of the children, 48 percent were White, 45 percent were Black, and 8 percent were another race. Also, 9 percent were Hispanic. The average age was 10, and 58 percent were girls. Based on BMI, 73 percent had obesity, and 27 percent had overweight.

Of the parents, 49 percent were White, 49 percent were Black, and 2 percent were another race. Also, 5 percent were Hispanic. The average age was 49, and 97 percent were women. Based on BMI, 76 percent had obesity, 17 percent had overweight, and 7 percent were in the healthy weight range.

What did the research team do?

The research team assigned families by chance to take part in one of the two programs. At the start of the study and six months later, the team measured the children’s BMI. They also collected information about parents’ weight, parents’ and children’s blood pressure, and families’ eating and exercise habits.

The research team worked with parents of children with obesity, community groups, and doctors to design and conduct the study.

What were the limits of the study?

Only 18 percent of eligible families enrolled in the study. Also, only 63 percent of iChoose families and 84 percent of Family Connections families completed the study. Results might have differed if more families joined or completed the study.

Future research could look at ways to get families to sign up for and complete programs for children with obesity or overweight.

How can people use the results?

Health professionals that serve families in areas with limited resources can use these results when considering ways to help children with obesity or overweight.

Final Research Report

View this project's final research report.

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. 

Peer reviewers commented and the researchers made changes or provided responses. Those comments and responses included the following:

  • The reviewers noted that the researchers highlighted improvements in study outcomes within treatment groups and touted descriptive information they considered to be clinically important. The reviewers asked the researchers to downplay these results and focus on between-groups differences that were the main aims and hypotheses of the project. The researchers clarified multiple times in the text that the between-groups outcomes were not significant and that the other results were more exploratory but maintained that they needed to report all of the results of the study, not just those related to the comparative effectiveness aim.
  • The reviewers cautioned the researchers regarding their interpretation of study results, given the level of missing data for study outcomes. The researchers disagreed that conclusions could not be made since they demonstrated in sensitivity analyses that missing data had little to no impact on study results.
  • One reviewer questioned whether there were any harms to study participants related to the interventions. The researchers added a section to the report on harms based on adverse event reporting, quality of life, and parents’ exit interviews.

Conflict of Interest Disclosures

Project Information

Paul Estabrooks, PhD, MS, and Jamie Zoellner, PhD
University of Virginia^
A Randomized-Controlled Trial to Compare the Reach, Effectiveness, and Maintenance of Two Family-Based Childhood Obesity Treatment Programs in a Medically Underserved Region

Key Dates

December 2016
March 2022

Study Registration Information

^This study was affiliated with Virginia Polytechnic Institute and State University when it was initially awarded.


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Last updated: January 31, 2023