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  • Mary Lynn Davis-Ajami

Mary Lynn Davis-Ajami

Associate Dean, Associate Professor, School of Nursing

Phone:
(812) 855-7089
Email:
mdavisaj@iu.edu
Campus:
IU Bloomington

Health: Feasibility of a Theory-Driven, Rurally-Tailored, Family-Based, Telehealth Intervention for Childhood Obesity: A Cluster Randomized Controlled Trial

Project abstract

Addressing obesity, diabetes, and physical activity has been identified as a pressing need in Orange County. Stakeholders report that pediatric obesity is an emerging problem. Research has demonstrated that, to have an effect and cause no harm, pediatric obesity interventions should have at least 26 contact hours. In rural areas, however, retention of families for a long duration remains a challenge; this can be addressed via telehealth. This is a single-blind, cluster randomized controlled feasibility trial of a theory-driven, family-based, rurally-tailored, telehealth intervention, aimed at sustainable behavioral changes that reduce overweight or obesity among 5-11 year old children (N=40). Parents and guardians of children will be involved in four focus group discussions to assess their health literacy, digital literacy, motivation to participate in the current study, prior attempts to manage child’s weight, and barriers to weight management. In this trial, neighborhoods and/or adjacent neighborhoods will be considered clusters, which will be randomly assigned to telehealth intervention group or active attention wait-list control group. When the control group will be receiving the intervention, the group which completed the intervention will be followed up for sustainability of outcomes. For the period of intervention, each family will be provided with an iPad, with or without cellular connectivity, depending on availability of broadband internet in their homes. Outcome evaluator will be blinded. For children, the primary outcomes are the objective measures of body mass index percentile and body fat percent. The secondary outcomes will be behaviors which will be measured either objectively, i.e., physical activity and sleep, or as self-reported, i.e., dietary intake, stigma, and social functioning. For parents and guardians, the primary outcomes will be self-reported attitudes and behaviors related to their child’s nutrition, physical activity, and sleep behavior, measured as constructs in the Theory of Planned Behavior. The secondary outcomes will be perceived stress related to childcare and quality of life. Tertiary outcomes will be technology feasibility, participant recruitment and retention feasibility, attendance, participation in activities of the intervention, implementation fidelity, distress related to intervention, and time conflicts with other commitments. This 4-month telehealth program consists of weekly group videoconferencing calls (1 hour sessions; 16 in total) and monthly calls with individual families for tailored delivery of intervention (1 hour sessions; 6 in total). The IU team will interact with families weekly via text messages and emails (15 minutes per week; 4 hours in total), and will send video/audio clips, etc. While families will receive 2GB data and a $25 gift card for every month of participation, they will return the iPad upon completion of the intervention. The Project will maximally utilize human and physical resources in the following areas: 1) a qualified, psychology-trained, locally-employed social worker will be trained to conduct telehealth calls; 2) the IU Health Paoli Hospital will serve as the intervention hub; 3) the local physician group, Community Health Outreach of the IU Health Paoli Hospital and Orange County Health Coalition, will help with family recruitment and retention.

Campus partners

  • IU School of Public Health

Community partners

  • Miles S. Faith, PhD University of Buffalo, NY

  • Yolanda Yoder, MD Southern Indiana Community Health Care, Paoli IN

Counties involved

Orange

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