Healthy Eating and Active Living Taught at Home (HEALTH) Dissemination & Implementation (D&I)
| Status: | Recruiting |
|---|---|
| Conditions: | Obesity Weight Loss |
| Therapuetic Areas: | Endocrinology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 3/14/2019 |
| Start Date: | January 25, 2019 |
| End Date: | September 2023 |
| Contact: | Rachel G Tabak, PhD, RD |
| Email: | rtabak@wustl.edu |
| Phone: | 3149350153 |
Disseminating and Implementing A Lifestyle Based Healthy Weight Program in a National Organization
This project evaluates the effectiveness of an evidence-based intervention (HEALTH) to
prevent weight gain and promote weight loss when disseminated and implemented in real-world
settings, through Parents as Teachers. To enhance the impact of HEALTH, the study also
evaluates implementation outcomes from the training curriculum (implementation strategy) and
external validity when HEALTH is implemented within this national home visiting organization.
This partnership has potential for significant impact on obesity and chronic diseases such as
cardiovascular disease and diabetes.
prevent weight gain and promote weight loss when disseminated and implemented in real-world
settings, through Parents as Teachers. To enhance the impact of HEALTH, the study also
evaluates implementation outcomes from the training curriculum (implementation strategy) and
external validity when HEALTH is implemented within this national home visiting organization.
This partnership has potential for significant impact on obesity and chronic diseases such as
cardiovascular disease and diabetes.
Excessive weight gain among young adult women age 18-35 years is an alarming and overlooked
trend that must be addressed to reverse the epidemics of obesity and chronic disease. During
this vulnerable period women tend to gain disproportionally large amounts of weight compared
to men and other life periods. A lifestyle modification intervention (HEALTH) that prevented
weight gain, promoted sustained weight loss, and reduced waist circumference was developed in
partnership with Parents as Teachers (PAT), a national home visiting, community based
organization with significant reach in this population. PAT provides parent-child education
and services free-of-charge to nearly 170,000 families through up to 25 free home visits per
year until the child enters kindergarten. This study will extend these findings with a
pragmatic cluster randomized controlled trial to evaluate dissemination and implementation of
HEALTH across three levels (mother, parent educator, PAT site) to achieve widespread impact.
The pragmatic cluster randomized controlled trial will evaluate HEALTH and the HEALTH
training curriculum (implementation strategy) on weight among mothers with overweight and
obesity across the US (N= 252 HEALTH; N= 252 usual care). Parent educators from 28 existing
PAT sites (14 HEALTH, 14 usual care) will receive the HEALTH training curriculum through the
PAT National Center, using PAT's existing training infrastructure, as a continuing education
opportunity. An extensive evaluation, guided by RE-AIM (Reach, Efficacy, Adoption,
Implementation, and Maintenance) will determine implementation outcomes (acceptability,
adoption, appropriateness, feasibility, fidelity, and adaptation) at the parent educator
level. The Conceptual Framework for Implementation research will characterize determinants
that influence HEALTH dissemination and implementation at three levels: mother, parent
educator, PAT site to enhance external validity (reach and maintenance) and population level
impact. The findings from this innovative study will have significant potential to help
reverse the trend of excessive weight gain among young adult women, a critical priority
target in battling the epidemics of obesity and chronic disease, by reaching women with an
evidence-based intervention nation-wide.
trend that must be addressed to reverse the epidemics of obesity and chronic disease. During
this vulnerable period women tend to gain disproportionally large amounts of weight compared
to men and other life periods. A lifestyle modification intervention (HEALTH) that prevented
weight gain, promoted sustained weight loss, and reduced waist circumference was developed in
partnership with Parents as Teachers (PAT), a national home visiting, community based
organization with significant reach in this population. PAT provides parent-child education
and services free-of-charge to nearly 170,000 families through up to 25 free home visits per
year until the child enters kindergarten. This study will extend these findings with a
pragmatic cluster randomized controlled trial to evaluate dissemination and implementation of
HEALTH across three levels (mother, parent educator, PAT site) to achieve widespread impact.
The pragmatic cluster randomized controlled trial will evaluate HEALTH and the HEALTH
training curriculum (implementation strategy) on weight among mothers with overweight and
obesity across the US (N= 252 HEALTH; N= 252 usual care). Parent educators from 28 existing
PAT sites (14 HEALTH, 14 usual care) will receive the HEALTH training curriculum through the
PAT National Center, using PAT's existing training infrastructure, as a continuing education
opportunity. An extensive evaluation, guided by RE-AIM (Reach, Efficacy, Adoption,
Implementation, and Maintenance) will determine implementation outcomes (acceptability,
adoption, appropriateness, feasibility, fidelity, and adaptation) at the parent educator
level. The Conceptual Framework for Implementation research will characterize determinants
that influence HEALTH dissemination and implementation at three levels: mother, parent
educator, PAT site to enhance external validity (reach and maintenance) and population level
impact. The findings from this innovative study will have significant potential to help
reverse the trend of excessive weight gain among young adult women, a critical priority
target in battling the epidemics of obesity and chronic disease, by reaching women with an
evidence-based intervention nation-wide.
For Parent educators:
Inclusion Criteria:
- Deliver PAT at a site participating in the study
- Provide informed consent
Exclusion Criteria:
- At least 18 years of age
For Participants:
Inclusion Criteria:
- 18-45 years of age
- overweight or obese (BMI 25-45 kg/m2)
- English or Spanish speaking
- participating or willing to participate in PAT at a participating PAT site for 2 years
- able to give informed consent for participation
Exclusion Criteria:
- currently pregnant or planning to become pregnant in the next 24 months
- unable to speak English or Spanish
- unable to engage in a walking program
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