Motivational Wellness Coaching to Reduce Childhood Obesity in Families and Kids

NCT05143697 | Recruiting DMC

• 2 other identifiers: KPSC IRB#126071R01DK127038-01
• Study Type: interventional
• Target: 6,600
• Locations: 1 country
• Sites: 1

Brief Summary

Primary care settings lack interventions to address the childhood obesity epidemic that are feasible and sustainable without requiring significant resources. The investigators propose to modify and test an intervention shown to lower children's body mass index(BMI) so that it is feasible, sustainable, and easily disseminated in a real-world clinical setting. If successful, the investigators will be able to provide recommendations to providers and health care systems that help prioritize future intervention strategies and research investments to reduce obesity in children that can be quickly translated into other settings and widely adopted after the study period, with the goal of halting and reversing the childhood obesity epidemic.

Conditions

Obesity

Keywords

Motivational Interviewing; Wellness; Coaching

Outcome Measures

Primary Outcomes (1)

• Determine the effectiveness and dose-response relationship of a pragmatic, system-integrated child-hood obesity intervention using mBMI2Kids (a modified BMI2 approach) at follow-up.

  Hypothesis 1-1: At 2-yr follow-up, patients ages 2-8 yrs with baseline BMI ≥85th percentile who were reached in intervention clinics will show a net mean BMI decrease between 0.8 and 1.0 kg/m2 (adjusted for sex, age) compared to usual care (population effect). Hypothesis 1-2: At 2-yr follow-up, patients who received the full planned MI-dose (defined as 8 of 12 sessions) will show a net mean BMI decrease between 1.0 and 1.2 kg/m2 (adjusted for sex, age) compared to usual care (individual effect).

  2 years

Secondary Outcomes (1)

• Investigate how patient characteristics such as minority or low-income background and parental obesity modify the effect of the mBMI2Kids intervention (Heterogeneity of effects).

  2 years

Study Arms (1)

Wellness Coaching for Families and Kids

OTHER

For clinics assigned to mBMI2Kids intervention, Pediatricians will be trained in Motivational Interviewing (MI) and behavioral intervention. Pediatricians will conduct up to 3 sessions with each parent (3 x 10 min) and refer patients electronically to experienced MI-trained lifestyle coaches. With full access to the electronic medical record coaches will call referred families (child's BMI-for-age ≥85th percentile) and deliver a telephonic MI counseling over two years (6 x 45 min) simultaneous with pediatricians. 49 clinics will be selected with 24 participating in the intervention and 25 providing patients with usual care.

Behavioral: Wellness Coaching for Families and Kids

Interventions

Wellness Coaching for Families and Kids BEHAVIORAL

The investigators propose to conduct a cluster-randomized pragmatic trial in 49 pediatric clinics in Kaiser Permanente Southern California (KPSC), to test the effectiveness of mBMI2Kids (a modified version of the BMI2 interven-tion) in pediatric clinics (randomization unit). Clinics serve over 45,000 children aged 2-8 yrs who are obese and have high racial/ethnic and socioeconomic diversity (53% Hispanic; 23% state-subsidized insurance). Clinics will be randomized into either 24 intervention or 25 usual care + attention control (enrolling 6,600 children). KP's long-standing electronic medical record (EMR) and stable membership, a research team embedded in care, existing team of lifestyle coaches, and ability to rapidly disseminate findings makes us uniquely positioned to conduct this study.

Also known as: WC4K

Wellness Coaching for Families and Kids

Eligibility Criteria

• Age: 2 Years - 8 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• Children age 2-8 years
• Body mass index in the 85 percentile or higher

You may not qualify if:

• Families that don't speak English or Spanish as a primary language

Sponsors & Collaborators

• Kaiser Permanente: lead
• National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): collaborator

Study Sites (1)

Kaiser Permanente Pasadena

Pasadena, California, 91101, United States

RECRUITING

Related Publications (21)

• Skinner AC, Skelton JA. Prevalence and trends in obesity and severe obesity among children in the United States, 1999-2012. JAMA Pediatr. 2014 Jun;168(6):561-6. doi: 10.1001/jamapediatrics.2014.21.

  PMID: 24710576 BACKGROUND

• Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA. 2014 Feb 26;311(8):806-14. doi: 10.1001/jama.2014.732.

  PMID: 24570244 BACKGROUND

• Resnicow K, Harris D, Wasserman R, Schwartz RP, Perez-Rosas V, Mihalcea R, Snetselaar L. Advances in Motivational Interviewing for Pediatric Obesity: Results of the Brief Motivational Interviewing to Reduce Body Mass Index Trial and Future Directions. Pediatr Clin North Am. 2016 Jun;63(3):539-62. doi: 10.1016/j.pcl.2016.02.008.

  PMID: 27261549 BACKGROUND

• Ogden CL, Fryar CD, Hales CM, Carroll MD, Aoki Y, Freedman DS. Differences in Obesity Prevalence by Demographics and Urbanization in US Children and Adolescents, 2013-2016. JAMA. 2018 Jun 19;319(23):2410-2418. doi: 10.1001/jama.2018.5158.

  PMID: 29922826 BACKGROUND

• US Preventive Services Task Force; Barton M. Screening for obesity in children and adolescents: US Preventive Services Task Force recommendation statement. Pediatrics. 2010 Feb;125(2):361-7. doi: 10.1542/peds.2009-2037. Epub 2010 Jan 18.

  PMID: 20083515 BACKGROUND

• Davis MM, Gance-Cleveland B, Hassink S, Johnson R, Paradis G, Resnicow K. Recommendations for prevention of childhood obesity. Pediatrics. 2007 Dec;120 Suppl 4:S229-53. doi: 10.1542/peds.2007-2329E.

  PMID: 18055653 BACKGROUND

• Spear BA, Barlow SE, Ervin C, Ludwig DS, Saelens BE, Schetzina KE, Taveras EM. Recommendations for treatment of child and adolescent overweight and obesity. Pediatrics. 2007 Dec;120 Suppl 4:S254-88. doi: 10.1542/peds.2007-2329F.

  PMID: 18055654 BACKGROUND

• Borrello M, Pietrabissa G, Ceccarini M, Manzoni GM, Castelnuovo G. Motivational Interviewing in Childhood Obesity Treatment. Front Psychol. 2015 Nov 12;6:1732. doi: 10.3389/fpsyg.2015.01732. eCollection 2015.

  PMID: 26617555 BACKGROUND

• Resnicow K, McMaster F, Bocian A, Harris D, Zhou Y, Snetselaar L, Schwartz R, Myers E, Gotlieb J, Foster J, Hollinger D, Smith K, Woolford S, Mueller D, Wasserman RC. Motivational interviewing and dietary counseling for obesity in primary care: an RCT. Pediatrics. 2015 Apr;135(4):649-57. doi: 10.1542/peds.2014-1880.

  PMID: 25825539 BACKGROUND

• Ford AL, Hunt LP, Cooper A, Shield JP. What reduction in BMI SDS is required in obese adolescents to improve body composition and cardiometabolic health? Arch Dis Child. 2010 Apr;95(4):256-61. doi: 10.1136/adc.2009.165340. Epub 2009 Dec 4.

  PMID: 19966092 BACKGROUND

• Frohlich G, Pott W, Albayrak O, Hebebrand J, Pauli-Pott U. Conditions of long-term success in a lifestyle intervention for overweight and obese youths. Pediatrics. 2011 Oct;128(4):e779-85. doi: 10.1542/peds.2010-3395. Epub 2011 Sep 12.

  PMID: 21911346 BACKGROUND

• Kirk S, Zeller M, Claytor R, Santangelo M, Khoury PR, Daniels SR. The relationship of health outcomes to improvement in BMI in children and adolescents. Obes Res. 2005 May;13(5):876-82. doi: 10.1038/oby.2005.101.

  PMID: 15919841 BACKGROUND

• Reinehr T, Kiess W, Kapellen T, Andler W. Insulin sensitivity among obese children and adolescents, according to degree of weight loss. Pediatrics. 2004 Dec;114(6):1569-73. doi: 10.1542/peds.2003-0649-F.

  PMID: 15574616 BACKGROUND

• Apter AJ. Understanding adherence requires pragmatic trials: lessons from pediatric asthma. JAMA Pediatr. 2015 Apr;169(4):310-1. doi: 10.1001/jamapediatrics.2014.3661. No abstract available.

  PMID: 25664425 BACKGROUND

• Asarnow J, Ougrin D. From efficacy to pragmatic trials: does the dodo bird verdict apply? Lancet Psychiatry. 2017 Feb;4(2):84-85. doi: 10.1016/S2215-0366(16)30404-7. Epub 2016 Dec 1. No abstract available.

  PMID: 27914904 BACKGROUND

• Ford I, Norrie J. Pragmatic Trials. N Engl J Med. 2016 Aug 4;375(5):454-63. doi: 10.1056/NEJMra1510059. No abstract available.

  PMID: 27518663 BACKGROUND

• Wright ME, Delacroix E, Sonneville KR, Considine S, Proctor T, Steffes J, Harris D, Shone LP, Woo H, Vaughan R, Grundmeier RW, Fiks AG, Stockwell MS, Resnicow K. Reducing paediatric overweight and obesity through motivational interviewing: study protocol for a randomised controlled trial in the AAP PROS research network. BMJ Open. 2020 Jul 28;10(7):e035720. doi: 10.1136/bmjopen-2019-035720.

  PMID: 32723736 BACKGROUND

• Glasgow RE, McKay HG, Piette JD, Reynolds KD. The RE-AIM framework for evaluating interventions: what can it tell us about approaches to chronic illness management? Patient Educ Couns. 2001 Aug;44(2):119-27. doi: 10.1016/s0738-3991(00)00186-5.

  PMID: 11479052 BACKGROUND

• Ogden CL, Carroll MD, Lawman HG, Fryar CD, Kruszon-Moran D, Kit BK, Flegal KM. Trends in Obesity Prevalence Among Children and Adolescents in the United States, 1988-1994 Through 2013-2014. JAMA. 2016 Jun 7;315(21):2292-9. doi: 10.1001/jama.2016.6361.

  PMID: 27272581 BACKGROUND

• Daniels SR, Arnett DK, Eckel RH, Gidding SS, Hayman LL, Kumanyika S, Robinson TN, Scott BJ, St Jeor S, Williams CL. Overweight in children and adolescents: pathophysiology, consequences, prevention, and treatment. Circulation. 2005 Apr 19;111(15):1999-2012. doi: 10.1161/01.CIR.0000161369.71722.10.

  PMID: 15837955 BACKGROUND

• Freedman DS, Mei Z, Srinivasan SR, Berenson GS, Dietz WH. Cardiovascular risk factors and excess adiposity among overweight children and adolescents: the Bogalusa Heart Study. J Pediatr. 2007 Jan;150(1):12-17.e2. doi: 10.1016/j.jpeds.2006.08.042.

  PMID: 17188605 BACKGROUND

MeSH Terms

Conditions

Obesity

Condition Hierarchy (Ancestors)

Overweight; Overnutrition; Nutrition Disorders; Nutritional and Metabolic Diseases; Body Weight; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Corinna Koebnick, PhD

  Kaiser Permanente

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Kimberly J Holmquist, MPHc

CONTACT

626-243-8604; Kimberly.J.Holmquist@kp.org

Jessica D Vallejo, MS

CONTACT

626-564-3035; Jessica.D.Vallejo@kp.org

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Model Details: The proposed study is a pragmatic cluster-randomized trial to test the impact of a modified version of the BMI2 intervention, which we have named mBMI2Kids. Target population are children aged 2-8 years with a BMI-for-age ≥85 percentile from 49 Kaiser Permanente pediatric clinics in Southern California. All children and their parent/guardian reached will be included according to the clinic in which they receive care (Intervention-to-treat approach).

Study Record Dates

• First Submitted: August 5, 2021
• First Posted: December 3, 2021
• Study Start: May 16, 2022
• Primary Completion (Estimated): June 30, 2026
• Study Completion (Estimated): June 30, 2026
• Last Updated: September 4, 2025

Record last verified: 2025-08

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)