This proposal focuses on interventions to treat obesity and reduce BP in overweight/obese urban youth. Although childhood obesity is multi-factorial in origin with contributors at the child-family, school-community, and policy environments, few studies have targeted multiple environments and examined innovative behavioral interventions that may be beneficial to disadvantaged youth. This proposal addresses these deficits, focusing on lifestyle change through both child-family and school-community environments. It asks two main questions: (1) What is the differential impact on BMI and BP of three distinct psycho-educational interventions targeting the child-family environment? (2) Will an enriched school-community environment (echoing the interventions'messages and providing a venue for their implementation) influence the interventions'impact? Our target population is Cleveland Metropolitan School District students (6th-8th grade;n=450) recruited via an established screening program. Participants will be drawn from two school-community environments (""""""""enriched"""""""" and """"""""non-enriched"""""""");25 CMSD schools each. Enriched schools will participate in an innovative YMCA partnership to increase students'physical activity, and have supplemental nutrition education programs, social marketing, and navigators. Using a 3-group stratified randomized trial design, participants in each enriched and non-enriched school will be randomized into 3 intervention arms: 1) SystemCHANGE, a promising new behavioral approach focusing on system redesign of the family environment and daily routines (based on ecological and personal process improvement theory), 2) HealthyCHANGE, a behavioral approach focusing on building skills and increasing intrinsic motivation (based mainly on cognitive behavioral theory), and 3) education only (attention control). Following 6 months of intensive intervention and 6 months of boosters, subjects will be followed for another year. Primary outcomes will be BMI and BP z scores. Other cardiovascular risk indices, costs, and quality of life will also be assessed, as will potential mediators and moderators of the interventions'effects. This project incorporates several innovations and has the potential to establish a replicable system of aligned programs that have major impact on pediatric obesity.

Public Health Relevance

Childhood obesity, often associated with elevated blood pressure, causes morbidity and may cause early death. Finding ways to effectively treat childhood obesity is therefore a top health priority. This research (a) assesses three behavioral approaches to treating obesity and reducing blood pressure in urban youth, and (b) examines the influence of the school-community environment on the interventions'impact.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01HL103622-02
Application #
8129647
Study Section
Special Emphasis Panel (ZHL1-CSR-W (M1))
Program Officer
Pratt, Charlotte
Project Start
2010-08-17
Project End
2017-04-30
Budget Start
2011-05-01
Budget End
2012-04-30
Support Year
2
Fiscal Year
2011
Total Cost
$1,093,160
Indirect Cost
Name
Case Western Reserve University
Department
Pediatrics
Type
Schools of Medicine
DUNS #
077758407
City
Cleveland
State
OH
Country
United States
Zip Code
44106
Heerman, William J; Berge, Jerica M; Barkin, Shari L (2018) Mentoring of Early-Stage Investigators When Funding Is Tight: The Childhood Obesity Prevention and Treatment Research Experience. JAMA Pediatr 172:4-6
Barkin, Shari L; Heerman, William J; Sommer, Evan C et al. (2018) Effect of a Behavioral Intervention for Underserved Preschool-Age Children on Change in Body Mass Index: A Randomized Clinical Trial. JAMA 320:450-460
Ruiz, Rachel M; Sommer, Evan C; Tracy, Dustin et al. (2018) Novel patterns of physical activity in a large sample of preschool-aged children. BMC Public Health 18:242
Moore, Shirley M; Komton, Vilailert; Adegbite-Adeniyi, Clara et al. (2018) Development of the Systems Thinking Scale for Adolescent Behavior Change. West J Nurs Res 40:375-387
French, Simone A; Sherwood, Nancy E; Veblen-Mortenson, Sara et al. (2018) Multicomponent Obesity Prevention Intervention in Low-Income Preschoolers: Primary and Subgroup Analyses of the NET-Works Randomized Clinical Trial, 2012-2017. Am J Public Health 108:1695-1706
van Bakergem, Margaret; Sommer, Evan C; Heerman, William J et al. (2017) Objective reports versus subjective perceptions of crime and their relationships to accelerometer-measured physical activity in Hispanic caretaker-child dyads. Prev Med 95 Suppl:S68-S74
Heerman, William J; JaKa, Meghan M; Berge, Jerica M et al. (2017) The dose of behavioral interventions to prevent and treat childhood obesity: a systematic review and meta-regression. Int J Behav Nutr Phys Act 14:157
Moore, Shirley M; Killion, Cheryl M; Andrisin, Sharon et al. (2017) Use of Appreciative Inquiry To Engage Parents as Codesigners of a Weight Management Intervention for Adolescents. Child Obes 13:182-189
Barkin, Shari L; Lamichhane, Archana P; Banda, Jorge A et al. (2017) Parent's Physical Activity Associated With Preschooler Activity in Underserved Populations. Am J Prev Med 52:424-432
Oelsner, Kathryn Tully; Guo, Yan; To, Sophie Bao-Chieu et al. (2017) Maternal BMI as a predictor of methylation of obesity-related genes in saliva samples from preschool-age Hispanic children at-risk for obesity. BMC Genomics 18:57

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