Child Health Project: Promoting health behavior change in the management of childhood obesity in primary care

Background: Childhood obesity is a threat to overall child health and a financial burden to the health care system. Management of childhood obesity in primary care is challenging due to clinic constraints. The Child Health Project (CHP) was a randomized control trial (RCT) in which parent-child pairs received tailored health education in primary care clinics. The purpose of the CHP was to improve physical activity and eating habits and decrease sedentary behaviors in families with children who are overweight/obese. Another purpose was to support primary care providers (PCPs) in the management of childhood obesity. Methods: Fourteen PCPs helped recruit participants. A convenience sample of 114 parent-child pairs participated in four brief advice sessions from health coaches who used motivational interviewing approaches. The 20-30 minute sessions were delivered in the clinic. Those in the experimental group received two home visits. Outcome measures were questionnaires administered through structured interviews. Child body mass index (BMI) was calculated from height and weight measures. Results: The majority of children were obese (n=103, 90.3%), most were boys (n=63, 55.3%), average age was 10.3 years (SD: 1.9). The only significant change was decreased sedentary behavior (p < .05). Participant retention was difficult (53%) and 60.6% of home visits were delivered. Program evaluations suggested that information was useful but did not promote behavior change. PCPs needed more information from the CHP and resources for patients. Conclusion: Future directions for the CHP include interventions for behavior skill building and a community resource database to promote health behavior changes.