The ADAPT Trial: Adapting Evidence-Based Obesity Interventions in Community Settings
Vanderbilt University Medical Center
Summary
Evidence-based obesity treatment is inaccessible to most children in the United States. This lack of access is a source of health inequity, whereby children from rural and minority communities, who have the highest rates of childhood obesity, are also the least likely to receive an evidence-based intervention. Developing strategies to improve access to evidence-based obesity interventions could reduce health disparities by improving reach to these underserved communities. The premise of this study is that using a systematic framework to adapt a community-based behavioral intervention for childhood obesity that accounts for individual, family, and community factors will increase reach and effectiveness among low-income, minority, and rural populations. COACH is a multi-level obesity intervention that supports 1) the individual child through developmentally appropriate health behavior curriculum, 2) the family by directly addressing parent weight loss and engaging parents as agents of change for their children, and 3) the community by building the capacity of local community centers to offer parent-child programming. The investigators propose testing the process of adapting COACH in a cluster-randomized trial.
Description
In Aim 1, the investigators will conduct a community readiness assessment for COACH in 50 community centers serving rural, minority, and low-income families in middle TN. In 25 randomly selected community centers, the investigators will use a systematic process to adapt the intervention protocol based on the assessment results, while maintaining fidelity to COACH's core components. In Aim 2, in a cluster-randomized trial, the investigators will test the comparative effectiveness of each implementation strategy (adaptation vs. original program) on the implementation outcomes of reach, adoption,…
Eligibility
- Age range
- 6–12 years
- Sex
- All
- Healthy volunteers
- Yes
Inclusion Criteria: * Child with an age ≥ 6 years and \< 12 years * Child body mass index ≥95th percentile for age and sex on standardized CDC growth curves * Index parent/legal guardian with an age ≥18 years * Parent and child speak English or Spanish * Family resides within or frequently visit selected zip codes within Middle TN surrounding the partnering community centers; * Have parental commitment to participate in a 6-month study; * Have the ability to view online trainings * Complete baseline data collection, including parent and child height and weight and at least 90% of baseline sur…
Interventions
- BehavioralCompetency Based Approaches to Community Health (COACH)
COACH is a multi-level intervention, consisting of 1) developmentally appropriate health curriculum for children; 2) family-based content that both targets parent weight loss and leverages a shared parent-child experience to improve family health behaviors; 3) community-level intervention to improve access and quality of family-based programming at local Parks and Rec centers.
Location
- Vanderbilt University Medical CenterNashville, Tennessee