Document text
Principal Investigator: William Heerman
Organization: VANDERBILT UNIVERSITY MEDICAL CENTER
Fiscal Year: 2024
Award: $634,252
Funding agency: Eunice Kennedy Shriver National Institute of Child Health and Human Development
PROJECT SUMMARY
Despite the recognition of health disparities in obesity, behavioral interventions among low-income and
minority populations have consistently met with limited success. This is partially explained by social
determinants of health. Constantly changing barriers at the household and community levels impede consistent
engagement in healthy behaviors. The current proposal tests a novel, culturally-tailored and multi-level
intervention designed to teach families to overcome dynamic barriers as the logical next step to address
obesity among low-income Latino families. It is based on the premise that by implementing a personalized
multi-level intervention that simultaneously addresses healthy weight for parents and children, we will improve
body mass index (BMI) among Latino parent-child pairs.
COACH (COmpetency-Based Approaches to Community Health) implements a personally tailored approach,
equipping families to engage in health behaviors despite dynamic barriers. COACH is a multi-level intervention
targeting 1) the individual child through developmentally appropriate health behavior curriculum, 2) the family
by addressing parent weight loss directly and engaging parents as agents of change for their children, and 3)
the community by building capacity of Parks and Rec centers to offer parent-child programming. Using novel
multi-component assessments throughout the study, the intervention identifies individual, family, and
community barriers to healthy behaviors and delivers structured yet personalized intervention content in 7
domains: fruits/vegetables, snacks, sugary drinks, physical activity, sleep, media use, and parenting.
Building on a successful pilot, this proposal will implement a randomized controlled trial to test the
effectiveness of COACH compared to an attention-matched school-readiness control group. We will enroll 300
parent-child pairs from Latino communities in Nashville, TN. Eligible children will be 3-5 years old and have a
BMI >50th percentile. Through our 10-year partnership with the Nashville Parks and Rec department, we
conduct COACH in neighborhood community centers, leveraging community infrastructure to facilitate health
behavior change. The primary outcome will be child BMI change at 2-year follow-up, using a growth curve
analysis. Secondary outcomes will include parent BMI, and parent/child diet and physical activity. The goals of
COACH are to 1) implement a novel personalized behavioral intervention, 2) test a two-generation solution to
obesity, 3) address health disparities by reducing obesity among Latino families, and 4) develop a scalable and
widely accessible approach to behavioral obesity interventions by delivering them in Parks and Rec centers.
Terms: <0-11 years old><5 year old><5 years of age><Accelerometer><Active Follow-up><Address><Affect><Age><Area><Attention><BMI><BMI percentile><BMI z-score><Behavior><Behavior Conditioning Therapy><Behavior Modification><Behavior Therapy><Behavior Treatment><Behavioral><Behavioral Conditioning Therapy><Behavioral Modification><Behavioral Therapy><Behavioral Treatment><Body Weight decreased><Body mass index><Child><Child Health><Child Rearing><Child Youth><Children (0-21)><Chronic Disease><Chronic Illness><Communities><Community Health><Competence><Conditioning Therapy><Control Groups><Cultural Sensitivity><Curriculum><Decrease health disparities><Development><Diet><Education><Educational Curriculum><Educational aspects><Educational process of instructing><Effectiveness><Effectiveness of Interventions><Eligibility><Eligibility Determination><Enrollment><Family><Foundations><Future><Generalized Growth><Generations><Goals><Growth><Health><Health behavior><Health behavior change><Health disparity mitigation><Health disparity reduction><Heterogeneity><Hour><Household><Individual><Individuals from minority><Individuals of minority><Infrastructure><Intervention><Intervention Strategies><Latino><Low income><Lower health disparities><Measures><Mediating><Minority><Minority Groups><Minority People><Minority Population><Minority individual><Mitigate health disparities><Modeling><Neighborhoods><Obesity><Outcome><Parenting><Parenting behavior><Parents><Participant><Pattern><Personalized medical approach><Phase><Physical activity><Population><Preparedness><Preventative intervention><Protocol Screening><Quetelet index><Randomization trial><Randomized, Controlled Trials><Readiness><Reduce health disparities><Schools><Self Determination><Sleep><Structure><Teaching><Testing><Tissue Growth><Weight><Weight Loss><Weight Reduction><accelerometry><active followup><activity monitor><activity tracker><adiposity><adolescent minority><adult adiposity><adult obesity><adults with obesity><age 5 years><ages><behavior intervention><behavioral intervention><body weight loss><child adiposity><child obesity><childhood adiposity><childhood obesity><childrearing><chronic disorder><coaching calls><community barrier><community building><community center><community centers><community-based health><community-level barrier><compare to control><comparison control><corpulence><developmental><diets><disease risk><disorder risk><disparity in health><early childhood><early-onset obesity><effectiveness testing><enroll><experience><family support><five year old><five years of age><flexibility><flexible><follow up><follow-up><followed up><followup><food insecurity><fruits and vegetables><group intervention><health disparity><health related behavior><healthy weight><improved><individualized approach><intervention design><intervention effect><intervention for prevention><interventional strategy><kids><lesson plans><media consumption><media use><minority children><minority communities><minority youth><novel><obese children><obesity during childhood><obesity in children><obesity intervention><obesity prevention><obesity therapy><obesity treatment><ontogeny><parent><pediatric minority><pediatric obesity><personalized approach><personalized health intervention><personalized intervention><phone coach><precision approach><precision interventions><prevent obesity><prevention intervention><preventional intervention strategy><preventive intervention><primary outcome><randomized control trial><randomized trial><scale up><secondary outcome><sex><social health determinants><success><tailored approach><telephone based coaching><telephone coaching><telephone counseling><theories><therapy design><treatment design><treatment effect><weights><wt-loss><young minority><youngster>