title: Incorporating primary and secondary prevention approaches to address childhood obesity prevention and treatment in a low-income, ethnically diverse population: study design and demographic data from the Texas Childhood Obesity Research Demonstration (TX CORD) study.
abstract: BACKGROUND
  There is consensus that development and evaluation of a systems-oriented approach for child obesity prevention and treatment that includes both primary and secondary prevention efforts is needed. This article describes the study design and baseline data from the Texas Childhood Obesity Research Demonstration (TX CORD) project, which addresses child obesity among low-income, ethnically diverse overweight and obese children, ages 2-12 years; a two-tiered systems-oriented approach is hypothesized to reduce BMI z-scores, compared to primary prevention alone.
  
  
  METHODS
  Our study aims are to: (1) implement and evaluate a primary obesity prevention program; (2) implement and evaluate efficacy of a 12-month family-centered secondary obesity prevention program embedded within primary prevention; and (3) quantify the incremental cost-effectiveness of the secondary prevention program. Baseline demographic and behavioral data for the primary prevention community areas are presented.
  
  
  RESULTS
  Baseline data from preschool centers, elementary schools, and clinics indicate that most demographic variables are similar between intervention and comparison communities. Most families are low income (≤$25,000) and Hispanic/Latino (73.3-83.8%). The majority of parents were born outside of the United States. Child obesity rates exceed national values, ranging from 19.0% in preschool to 35.2% in fifth-grade children. Most parents report that their children consume sugary beverages, have a television in the bedroom, and do not consume adequate amounts of fruits and vegetables.
  
  
  CONCLUSIONS
  Interventions to address childhood obesity are warranted in low-income, ethnically diverse communities. Integrating primary and secondary approaches is anticipated to provide sufficient exposure that will lead to significant decreases in childhood obesity.
authors.affiliation: 1 Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health , Austin, TX.
authors.forename: Deanna M
authors.initials: DM
authors.lastname: Hoelscher
authors.forename: Nancy F
authors.initials: NF
authors.lastname: Butte
authors.forename: Sarah
authors.initials: S
authors.lastname: Barlow
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Vandewater
authors.forename: Shreela V
authors.initials: SV
authors.lastname: Sharma
authors.forename: Terry
authors.initials: T
authors.lastname: Huang
authors.forename: Eric
authors.initials: E
authors.lastname: Finkelstein
authors.forename: Stephen
authors.initials: S
authors.lastname: Pont
authors.forename: Paul
authors.initials: P
authors.lastname: Sacher
authors.forename: Courtney
authors.initials: C
authors.lastname: Byrd-Williams
authors.forename: Abiodun O
authors.initials: AO
authors.lastname: Oluyomi
authors.forename: Casey
authors.initials: C
authors.lastname: Durand
authors.forename: Linlin
authors.initials: L
authors.lastname: Li
authors.forename: Steven H
authors.initials: SH
authors.lastname: Kelder
mesh_terms: D001294:Attitude to Health; D002648:Child; D002675:Child, Preschool; D055812:Community-Based Participatory Research; D005260:Female; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D008297:Male; D016487:Parenting; D063766:Pediatric Obesity / Q000453:epidemiology / Q000517:prevention & control*; D011322:Primary Prevention / Q000458:organization & administration*; D015397:Program Evaluation; D012107:Research Design; D012572:School Health Services / Q000458:organization & administration*; D012574:Schools / Q000706:statistics & numerical data*; D055502:Secondary Prevention / Q000458:organization & administration*; D012959:Socioeconomic Factors; D013781:Texas / Q000453:epidemiology