Childhood Obesity Research Demonstration Project: Cross-Site Evaluation Methods

O’Connor, Daniel P.; Lee, Rebecca E.; Mehta, Paras; Thompson, Debbe; Bhargava, Alok; Carlson, Coleen D.; Kao, Dennis; Layne, Charles S.; Ledoux, Tracey; O’Connor, Teresia M.; Rifai, Hanadi S.; Gulley, Lauren D.; Hallett, Allen M.; Kudia, Ousswa; Joseph, Sitara; Modelska, Maria; Ortega, Dana; Parker, Nathan H.; Stevens, Andria M.

doi:10.1089/chi.2014.0061

Cited by 27 publications

(51 citation statements)

References 34 publications

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“…[29][30][31] Other questionnaire items include CORD common measures. 32 All measurement instruments are translated into Spanish and pilot tested for cultural competence.…”

Section: Primary Prevention Measuresmentioning

confidence: 99%

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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

Hoelscher¹,

Butte

Barlow

et al. 2015

Childhood Obesity

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Background: There is consensus that development and evaluation of a systems-oriented approach for child obesity prevention and treatment that includes both primary and secondary prevention efforts is needed. This article describes the study design and baseline data from the Texas Childhood Obesity Research Demonstration (TX CORD) project, which addresses child obesity among lowincome, ethnically diverse overweight and obese children, ages 2-12 years; a two-tiered systems-oriented approach is hypothesized to reduce BMI z-scores, compared to primary prevention alone.Methods: Our study aims are to: (1) implement and evaluate a primary obesity prevention program; (2) implement and evaluate efficacy of a 12-month family-centered secondary obesity prevention program embedded within primary prevention; and (3) quantify the incremental cost-effectiveness of the secondary prevention program. Baseline demographic and behavioral data for the primary prevention community areas are presented.Results: Baseline data from preschool centers, elementary schools, and clinics indicate that most demographic variables are similar between intervention and comparison communities. Most families are low income ( £ $25,000) and Hispanic/Latino (73.3-83.8%). The majority of parents were born outside of the United States. Child obesity rates exceed national values, ranging from 19.0% in preschool to 35.2% in fifth-grade children. Most parents report that their children consume sugary beverages, have a television in the bedroom, and do not consume adequate amounts of fruits and vegetables.

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“…[29][30][31] Other questionnaire items include CORD common measures. 32 All measurement instruments are translated into Spanish and pilot tested for cultural competence.…”

Section: Primary Prevention Measuresmentioning

confidence: 99%

“…Clinic staff surveys are adapted from Polacsek and colleagues, 38 as well as the common CORD measures. 32 Community-level assessments. To assess coalition strength, the Wilder survey 39 is administered to the advisory committee, as well as program stakeholders.…”

Section: Primary Prevention Measuresmentioning

confidence: 99%

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

Hoelscher¹,

Butte

Barlow

et al. 2015

Childhood Obesity

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show abstract

“…To avoid component effects being confounded with the study effect, it is important that a study uses more than one component and that a particular component be used in more than one study. However, since it is likely that components are not exactly the same across studies, in order to consider components as Bsimilar,^a common taxonomy could be utilized ( [10] ) (see Tate et al in this issue). Note that the control or Bstandard care^arm may include some Bactiveĉ omponents, and they would also need to be accounted for in the analysis.…”

Section: Practice and Public Health Policiesmentioning

confidence: 99%

Statistical methodologies to pool across multiple intervention studies

Bangdiwala

Bhargava

O’Connor

et al. 2016

Behav. Med. Pract. Policy Res.

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Combining and analyzing data from heterogeneous randomized controlled trials of complex multiplecomponent intervention studies, or discussing them in a systematic review, is not straightforward. The present article describes certain issues to be considered when combining data across studies, based on discussions in an NIH-sponsored workshop on pooling issues across studies in consortia (see Belle et al. in Psychol Aging, 18(3):396-405, 2003). Several statistical methodologies are described and their advantages and limitations are explored. Whether weighting the different studies data differently, or via employing random effects, one must recognize that different pooling methodologies may yield different results. Pooling can be used for comprehensive exploratory analyses of data from RCTs and should not be viewed as replacing the standard analysis plan for each study. Pooling may help to identify intervention components that may be more effective especially for subsets of participants with certain behavioral characteristics. Pooling, when supported by statistical tests, can allow exploratory investigation of potential hypotheses and for the design of future interventions. KeywordsStatistical pooling of studies, Random-effects metaanalysis, Study-level meta-regression, Multilevel meta-regression, Multilevel structural models INTRODUCTION Randomized controlled trials (RCTs) are considered the gold standard experimental study design for establishing the causal effect of an intervention on an outcome of interest. RCTs are usually designed to have high internal validity in addressing specific hypotheses but may have less external validity as their inclusion and exclusion criteria may be very restrictive. Often there are many similar trials addressing the same type of research hypotheses but with different target populations, settings, or outcome measures. Such trials may not evaluate exactly the same intervention, especially in trials of interventions that include combinations of multiple behavioral, social, pharmacological and/or environmental components.

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“…More detailed descriptions of the overall CORD project, the CA-CORD and MA-CORD interventions, and the communities in which they are being implemented are available elsewhere. 48,49,60,61 …”

Section: Initial Conceptualization Of the Multilevel Implementation Fmentioning

confidence: 99%

“…Data on three dimensions of implementation effectiveness (dose delivered, reach, and fidelity) and participant-level intervention outcomes (e.g., child BMI, physical activity, and fruit and vegetable consumption) will be collected as part of the overall CORD evaluation and are described in more detail elsewhere. 60,61 Data on participant responsiveness and differentiation will be collected as part of the qualitative procedures outlined above.…”

Section: Measuring Implementation Effectivenessmentioning

confidence: 99%

Evaluation Protocol To Assess an Integrated Framework for the Implementation of the Childhood Obesity Research Demonstration Project at the California (CA-CORD) and Massachusetts (MA-CORD) Sites

et al. 2015

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Background: The long-term success of child obesity prevention and control efforts depends not only on the efficacy of the approaches selected, but also on the strategies through which they are implemented and sustained. This study introduces the Multilevel Implementation Framework (MIF), a conceptual model of factors affecting the implementation of multilevel, multisector interventions, and describes its application to the evaluation of two of three state sites (CA and MA) participating in the Childhood Obesity Research Demonstration (CORD) project.Methods/Design: A convergent mixed-methods design is used to document intervention activities and identify determinants of implementation effectiveness at the CA-CORD and MA-CORD sites. Data will be collected from multiple sectors and at multiple levels of influence (e.g., delivery system, academic-community partnership, and coalition). Quantitative surveys will be administered to coalition members and staff in participating delivery systems. Qualitative, semistructured interviews will be conducted with project leaders and key informants at multiple levels (e.g., leaders and frontline staff) within each delivery system. Document analysis of project-related materials and in vivo observations of training sessions will occur on an ongoing basis. Specific constructs assessed will be informed by the MIF. Results will be shared with project leaders and key stakeholders for the purposes of improving processes and informing sustainability discussions and will be used to test and refine the MIF.Conclusions: Study findings will contribute to knowledge about how to coordinate and implement change strategies within and across sectors in ways that effectively engage diverse stakeholders, minimize policy resistance, and maximize desired intervention outcomes.

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Childhood Obesity Research Demonstration Project: Cross-Site Evaluation Methods

Cited by 27 publications

References 34 publications

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

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

Statistical methodologies to pool across multiple intervention studies

Evaluation Protocol To Assess an Integrated Framework for the Implementation of the Childhood Obesity Research Demonstration Project at the California (CA-CORD) and Massachusetts (MA-CORD) Sites

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