Childhood obesity is a significant long-term public health problem affecting nearly 1 in 5 children in the United States and affecting children of racial and ethnic minority groups and of low socioeconomic status in a disparate manner. The proposed K23 career development award for Thao-Ly Tam Phan, M.D. is responsive to the NIH's strategic plan to develop innovative obesity interventions that address healthcare disparities and leverage the capabilities of health information technology. The proposed career development plan provides the means by which Dr. Phan will complete scholarly training and practical experience important to becoming an independent investigator in the area of pediatric obesity. Parenting interventions for parents of children who are obese have shown promise in improving child behaviors and weight, but are often resource-intensive and do not always consider the perspective of parents of children of diverse backgrounds with significant need for weight reduction. The proposed study will develop an intervention consisting of brief, tailored, culturally sensitive videos to provide guidance on the use of evidence-based parenting techniques for managing a child's obesity-related behaviors, incorporating qualitative feedback from parents during the development process (Aim 1). Parents of obese children between the ages of four and eleven years presenting for an initial visit to the Nemours Weight Management Clinic will be randomly assigned to receive the intervention, which will be delivered in conjunction with a child's visits to the clinic over three months. The study will test the feasibilty of delivering the intervention through a patient portal linked to the child's electronic health recrd and assess the impact of the intervention on facilitating discussion about parenting topics during clinic visits (Aim 2). Additionally, the study will evaluate the impact of the intervention on parental self-efficacy, child obesity-related behaviors, and child weight (Aim 3). Through a combination of formal didactics and direct mentored training experiences with her mentoring team (Drs. Kazak, Abatemarco, Metzler, and Bunnell), Dr. Phan will acquire skills and expertise in the following areas: (1) family-based intervention research, (2) media-based delivery of parenting interventions, (3) complexity science as it applies to pediatric practice change, and (4) use of health information technology for health care delivery. Nemours, a national leader in the fields of pediatric obesity and health informatics, will provide Dr. Phan with the ideal environment to successfully complete the proposed project and to achieve her goals of becoming an independent investigator, developing and testing innovative strategies to engage families in the treatment and prevention of pediatric obesity.

Public Health Relevance

Childhood obesity is a significant public health problem and affects children in the United States in a disparate manner. Culturally-sensitive videos to guide parents on the management of a child's obesity-related behaviors, delivered in conjunction with pediatric healthcare visits, have the potential to improve the reach and access of obesity interventions, adding to public health efforts to reduce the burden of child obesity and improve the health of children in our country. Through the implementation of the proposed research and a strong career development plan, this award will provide Dr. Phan with the training necessary to becoming an independent clinician investigator in the field of pediatric obesity.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Mentored Patient-Oriented Research Career Development Award (K23)
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Pediatrics Subcommittee (CHHD)
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Esposito, Layla E
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Alfred I. Du Pont Hosp for Children
United States
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Phan, Thao-Ly T; Chen, Fang Fang; Pinto, Alison Taggi et al. (2018) Impact of Psychosocial Risk on Outcomes among Families Seeking Treatment for Obesity. J Pediatr 198:110-116
Tester, June M; Phan, Thao-Ly T; Tucker, Jared M et al. (2018) Characteristics of Children 2 to 5 Years of Age With Severe Obesity. Pediatrics 141:
Hill, Samareh G; Phan, Thao-Ly T; Datto, George A et al. (2018) Integrating childhood obesity resources into the patient-centered medical home: Provider perspectives in the United States. J Child Health Care :1367493518777308
Mirza, Nazrat; Phan, Thao-Ly; Tester, June et al. (2018) A Narrative Review of Medical and Genetic Risk Factors among Children Age 5 and Younger with Severe Obesity. Child Obes 14:443-452
Cohen, Megan J; Curran, Jennifer L; Phan, Thao-Ly T et al. (2017) Psychological contributors to noncompletion of an adolescent preoperative bariatric surgery program. Surg Obes Relat Dis 13:58-64
Stubblefield, Sam; Datto, George; Phan, Thao-Ly T et al. (2017) Problem Video Gaming Among Children Enrolled in Tertiary Weight Management Programs. Cyberpsychol Behav Soc Netw 20:109-116