Background: Socioeconomically-disadvantaged households have a high prevalence of pediatric overweight/obesity, and also face barriers to accessing weight loss treatment in healthcare settings. Delivering family-based pediatric weight loss treatment in the home setting may enhance its efficacy by facilitating treatment attendance, enabling more tailored treatment recommendations informed by observations of the home environment, and increasing accountability. This paper describes the design of the Creating Health Environments for Chicago Kids (CHECK) Trial, which evaluates the efficacy, cost-effectiveness, and mechanisms of home visitation in family-based pediatric weight loss treatment for children in low-income households. Design: CHECK is a two-arm, parallel group, randomized controlled trial that is enrolling N = 266 children, ages 6–12 y, who have overweight/obesity (BMI percentile ≥85) and live in a low-income household. Participants are randomized in a 1:1 ratio to either standard of care family-based weight loss treatment delivered in the home, or the identical intervention delivered in an academic medical center. The primary outcome is change in child BMI z-score from baseline to 12 months. Program delivery costs are rigorously documented to enable cost-effectiveness analyses from the societal and payer perspectives. Objectively-documented changes to the home environment and aspects of intervention delivery (e.g., hours of in-person contact received, quantity of behavioral goals set per session) will be tested as hypothesized treatment mechanisms. Implications: Findings will inform the design of future interventions, and treatment dissemination decisions by public health agencies and third-party payers. Trial Registration:ClinicalTrials.gov identifier: NCT03195790
Bibliographical noteFunding Information:
We are grateful for assistance from Tamara Olinger; Elizabeth Avery; Michelle Li; Melanie Battaglia; Eileen Cameron; Dan Lindich; Serina Sylvestry; Alyssa Cho; and members of the Data Safety Monitoring Board (Kristin Schneider, PhD; Amanda Osta, MD; Yoonsang Kim, MPH, PhD). This study was supported by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) grant R01DK111358. The content is solely the responsibility of the authors and does not necessarily reflect the official views of the NIH.
This study was supported by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) grant R01DK111358 . The content is solely the responsibility of the authors and does not necessarily reflect the official views of the NIH.
- Cost effectiveness
- Pediatric obesity
- Socioeconomic status
- Weight loss