Academic journal article Childhood Obesity

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

Academic journal article Childhood Obesity

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

Article excerpt

[Author Affiliation]

Deanna M. Hoelscher. 1 Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Austin, TX.

Nancy F. Butte. 2 Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX.

Sarah Barlow. 3 Department of Pediatric Medicine, GI, Hepatology and Nutrition, Texas Children's Hospital, Baylor College of Medicine, Houston, TX.

Elizabeth A. Vandewater. 1 Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Austin, TX.

Shreela V. Sharma. 8 Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Houston, TX.

Terry Huang. 4 Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE.

Eric Finkelstein. 5 Program in Health Services Systems Research, Duke University Global Health Institute, Singapore.

Stephen Pont. 6 Texas Center for the Prevention and Treatment of Childhood Obesity, Dell Children's Medical Center, University of Texas Southwestern-Austin, Austin, TX.

Paul Sacher. 7 Childhood Nutrition Research Center, University College, London, United Kingdom.

Courtney Byrd-Williams. 1 Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Austin, TX.

Abiodun O. Oluyomi. 1 Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Austin, TX.

Casey Durand. 8 Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Houston, TX.

Linlin Li. 1 Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Austin, TX.

Steven H. Kelder. 1 Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Austin, TX.

Address correspondence to: Deanna M. Hoelscher, PhD, RD, Director, Michael & Susan Dell Center for Healthy Living, University of Texas School of Public Health, Austin Regional Campus, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, E-mail: Deanna.M.Hoelscher@uth.tmc.edu

Introduction

Because of its high prevalence, adverse metabolic effects, ethnic and socioeconomic (SES) disparities, and costs, addressing childhood obesity is a national public health imperative. Recent data from the United States estimate that 22.8% of children 2-5 years of age and 34.2% of children 6-11 years are overweight or obese,1 with prevalence rates highest among black and Latino children. Childhood obesity is associated with metabolic and endocrine disorders that lead to early development of type 2 diabetes, cardiovascular disease, hypertension, and nonalcoholic fatty liver disease.2,3 Annually, obesity accounts for roughly 9% of all medical expenditures, and this cost may increase as today's obese youth enter adulthood.4

Recent systematic reviews indicate that behavior changes and weight loss among obese children are possible5,6 ; however, reported weight losses were modest and the maintenance of effects was rarely measured. Moreover, the generalizability and reproducibility of the findings are unclear because of small sample sizes, nonstandardized outcome measures, inadequate inclusion of low-income minority children, and limited program accessibility.

Recognizing the complexity of childhood obesity, there is a consensus that development and evaluation of a systems-oriented approach for child obesity prevention and treatment is needed.7 A systems approach would simultaneously address the drivers of obesity at the individual, family, healthcare, community, organizational, and societal levels through primary prevention and secondary prevention efforts. …

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