Many clinicians consider childhood obesity to be one of the most frustrating problems they face. Yet, efficacious treatments do exist. A recent evidence review for The US Preventive Services Task Force concluded that family-based, group, behavioral treatments with 26 or more hours of intervention contact were most likely to help reduce excess weight in children and adolescents with obesity. The Stanford Pediatric Weight Control Program (SPWCP) is a family-based group behavioral treatment program producing outstanding retention and outcomes in real world clinical settings. We propose to utilize technology, design, behavioral theory and biomedical business innovation strategies to package and spread the Stanford Pediatric Weight Control Program to reach low- income children throughout the U.S. To accomplish this aim, we are guided by an approach that merges design thinking, behavioral science, and business development strategy. Our proposed solution includes the following components: 1. User-friendly, human subjects and HIPAA compliant web-based and mobile software that guides providers through every step of SPWCP implementation. 2. The delivery of key content components of the SPWCP via brief videos highlighting past participants. 3. Web and mobile apps for patients. 4. Onsite and online provider training. 5. Ongoing technical assistance/support. 6. Certification of providers based on process parameters and outcomes. We will develop the packaging described above over the first two years of the award. Year 3 of the award will include beta testing of all components with one to two groups of participants by several local partner providers and organizations representing different settings serving low-income families. A pilot implementation study will commence at the end of Year 3 and continue through the middle of Year 5. We will partner with at least 4 different community partners representing different types of providers serving low income families. We will evaluate six-month changes in percent over median BMI for age and sex (the primary outcome measure) using generalized linear mixed effects regression techniques, in a one- arm interventional trial conducted in an intent-to-treat cohort of 80 children with BMI ? 95th percentile for age and sex on the 2000 CDC growth reference or with BMI ? 85th percentile for age and sex and at least one parent with obesity (BMI ? 30 kg/m2) and/or prior diagnosis of an obesity-related co-morbid condition. Results and additional testing will inform a dissemination and sustainability strategy for widespread dissemination, adoption, implementation and maintenance by a wide array for providers nationwide.

U18DP006423

2019-04-01

2024-03-31