The epidemic of childhood obesity is a major public health concern. Childhood obesity has been linked to type 2 diabetes, insulin resistance, abnormal glucose tolerance, and other negative health outcomes. Successful treatment of childhood obesity is associated with significant health benefits. Behavioral family-based interventions including both children and parents have been successful in producing weight loss in children. However, the generalizability of these interventions is limited, and there are virtually no randomized trials examining weight loss interventions for children and families in community-based, rural settings. Recent research suggests that exclusively targeting parents in the behavioral treatment of childhood obesity may lead to similar outcomes, and may be more cost-effective than interventions including both children and parents. These two treatment approaches, however, have yet to be compared in a randomized controlled trial (RCT). This feasibility study entails a three arm RCT to test the effectiveness of two group interventions designed to promote weight management in overweight children and their parents in medically underserved, rural settings. Participants will be randomly assigned to a Behavioral Family-Based Intervention (BFI), Behavioral Parent-Based Intervention (BPI), or a Wait List Control (WLC). Both treatment programs will take a behavioral lifestyle approach to modify dietary and physical activity patterns. In the BPI, only parents will attend group meetings, while in the BFI both children and parents will attend group sessions. Both interventions will include 12 sessions over 4-months, with assessment at baseline, post-treatment, and 6-month follow-up (month 10). It is hypothesized that, (a) children in the BFI and BPI will exhibit greater improvements in weight status than children in the WLC at month 10, (b) children in the BPI will exhibit greater improvements in weight status than those in the BFI at month 10, and (c) the BPI will demonstrate greater cost-effectiveness than the BFI. Findings will provide critical information for planning the R18 RCT.
