We propose an innovative parent-based intervention targeting childhood obesity to address the specific needs of underserved patients at Community Health Centers (CHCs). Preventing and alleviating childhood obesity among these populations is challenging because parents often face issues related to low income, limited access to resources, and time constraints. Even when parents are knowledgeable about nutrition, they may find it difficult to reinforce limits on their child’s eating behavior and integrate increased physical activity into the child’s daily routine. These parents are likely to benefit from an intervention that addresses parenting style as related to healthy eating and staying active.
A Parenting Group Targeting Childhood Obesity (PGTCO), led by a behavioral health clinician, will meet weekly for eight weeks. In a supportive group environment parents will discuss parenting styles, increasing positive parent-child interactions, setting appropriate limits, tantrum management, and promoting healthy practices. We expect that encouraging a warm parenting style, accompanied by the ability to set appropriate limits, motivating healthy practices, and encouraging success will serve to prevent and ameliorate childhood obesity. Child and adolescent BMIs and parenting styles will be measured to evaluate the intervention’s impact. We need financial support for program curriculum development and evaluation, and incentives for participation.
The creativity and innovation of this project is in leveraging the relationship between childhood obesity and factors such as family structure and parenting style to develop a parent-based and group-based intervention targeting childhood obesity. Current interventions often fail to consider familial components that may affect a child’s weight. Modifying parenting style in an effort to decrease the occurrence of or treat childhood obesity is a unique and innovative aspect of this program, which is designed to target underserved populations facing multiple problems including low income, unemployment, poor physical and mental health, disabilities, and drug and alcohol use and abuse. The program will address factors unique to this underserved population disproportionately affected by childhood obesity. This program is based on an innovative integrated approach and seeks to modify parenting style in such way that children suffering from obesity will have increased support in reaching weight management goals and making healthy decisions.
CHC has made reducing childhood obesity an agency priority and through this program CHC will be the first Federally Qualified Health Center and primary care setting to implement a parent-based behavioral health intervention to target childhood obesity. Upon completion of pilot testing, the PGTCO will be offered at additional CHC sites. If successful, this program could lead behavioral health providers across the nation in providing a parent-based intervention for childhood obesity that can be delivered in a supportive group environment in integrated primary care and behavioral health settings. Through conference presentations and publications, results will be shared with the national network of community health centers serving over 22 million people at over 9,000 sites. We will provide the information, motivation, knowledge, and methods we used so that other safety net organizations can achieve the same level of success.
The program will be implemented at the Community Health Center, Inc. (CHCI). CHCI is the largest federally qualified health center in Connecticut, providing medical, behavioral health, and dental care to over 130,000 medically underserved patients across the state. Leadership of CHCI is devoted to providing quality care and has listed the amelioration of childhood obesity as an agency priority. This demonstrates that this project will be supported by leadership and staff. The program will also be supported by the Weitzman Institute (WI) which is a dedicated research and quality improvement institute that focuses on answering questions that arise in the daily practice of primary care and adopting patient-centered strategies and evidence-based care.
The project has minor start-up costs but is backed by support from agency leadership and it will become self-sustaining through the billing of patient participation in the parenting behavioral health groups.
Following the pilot testing of the PGTCO, modifications will be made based on results. In the next phase, appropriate training will be provided so that the Parenting Group can be adapted and duplicated for regular delivery at all CHCI sites. A clear curriculum will be written up to facilitate ease of replication both internally and externally. The PI will summarize the curriculum and information regarding program development for publication in peer reviewed journals. The ultimate goal is to provide for the implementation of the Parenting Group Targeting Childhood Obesity at all FQHCs in an effort to decrease the national impact of childhood obesity and related health problems. This will be achieved by dissemination of the group curriculum at national conferences, by sharing our program results with existing FQHC contacts, and by publishing findings and the program’s curriculum.
Guided by the needs of parents and their children with weight problems, the goals of this project are to test the implementation of an innovative and scalable system level intervention in a community health center serving vulnerable populations, and to determine its effect on a child’s weight-related behaviors and anthropometric outcomes. Changes in parenting style as a result of participation in the group will be examined through the Parenting Style Questionnaire, administered both pre and post intervention. The child’s BMI will also be tracked throughout the 8-week session, and monthly for a six month follow-up period. Data will be analyzed to determine if a particular parenting style is associated with a greater likelihood of obesity as measured by BMI. Comparisons will be made between children’s BMIs and their parent’s reported parenting styles before and after involvement in the Parenting Group to determine the overall effectiveness of this intervention.