Because lifestyle behaviors and weight are established in early childhood and continue through adulthood, the preschool years are a critical time for intervening on obesity. Obesity-related health inequities persist for preschoolers from low-income and minority backgrounds. We are currently engaged with the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) to identify feasible, sustainable, scalable, and effective approaches for how WIC services can be enhanced to better address excessive weight gain in early childhood. The purpose of the current proposal is to create a similar partnership for treating preschool obesity in primary care settings. We are targeting primary care because the literature suggests this is where families from low-income and minority backgrounds want to discuss preschooler weight status and where expert guidelines suggest childhood obesity prevention and intervention should start. Building on collaboration with a local primary care research network, we will recruit clinical providers and caregivers of overweight/obese preschoolers from primary care settings (e.g., pediatric practices, family medicine clinics, federally qualified health centers) to form a partnership that will serve as the foundation for a trajectory of patient-centered comparative effectiveness research to improve care and health outcomes for overweight and obese preschoolers. In Detroit, 82 percent of residents identify as African American, and more children live in poverty there than in any other US city. In this setting, with committed partners, we are well positioned to identify patient-centered strategies to reduce obesity-related health inequities.
*All proposed projects, including requested budgets and project periods, are approved subject to a programmatic and budget review by PCORI staff and the negotiation of a formal award contract.