Objective The objective of the current study was to examine the feasibility of telemedicine vs. telephone for the delivery of a multidisciplinary weekly family based behavioral group intervention to treat pediatric obesity delivered to families living in rural areas using a randomized controlled trial methodology. Methods 103 rural children and their families were recruited. Feasibility measures included participant satisfaction, session attendance and retention. Treatment outcome measures included child BMIz, Parent BMI, 24-hour dietary recalls, accelerometer data, Child Behavior Checklist and the Behavioral Pediatrics Feeding Assessment Scale. Results Participants were highly satisfied with the intervention both via telemedicine and via telephone. Completion rates were much higher than for other pediatric obesity intervention programs, and both methodologies were highly feasible. There were no differences in telemedicine and telephone groups on primary outcomes. Conclusion Both telemedicine and telephone intervention appear to be feasible and acceptable methods of delivering pediatric obesity treatment to rural children.

Technology adjuncts are feasible, used by hard-to-reach participants, and show promise for improving child weight status in obesity treatment programs.

Children in rural areas are disproportionately affected by pediatric obesity. Poor access to healthcare providers, lack of nutrition education, lower socioeconomic status, and fewer

It is possible to enroll and maintain urban, minority, low-income families in a family-based behavioral group treatment program for pediatric obesity. Outcome data indicate that these families achieve significant outcomes on zBMI, and that children who remain available for assessment maintain this at 1 year, which is an improvement over previous research using other intervention methodologies with this population.