Pediatric Primary Care Obesity Prevention

Nancy Sherwood, Ph.D.
HealthPartners Research Foundation, Minneapolis, MN

In addition to increasing risk for diabetes and heart disease, there is increasing evidence that obesity influences the development of certain forms of cancer (e.g., breast, colon). Effective obesity prevention programs targeting children are a critical public health need because they bear the greatest lifetime health risk from obesity. The pediatric primary care setting is a relatively untapped resource for initiating obesity prevention efforts. Addressing the unique challenges associated with intervention delivery in the primary care setting requires knowledge and expertise from multiple areas.

The proposed project is transdisciplinary and translational. The research team assembled for this study brings together expertise in obesity prevention and treatment, behavior change and treatment adherence, psychology, social work, pediatrics, and exercise physiology, all necessary for successful development and implementation of an effective intervention.

We propose to test the feasibility of a relatively low cost intervention targeting obesity prevention in health care delivery settings. Forty children at risk for obesity would be randomized to receive an unhealthy weight gain prevention intervention initiated by primary care physicians and followed up with telephone counseling support in two HMOs, one in Minneapolis and one in Seattle. Physicians will deliver concise messages to parents about the child's risk and specific steps to take to reduce that risk and, these physician-delivered messages will be reinforced by counseling calls from trained counselors to parents.

Primary goals of this pilot are to assess the feasibility, acceptability, and potential efficacy of the intervention. We will estimate intervention impact on BMI and we expect to see at least a trend in BMI change and parent feeding and activity practices over time and Treatment Credibility Scale items will yield invaluable information regarding parent and physician perceptions of the intervention. Our study setting is ideal given our expertise in phone-based obesity interventions and access to a pediatric primary care population and associated health information systems. If successful, we hope this pilot study will lead to a larger NIH-funded collaborative study involving the Minnesota and Seattle TREC centers, HealthPartners and Group Health Puget Sound to determine if the intervention can reduce excess weight gain among at-risk children.