An Ecological Approach to Addressing Childhood Obesity Issues in Imperial County (Our Choice)

San Diego State University

Status: Completed

Conditions: Childhood Obesity

Treatments: Behavioral: No intervention; Behavioral: Environment, policy, and systems changes in schools, early child care education & recreation; Behavioral: Physical activity, healthy eating, water drinking, healthy sleep promotion; Behavioral: Family wellness workshops; Behavioral: Environment, policy, systems changes in clinic setting only; Behavioral: Obesity chronic care model

Study type: Interventional

Funder types: Other; Other U.S. Federal agency

Identifiers

NCT02197390

1U18DP003377-03

Details and patient eligibility

About

Our Choice is one of three CORD (Childhood Obesity Research Demonstration) studies funded by the Centers for Disease Control and Prevention in 2011 to test multi-sector, multi-level approaches to prevent and control childhood obesity. Our Choice is translating evidence-based approaches for modifying behaviors, policies, systems, and environments to promote fruit and vegetable consumption, physical activity, water consumption, and quality sleep. The ultimate goal is to assist Children's Health Insurance Program-eligible children between 2-12 years old attain a healthy weight. In addition to site-specific intervention and evaluation activities, Our Choice is working with the University of Houston Evaluation Center to conduct a cross-site evaluation on a set of shared measures.

Full description

Our Choice is a partnership between a university-affiliated research institute, a federally qualified health center, and a county public health department. We used formative research, advisory committee members' recommendations, and previous research to inform the development of the Our Choice project. Our theory-informed multi-sector, multi-level intervention targets improvements in four health behaviors: fruit, vegetable, and water consumption, physical activity, and sleep. Intervention partners include 1200 families, a federally qualified health center (including three clinics), 26 early care and education centers, two elementary school districts (and 20 elementary schools), three community recreation centers, and three restaurants. Intervention components in all sectors target changes in behaviors, policies, systems, and the social and physical environment. Evaluation activities include assessment of the primary outcome, BMI z-score, at baseline, 12- and 18-months post-baseline, and sector evaluations at baseline, 12, and 24-months.

Enrollment: 1,184 patients

Sex: All

Ages: 2 to 11 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• If family had school-age child, child must attend one of the designated Our Choice schools located in one of three designated cities.
• If family had preschool-age child, family must reside in one of three designated cities.
• Children ages 2-11 years old
• Maximum two children per household
• Children above the 5th percentile body mass index
• Family agrees to remain in the area throughout the duration of the study
• Participating parent had to understand English or Spanish

Exclusion criteria

• Child has any condition that significantly limits eating or physical activity in a way that interventions would be impacted

Trial design

Primary purpose: Prevention

Allocation: Non-Randomized

Interventional model: Factorial Assignment

Masking: None (Open label)

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1,184 participants in 4 patient groups

Health Care plus Public Health

Experimental group

Description:

The Health Care intervention involves the implementation of an obesity care model within a Federally Qualified Health Center (FQHC) and includes a Family Wellness Program delivered by Community Health Workers (CHWs). The Public Health intervention involves working with early care and education centers, schools, community recreation organizations, and restaurants to promote four health behaviors: fruit and vegetable consumption, physical activity, water consumption, and quality sleep.

Treatment:

Behavioral: Environment, policy, systems changes in clinic setting only

Behavioral: Obesity chronic care model

Behavioral: Family wellness workshops

Behavioral: Physical activity, healthy eating, water drinking, healthy sleep promotion

Behavioral: Environment, policy, and systems changes in schools, early child care education & recreation

Health Care

Experimental group

Description:

The Health Care intervention involves the implementation of an obesity care model within a Federally Qualified Health Center (FQHC) and includes a Family Wellness Program delivered by Community Health Workers (CHWs).

Treatment:

Behavioral: Environment, policy, systems changes in clinic setting only

Behavioral: Obesity chronic care model

Behavioral: Family wellness workshops

Behavioral: Physical activity, healthy eating, water drinking, healthy sleep promotion

Public Health

Experimental group

Description:

The Public Health intervention involves working with early care and education centers, schools, community recreation organizations, and restaurants to promote four health behaviors: fruit and vegetable consumption, physical activity, water consumption, and quality sleep.

Treatment:

Behavioral: Environment, policy, systems changes in clinic setting only

Behavioral: Physical activity, healthy eating, water drinking, healthy sleep promotion

Control

Experimental group

Description:

No intervention.

Treatment:

Behavioral: No intervention