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A Randomized Controlled Trial to Enhance Nutrition and Activity Among Rural Child

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Obesity in childhood is a growing public health concern reaching pandemic proportions. Current data indicate that weight status by age 7 is directly related to adult weight status and adult health concerns. Thus, preventing and treating obesity in childhood may lead to improved adult health outcome. Many interventions have been developed to treat childhood obesity and these interventions have led to improved weight status with varying degrees of maintenance of improvements over time. However, participants in these studies have generally been from large urban or suburban areas. Research indicates that adult and pediatric obesity is actually more prevalent among rural individuals, and that there are very few services available to treat these rural patients. The primary aim of the current study is to estimate the decrease in BMIz for two pediatric obesity treatment methodologies (phone, Elluminate) among rural 5th grade children using a rurally tailored behavioral intervention. Ten participating schools will be matched and then randomized at the school level to either phone or Elluminate. The 8-month intervention was tailored to the findings of previous research identifying the unique barriers and needs of parents trying to help their children lose weight in rural areas. Subjects will include 60 5th grade children and their parents. Secondarily, we hypothesize that the Elluminate group will have a significantly greater positive change in eating habits (daily calorie intake, total daily fat intake, daily percentage of calories from dietary fat, number of sugar sweetened beverages per day, number of junk food items per day, number of meals eaten away from home per day) when compared to the phone group, and that the Elluminate group will have a significantly greater positive change in physical activity habits (Actigraph counts, weekly physical activity and screen time) when compared to the phone group. Measures include BMIz, 24 hour food recall, self-reported physical and sedentary activity (SPARK), and ActiGraph Physical Activity counts and will be completed at baseline and after the 8 month intervention. We also propose to assess several items qualitatively including 1) key intervention components via structured interviews, 2) attendance rates, 3) satisfaction via surveys, and 4) cost analysis. PUBLIC HEALTH RELEVANCE: The current study addresses the key health issue of pediatric obesity among an underserved population, rural children. The findings of the current study will lead to identification the most appropriate methodology to deliver intervention services to these families in need, and provide the necessary information to lead to a larger randomized controlled trial of these methodologies.

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