Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2023 May:128:107140.
doi: 10.1016/j.cct.2023.107140. Epub 2023 Mar 7.

Rationale and design of integrating a parents first obesity intervention with a pediatric weight management intervention for rural families - Evaluating the ripple effect

Ann M Davis  1 , Christie A Befort  2 , Brittany D Lancaster  3 , Chris Tuck  4 , Barbara J Polivka  5 , Jordan A Carlson  6 , Kandace Fleming  7 , Rebecca Swinburne Romine  7 , Kelsey Dean  6 , Megan Murray  3
Affiliations
Randomized Controlled Trial

Rationale and design of integrating a parents first obesity intervention with a pediatric weight management intervention for rural families - Evaluating the ripple effect

Ann M Davis et al. Contemp Clin Trials. 2023 May.

Abstract

Rural families are disproportionately affected by obesity. Obesity often runs in families and is impacted by hereditary components, the shared home environment, and parent modeling/child observational learning. Moreover, parent changes in weight predict child changes in weight. Thus, targeting the family unit has the potential to enhance outcomes for adults and children simultaneously. Additionally, engaging rural nurses in medical clinics and schools may be important in determining whether rural telehealth programs are successfully implemented and sustained. This paper describes the rationale and design of a randomized control trial (RCT) evaluating the effectiveness of an integrated adult- and child-focused obesity treatment tailored for rural participants. Outcomes of this study include participant weight loss from baseline to 9-months, device-measured physical activity, and dietary intake. This project will additionally compare reach between clinic and school settings and evaluate the impact of nurse engagement. This study will include 240 participants from eight rural communities who will be randomized to either a Parent +Family-based group or a Newsletter +Family-based group. Parents in the Parent +Family-based group will receive a 3-month adult obesity treatment designed for adult behavior change as a first step. Then, parents and children together will enter the family-based program (iAmHealthy), allowing for potential enhancement of a theorized ripple effect. Parents in the Newsletter +Family-based group will receive 3 monthly newsletters and then participate in the 6-month family-based intervention designed for child behavior change. This study is the first RCT to examine the effectiveness of an integrated adult- and child-focused obesity treatment program. Registered with ClinicalTrials.gov NCT ID NCT05612971.

Keywords: Clinic; Obesity; Parent; Rural; School; mHealth.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest None of the authors have any competing interests or financial interests to disclose.

Figures

Figure 1:
Figure 1:
Study Design Note. Figure 1 displays the study flow diagram.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Johnson Iii JA, Johnson AM. Urban-rural differences in childhood and adolescent obesity in the United States: a systematic review and meta-analysis. Childhood Obesity. 2015;11(3):233–241. - PubMed
    1. Hales CM, Fryar CD, Carroll MD, Freedman DS, Aoki Y, Ogden CL. Differences in obesity prevalence by demographic characteristics and urbanization level among adults in the United States, 2013–2016. JAMA. 2018;319(23):2419–2429. - PMC - PubMed
    1. Freedman DS, Mei Z, Srinivasan SR, Berenson GS, Dietz WH. Cardiovascular risk factors and excess adiposity among overweight children and adolescents: the Bogalusa Heart Study. J Pediatr. Jan 2007;150(1):12–17 e2. doi:10.1016/j.jpeds.2006.08.042 - DOI - PubMed
    1. Wang Y, Min J, Khuri J, Li M. A systematic examination of the association between parental and child obesity across countries. Advances in Nutrition. 2017;8(3):436–448. - PMC - PubMed
    1. McCaffery JM. Precision behavioral medicine: Implications of genetic and genomic discoveries for behavioral weight loss treatment. American Psychologist. 2018;73(8):1045. - PMC - PubMed

Publication types

Associated data