Sensible Treatment of Obesity in Rural Youth (STORY): Design and methods

Abstract

Project STORY is a 3-arm, randomized, planning and feasibility study assessing the effectiveness of two behavioral weight management interventions in an important and at-risk population, overweight children and their parents in medically underserved rural counties.Participants will include 90 parent-child dyads from rural counties in north central Florida. Families will be randomized to one of three conditions: (a) a Family-Based Behavioral Group Intervention, (b) a Parent-Only Behavioral Group Intervention, and (c) a waitlist control condition. Child and parent participants will be assessed at baseline (month 0), post-treatment (month 4) and follow-up (month 10). Assessment and intervention sessions will be held at Cooperative Extension offices within each local participating county. The primary outcome measure is change in child body mass index (BMI) z-score. Additional key outcome measures include child dietary intake, physical activity, self-esteem, body image, and parent BMI.The goals of the study are to (a) assess the feasibility of recruitment in rural settings, (b) develop and evaluate training protocol for group leaders, (c) determine strategies to increase adherence to monitoring and goal setting protocol, (d) evaluate strategies for participant retention, (e) assess the relative cost-effectiveness of the interventions, (f) assess the acceptability of the intervention to families and Cooperative Extension administrators and personnel, and (g) if successful, estimate the sample size needed for a full scale trial. This research has potential implications for medically underserved rural communities with limited resources and preventive health care services. If successful, a Parent-Only intervention program may provide a cost-effective and practical intervention for families in underserved rural communities.

Small steps are easier together: A goal-based ecological intervention to increase walking by women in rural worksites

“…Leaders were given materials, one hour of orientation, and on-going consultation from local CCE educators and researchers. This study adds to the evidence that Cooperative Extension (CE) educators can be instrumental in promoting physical activity in weight-loss trials with rural adults (Janicke et al, 2008;Perri et al, 2008) or in general health promotion as members of community coalitions (Meister and de Zapien, 2005). The current study shows that the national CE network can promote walking in rural worksites and it complements earlier rural community walking interventions (Brownson et al, 2004).…”

Evaluating Parents and Adult Caregivers as “Agents of Change” for Treating Obese Children: Evidence for Parent Behavior Change Strategies and Research Gaps

“…34,[97][98][99][100][101][102][103][104][105][106][107] These investigations varied (by random assignment) whether PACs were treated together with (versus separately from) their obese child or varied whether PACs (versus the youths) were the primary target of intervention. We retrieved trials dating from 1975 108 through 2008 106 that examined whether there were significant differences among treatment groups with respect to improvements in child overweight status after treatment or at follow-up.…”

Effectiveness of Lifestyle Interventions in Child Obesity: Systematic Review With Meta-analysis

“…Nearly half of the studies were conducted in the United States (n = 18), 22,24,29,33,41,[46][47][48][49]50,56,63,64,[66][67][68][69]71 5 in Australia, 25,30,[35][36][37] and the others in Israel (n = 3), 39,43,44 Germany (n = 2), 32,51 the United Kingdom (n = 2), 34,40 Belgium, 65 China, 28 Finland, 42 Iran, 45 Korea, 31 Mexico, 38 Taiwan, 26 and Tunisia. 23 Eighteen studies targeted obese children exclusively, 22,23,26,28,29,31,34,38,[40][41][42]44,46,…”