Connect for Health: Design of a clinical-community childhood obesity intervention testing best practices of positive outliers.

BACKGROUND

The Connect for Health study is designed to assess whether a novel approach to care delivery that leverages clinical and community resources and addresses socio-contextual factors will improve body mass index (BMI) and family-centered, obesity-related outcomes of interest to parents and children. The intervention is informed by clinical, community, parent, and youth stakeholders and incorporates successful strategies and best practices learned from 'positive outlier' families, i.e., those who have succeeded in changing their health behaviors and improve their BMI in the context of adverse built and social environments.

DESIGN

Two-arm, randomized controlled trial with measures at baseline and 12 months after randomization.

PARTICIPANTS

2-12 year old children with overweight or obesity (BMI ≥ 85th percentile) and their parents/guardians recruited from 6 pediatric practices in eastern Massachusetts.

INTERVENTION

Children randomized to the intervention arm receive a contextually-tailored intervention delivered by trained health coaches who use advanced geographic information system tools to characterize children's environments and neighborhood resources. Health coaches link families to community-level resources and use multiple support modalities including text messages and virtual visits to support families over a one-year intervention period. The control group receives enhanced pediatric care plus non-tailored health coaching.

MAIN OUTCOME MEASURES

Lower age-associated increase in BMI over a 1-year period. The main parent- and child-reported outcome is improved health-related quality of life.

CONCLUSIONS

The Connect for Health study seeks to support families in leveraging clinical and community resources to improve obesity-related outcomes that are most important to parents and children.