Guided Self-Help Obesity Treatment in the Doctor's Office - GOT Doc

Currently 1/3 of our nation's children are overweight or obese. The goal of Healthy People
2020 is to reduce the proportion of children who are obese and increase the proportion of
primary care visits that include nutrition and weight-related counseling. However, there are
a lack of resources and providers that can offer effective weight-related counseling and
treatment. Gold-standard family-based weight control programs for children are often
provided at tertiary care academic centers and can be difficult to access. Furthermore,
primary care providers (PCPs), who have been identified as key players in the treatment of
childhood obesity, are not well-equipped to address this issue, engage in behavior
modification/lifestyle counseling, or provide effective treatment in the primary care
setting. As a result, new models of care are needed so that a greater proportion of
overweight/obese (OW/OB) children and their parents can access care and receive quality
treatment for obesity. The investigators propose to train health coaches in the primary care
setting to deliver Guided Self-Help (GSH) treatment of childhood obesity. Implementing this
program in the primary care setting will increase our ability to deliver nutrition and
weight-related counseling in the primary care office and serve patients closer to home,
thereby increasing access to effective treatment, improving adherence to recommended
changes, and meeting the goals of Healthy People 2020.

The goal of this study is to conduct a pragmatic clinical trial in two large pediatric
practices in San Diego County (n=200) where 38% and 39% of children are OW/OB. The
intervention group will receive GSH (12 sessions over 6 months) delivered by a health coach
in the clinic. The control group will receive usual care, i.e. PCP provides obesity
management using decision support tools in the electronic health record and refers to a
tertiary care program (20 sessions over 6 months) at the academic center.

Inclusion Criteria:

- an OW/OB child (BMI ≥ 85th%ile for age and gender) in the family who is between the
ages of 5 and 13 years old

- parent who is responsible for food preparation willing to participate

- parent who can read English or Spanish at a minimum of a 5th grade level

- family who is willing to commit to attendance at all assessment visits

- family not moving out of the San Diego area within the time frame of the study.

Exclusion Criteria:

- child who is taking medications that may impact weight

- child or parent with a psychiatric or behavioral illness that will impact their
ability to participate in treatment

- child with physical difficulties that limit the ability to exercise