Project Number: 6250-51000-053-20
Project Type: Specific Cooperative Agreement

Start Date: Apr 01, 2009
End Date: Mar 31, 2014

Objective:
Objective 1: Investigate the effectiveness of community-based intervention strategies to prevent childhood obesity and its associated health risks in 8- to 12-y-old Hispanic children with BMI >/= 85th percentile. Sub-objective 1.A. Test the effectiveness of diet behavior modification, structured aerobic exercise, or diet behavior modification plus structured aerobic exercise for obesity prevention and improvement in fitness, health risks, and psychological state in at-risk Hispanic children, ages 8-12 y, assigned to one of three treatment groups or control in a 12-month family-based RCT. Sub-objective 1.B. Evaluate the role of genetic variation in response to strategies aimed at diet and PA. Sub-objective 1.C. Model energy balance in growing children to predict the obligatory changes in energy intake and/or energy expenditure and PAL required for obesity prevention. Objective 2: Develop and evaluate family-centered intervention strategies for the pediatric primary care setting to prevent childhood obesity. Sub-objective 2.A. Develop a conceptual model and perform formative work to evaluate the model for a pediatric obesity prevention program for primary care clinics. Sub-objective 2.B. Develop and pilot test a parent-targeted obesity prevention program for pediatric primary care clinics. Sub-objective 2.C. Evaluate the parent-targeted prevention program for effectiveness in pediatric primary care clinics.

Approach:
The long-term objective of this project is to increase our understanding of how to prevent childhood obesity through targeted community interventions. A multifactorial theoretical approach based on Social Cognitive Theory (SCT) and parenting theory will be taken to address the built environment as well as family dynamics and child behavior at the community and primary care level. A 12-month family-based randomized controlled trial (RCT) will be conducted to test the effectiveness of diet behavior modification, structured aerobic exercise, or diet behavior modification plus structured aerobic exercise for obesity prevention and improvement in fitness, health risks, and psychological state in at-risk Hispanic children (Objective 1). The role of genetic variation in response to strategies aimed at diet and physical activity (PA) will be evaluated and a model developed to predict the obligatory changes in energy intake and physical activity level (PAL) required for obesity prevention. Family-centered intervention strategies will be developed and evaluated for the pediatric primary care setting to prevent childhood obesity (Objective 2). A conceptual model will be developed and formative work performed to evaluate the model for obesity prevention program for primary care clinics. A parent-targeted obesity prevention program will be developed and a pilot study conducted in pediatric primary care clinics. A RCT will be conducted to evaluate the parent-targeted prevention program for effectiveness in pediatric primary care clinics. Together, these strategies form a new paradigm that integrates community resources and pediatric primary care in support of the child and the family in the prevention and management of childhood obesity.