Comprehensive multisector, multilevel approaches are needed to address childhood obesity. This ar... more Comprehensive multisector, multilevel approaches are needed to address childhood obesity. This article introduces the structure of a multidisciplinary team approach used to support and guide the multisite, multisector interventions implemented as part of the Childhood Obesity Research Demonstration (CORD) project. This article will describe the function, roles, and lessons learned from the CDC-CORD approach to project management. The CORD project works across multisectors and multilevels in three demonstration communities. Working with principal investigators and their research teams who are engaging multiple stakeholder groups, including community organizations, schools and child care centers, health departments, and healthcare providers, can be a complex endeavor. To best support the community-based research project, scientific and programmatic expertise in a wide range of areas was required. The team was configured based on the skill sets needed to interact with the various levels of staff working with the project. By thoughtful development of the team and processes, an efficient system for supporting the multisite, multisector intervention project sites was developed. The team approach will be formally evaluated at the end of the project period.
This is the first of a set of articles in this issue on the Childhood Obesity Research Demonstrat... more This is the first of a set of articles in this issue on the Childhood Obesity Research Demonstration (CORD) project and provides an overview of the multisite approach and community-wide interventions. Innovative multisetting, multilevel approaches that integrate primary healthcare and public health interventions to improve outcomes for children with obesity need to be evaluated. The CORD project aims to improve BMI and obesity-related behaviors among underserved 2- to 12-year-old children by utilizing these approaches. The CORD consortium, structure, model terminology and key components, and common measures were solidified in year 1 of the CORD project. Demonstration sites applied the CORD model across communities in years 2 and 3. Evaluation plans for year 4 include site-specific analyses as well as cross-site impact, process, and sustainability evaluations. The CORD approach resulted in commonalities and differences in participant, intervention, comparison, and outcome elements across sites. Products are to include analytic results as well as cost assessment, lessons learned, tools, and materials. Foreseen opportunities and challenges arise from the similarities and unique aspects across sites. Communities adapted interventions to fit their local context and build on strengths, but, in turn, this flexibility makes cross-site evaluation challenging. The CORD project represents an evidence-based approach that integrates primary care and public health strategies and evaluates multisetting multilevel interventions, thus adding to the limited research in this field. CORD products will be disseminated to a variety of stakeholders to aid the understanding, prevention, and management of childhood obesity.
Background: With the widespread availability of internet access in the United States, it is incre... more Background: With the widespread availability of internet access in the United States, it is increasingly used as a medium through which health information is obtained. Purpose: This study aimed to assess whether internet use for health information (IUHI) among adults in the United States is associated with increased awareness of and compliance with national physical activity (PA) guidelines. Methods: We analyzed cross-sectional data from 2009 HealthStyles, a mailed population-based survey of adults ≥18 years old. We assessed the effect of IUHI on recall of PA guidelines and self-reported PA level using multivariate logistical regression, controlling for key sociodemographic variables. Results: Analysis of 3910 respondents found that 49% used the internet for health information. IUHI was significantly associated in bivariate modeling with awareness of (OR=1.44, 95%CI=1.16C1.79) and compliance with (OR=1.25, 95%CI=1.03C1.52) PA recommendations. Multivariate modeling did not find IUHI ...
Pediatric health care professionals report that one of the most frequent barriers in the manageme... more Pediatric health care professionals report that one of the most frequent barriers in the management of childhood obesity is lack of parental involvement. In a cross sectional survey study 100 hundred parents of overweight children between 6-12 years old completed questionnaires after an encounter with their child's health care provider at two urban health care centers. Families were primarily African American and Hispanic. Survey included a Family Demographics Questionnaire, the Center for Epidemiologic Studies Depression Scale (CES-D), and the Weight Efficacy Lifestyle Questionnaire. The variables of parents' self-perceived weight, parents' perceived self-efficacy for child's weight loss, parental depression, and parents' perception of the pediatric provider's weight were assessed for their impact on the parents' intention to make lifestyle changes for their overweight child. Expected results: parents who reported higher levels of depressive symptoms had...
The elimination of disparities in cardiovascular health is a major focus of the Healthy People 20... more The elimination of disparities in cardiovascular health is a major focus of the Healthy People 2010 national public health agenda. However, identifying and addressing such disparities within the realm of pediatrics in general, and preventive cardiology in particular, has not received recent attention. In published pediatric clinical trials of statins in heterozygous familial hypercholesterolemia that report race, minority children are underrepresented. The purpose of this analysis was 3-fold: 1) to obtain and report on the racial composition of statin trials in children with heterozygous familial hypercholesterolemia; 2) to explore the hypothesis that founder effects among populations of White children may have facilitated or favored their inclusion in statin trials; and 3) to determine whether the selective lipid screening guidelines based on family history may inadvertently identify fewer minority children who would otherwise qualify for investigative trials. We conducted a Medlin...
Medical facilities are natural leaders for health promotion because of their mission, influence, ... more Medical facilities are natural leaders for health promotion because of their mission, influence, and reach. We sought to determine the frequency of physicians reporting supportive, health-promoting environments in their facility and identify characteristics of physicians and medical practices associated with support. We analyzed a sample of 1485 U.S. primary care physicians in DocStyles 2012 survey. Physicians rated their facility's support for healthy nutrition, physical activity, and lactation environments. Frequencies and adjusted odds ratios for supportive environments (rated "Good" or "Very Good") were assessed by select characteristics. The frequency of physicians reporting supportive environments was 70.0% for nutrition, 60.0% for physical activity, 76.0% for lactation, and 40.4% for all 3 environments combined. Supportive nutrition [odds ratio: 2.91 (1.49-5.66)] and physical activity [2.13 (1.19-3.83)] environments were associated with physicians seei...
This study examines the relationships between participation in the African American church and ov... more This study examines the relationships between participation in the African American church and overweight/obesity (body mass index (BMI) > or = 25 kg/m2). This cross-sectional analysis was based on the National Survey of American Life 2001-2003 and included 2,689 African American Protestant (AAP) adults. Multivariate logistic regression was used to calculate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for overweight/obesity. Two practices were examined--frequency of participation in church activities (excluding services) and frequency of church service attendance. Each practice was analyzed in separate models. Each model included the following covariates: age, marital status, education, poverty, smoking, and region of country. We also adjusted models for sex. After adjustment, African American Protestant men (AAPM) who participated in church activities at least weekly were more likely to be overweight/obese (aOR=2.17; 95% CI = 1.25, 3.77) compared to AAPM who did...
Comprehensive multisector, multilevel approaches are needed to address childhood obesity. This ar... more Comprehensive multisector, multilevel approaches are needed to address childhood obesity. This article introduces the structure of a multidisciplinary team approach used to support and guide the multisite, multisector interventions implemented as part of the Childhood Obesity Research Demonstration (CORD) project. This article will describe the function, roles, and lessons learned from the CDC-CORD approach to project management. The CORD project works across multisectors and multilevels in three demonstration communities. Working with principal investigators and their research teams who are engaging multiple stakeholder groups, including community organizations, schools and child care centers, health departments, and healthcare providers, can be a complex endeavor. To best support the community-based research project, scientific and programmatic expertise in a wide range of areas was required. The team was configured based on the skill sets needed to interact with the various level...
This is the first of a set of articles in this issue on the Childhood Obesity Research Demonstrat... more This is the first of a set of articles in this issue on the Childhood Obesity Research Demonstration (CORD) project and provides an overview of the multisite approach and community-wide interventions. Innovative multisetting, multilevel approaches that integrate primary healthcare and public health interventions to improve outcomes for children with obesity need to be evaluated. The CORD project aims to improve BMI and obesity-related behaviors among underserved 2- to 12-year-old children by utilizing these approaches. The CORD consortium, structure, model terminology and key components, and common measures were solidified in year 1 of the CORD project. Demonstration sites applied the CORD model across communities in years 2 and 3. Evaluation plans for year 4 include site-specific analyses as well as cross-site impact, process, and sustainability evaluations. The CORD approach resulted in commonalities and differences in participant, intervention, comparison, and outcome elements ac...
Comprehensive multisector, multilevel approaches are needed to address childhood obesity. This ar... more Comprehensive multisector, multilevel approaches are needed to address childhood obesity. This article introduces the structure of a multidisciplinary team approach used to support and guide the multisite, multisector interventions implemented as part of the Childhood Obesity Research Demonstration (CORD) project. This article will describe the function, roles, and lessons learned from the CDC-CORD approach to project management. The CORD project works across multisectors and multilevels in three demonstration communities. Working with principal investigators and their research teams who are engaging multiple stakeholder groups, including community organizations, schools and child care centers, health departments, and healthcare providers, can be a complex endeavor. To best support the community-based research project, scientific and programmatic expertise in a wide range of areas was required. The team was configured based on the skill sets needed to interact with the various levels of staff working with the project. By thoughtful development of the team and processes, an efficient system for supporting the multisite, multisector intervention project sites was developed. The team approach will be formally evaluated at the end of the project period.
This is the first of a set of articles in this issue on the Childhood Obesity Research Demonstrat... more This is the first of a set of articles in this issue on the Childhood Obesity Research Demonstration (CORD) project and provides an overview of the multisite approach and community-wide interventions. Innovative multisetting, multilevel approaches that integrate primary healthcare and public health interventions to improve outcomes for children with obesity need to be evaluated. The CORD project aims to improve BMI and obesity-related behaviors among underserved 2- to 12-year-old children by utilizing these approaches. The CORD consortium, structure, model terminology and key components, and common measures were solidified in year 1 of the CORD project. Demonstration sites applied the CORD model across communities in years 2 and 3. Evaluation plans for year 4 include site-specific analyses as well as cross-site impact, process, and sustainability evaluations. The CORD approach resulted in commonalities and differences in participant, intervention, comparison, and outcome elements across sites. Products are to include analytic results as well as cost assessment, lessons learned, tools, and materials. Foreseen opportunities and challenges arise from the similarities and unique aspects across sites. Communities adapted interventions to fit their local context and build on strengths, but, in turn, this flexibility makes cross-site evaluation challenging. The CORD project represents an evidence-based approach that integrates primary care and public health strategies and evaluates multisetting multilevel interventions, thus adding to the limited research in this field. CORD products will be disseminated to a variety of stakeholders to aid the understanding, prevention, and management of childhood obesity.
Background: With the widespread availability of internet access in the United States, it is incre... more Background: With the widespread availability of internet access in the United States, it is increasingly used as a medium through which health information is obtained. Purpose: This study aimed to assess whether internet use for health information (IUHI) among adults in the United States is associated with increased awareness of and compliance with national physical activity (PA) guidelines. Methods: We analyzed cross-sectional data from 2009 HealthStyles, a mailed population-based survey of adults ≥18 years old. We assessed the effect of IUHI on recall of PA guidelines and self-reported PA level using multivariate logistical regression, controlling for key sociodemographic variables. Results: Analysis of 3910 respondents found that 49% used the internet for health information. IUHI was significantly associated in bivariate modeling with awareness of (OR=1.44, 95%CI=1.16C1.79) and compliance with (OR=1.25, 95%CI=1.03C1.52) PA recommendations. Multivariate modeling did not find IUHI ...
Pediatric health care professionals report that one of the most frequent barriers in the manageme... more Pediatric health care professionals report that one of the most frequent barriers in the management of childhood obesity is lack of parental involvement. In a cross sectional survey study 100 hundred parents of overweight children between 6-12 years old completed questionnaires after an encounter with their child's health care provider at two urban health care centers. Families were primarily African American and Hispanic. Survey included a Family Demographics Questionnaire, the Center for Epidemiologic Studies Depression Scale (CES-D), and the Weight Efficacy Lifestyle Questionnaire. The variables of parents' self-perceived weight, parents' perceived self-efficacy for child's weight loss, parental depression, and parents' perception of the pediatric provider's weight were assessed for their impact on the parents' intention to make lifestyle changes for their overweight child. Expected results: parents who reported higher levels of depressive symptoms had...
The elimination of disparities in cardiovascular health is a major focus of the Healthy People 20... more The elimination of disparities in cardiovascular health is a major focus of the Healthy People 2010 national public health agenda. However, identifying and addressing such disparities within the realm of pediatrics in general, and preventive cardiology in particular, has not received recent attention. In published pediatric clinical trials of statins in heterozygous familial hypercholesterolemia that report race, minority children are underrepresented. The purpose of this analysis was 3-fold: 1) to obtain and report on the racial composition of statin trials in children with heterozygous familial hypercholesterolemia; 2) to explore the hypothesis that founder effects among populations of White children may have facilitated or favored their inclusion in statin trials; and 3) to determine whether the selective lipid screening guidelines based on family history may inadvertently identify fewer minority children who would otherwise qualify for investigative trials. We conducted a Medlin...
Medical facilities are natural leaders for health promotion because of their mission, influence, ... more Medical facilities are natural leaders for health promotion because of their mission, influence, and reach. We sought to determine the frequency of physicians reporting supportive, health-promoting environments in their facility and identify characteristics of physicians and medical practices associated with support. We analyzed a sample of 1485 U.S. primary care physicians in DocStyles 2012 survey. Physicians rated their facility's support for healthy nutrition, physical activity, and lactation environments. Frequencies and adjusted odds ratios for supportive environments (rated "Good" or "Very Good") were assessed by select characteristics. The frequency of physicians reporting supportive environments was 70.0% for nutrition, 60.0% for physical activity, 76.0% for lactation, and 40.4% for all 3 environments combined. Supportive nutrition [odds ratio: 2.91 (1.49-5.66)] and physical activity [2.13 (1.19-3.83)] environments were associated with physicians seei...
This study examines the relationships between participation in the African American church and ov... more This study examines the relationships between participation in the African American church and overweight/obesity (body mass index (BMI) > or = 25 kg/m2). This cross-sectional analysis was based on the National Survey of American Life 2001-2003 and included 2,689 African American Protestant (AAP) adults. Multivariate logistic regression was used to calculate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for overweight/obesity. Two practices were examined--frequency of participation in church activities (excluding services) and frequency of church service attendance. Each practice was analyzed in separate models. Each model included the following covariates: age, marital status, education, poverty, smoking, and region of country. We also adjusted models for sex. After adjustment, African American Protestant men (AAPM) who participated in church activities at least weekly were more likely to be overweight/obese (aOR=2.17; 95% CI = 1.25, 3.77) compared to AAPM who did...
Comprehensive multisector, multilevel approaches are needed to address childhood obesity. This ar... more Comprehensive multisector, multilevel approaches are needed to address childhood obesity. This article introduces the structure of a multidisciplinary team approach used to support and guide the multisite, multisector interventions implemented as part of the Childhood Obesity Research Demonstration (CORD) project. This article will describe the function, roles, and lessons learned from the CDC-CORD approach to project management. The CORD project works across multisectors and multilevels in three demonstration communities. Working with principal investigators and their research teams who are engaging multiple stakeholder groups, including community organizations, schools and child care centers, health departments, and healthcare providers, can be a complex endeavor. To best support the community-based research project, scientific and programmatic expertise in a wide range of areas was required. The team was configured based on the skill sets needed to interact with the various level...
This is the first of a set of articles in this issue on the Childhood Obesity Research Demonstrat... more This is the first of a set of articles in this issue on the Childhood Obesity Research Demonstration (CORD) project and provides an overview of the multisite approach and community-wide interventions. Innovative multisetting, multilevel approaches that integrate primary healthcare and public health interventions to improve outcomes for children with obesity need to be evaluated. The CORD project aims to improve BMI and obesity-related behaviors among underserved 2- to 12-year-old children by utilizing these approaches. The CORD consortium, structure, model terminology and key components, and common measures were solidified in year 1 of the CORD project. Demonstration sites applied the CORD model across communities in years 2 and 3. Evaluation plans for year 4 include site-specific analyses as well as cross-site impact, process, and sustainability evaluations. The CORD approach resulted in commonalities and differences in participant, intervention, comparison, and outcome elements ac...
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