title: Connect for Health: Design of a clinical-community childhood obesity intervention testing best practices of positive outliers.
abstract: BACKGROUND
  The Connect for Health study is designed to assess whether a novel approach to care delivery that leverages clinical and community resources and addresses socio-contextual factors will improve body mass index (BMI) and family-centered, obesity-related outcomes of interest to parents and children. The intervention is informed by clinical, community, parent, and youth stakeholders and incorporates successful strategies and best practices learned from 'positive outlier' families, i.e., those who have succeeded in changing their health behaviors and improve their BMI in the context of adverse built and social environments.
  
  
  METHODS
  Two-arm, randomized controlled trial with measures at baseline and 12 months after randomization.
  
  
  METHODS
  2-12 year old children with overweight or obesity (BMI ≥ 85th percentile) and their parents/guardians recruited from 6 pediatric practices in eastern Massachusetts.
  
  
  METHODS
  Children randomized to the intervention arm receive a contextually-tailored intervention delivered by trained health coaches who use advanced geographic information system tools to characterize children's environments and neighborhood resources. Health coaches link families to community-level resources and use multiple support modalities including text messages and virtual visits to support families over a one-year intervention period. The control group receives enhanced pediatric care plus non-tailored health coaching.
  
  
  METHODS
  Lower age-associated increase in BMI over a 1-year period. The main parent- and child-reported outcome is improved health-related quality of life.
  
  
  CONCLUSIONS
  The Connect for Health study seeks to support families in leveraging clinical and community resources to improve obesity-related outcomes that are most important to parents and children.
authors.affiliation: Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States; Department of Nutrition, Harvard School of Public Health, Boston, MA, United States. Electronic address: elsie.taveras@mgh.harvard.edu.
authors.forename: Elsie M
authors.initials: EM
authors.lastname: Taveras
authors.affiliation: Department of Pediatrics, Harvard Vanguard Medical Associates, Boston, MA, United States.
authors.forename: Richard
authors.initials: R
authors.lastname: Marshall
authors.affiliation: Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States.
authors.forename: Mona
authors.initials: M
authors.lastname: Sharifi
authors.affiliation: Boston Children's Hospital, Boston, MA, United States.
authors.forename: Earlene
authors.initials: E
authors.lastname: Avalon
authors.affiliation: Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States.
authors.forename: Lauren
authors.initials: L
authors.lastname: Fiechtner
authors.affiliation: Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States.
authors.forename: Christine
authors.initials: C
authors.lastname: Horan
authors.affiliation: Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States.
authors.forename: John
authors.initials: J
authors.lastname: Orav
authors.affiliation: Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States.
authors.forename: Sarah N
authors.initials: SN
authors.lastname: Price
authors.affiliation: Partners HealthCare System, Inc., Boston, MA, United States.
authors.forename: Thomas
authors.initials: T
authors.lastname: Sequist
authors.affiliation: Department of Pediatrics, Harvard Vanguard Medical Associates, Boston, MA, United States.
authors.forename: Daniel
authors.initials: D
authors.lastname: Slater
mesh_terms: D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D004777:Environment; D005192:Family Health; D005260:Female; D040362:Geographic Information Systems; D015438:Health Behavior; D006293:Health Promotion / Q000458:organization & administration; D006801:Humans; D008297:Male; D050177:Overweight / Q000628:therapy; D010290:Parents / Q000193:education*; D063766:Pediatric Obesity / Q000628:therapy*; D011320:Primary Health Care / Q000458:organization & administration; D011788:Quality of Life; D012959:Socioeconomic Factors; D017216:Telemedicine / Q000379:methods; D060145:Text Messaging; D061217:Weight Reduction Programs / Q000458:organization & administration*
keywords: Children; Clinical; Community; Health coaching; Mobile technology; Obesity; Randomized controlled trial