Childhood Obesity Research Demonstration (CORD)

Following in the footsteps of the previous two posts, this one looks at government agencies that are in danger of reduced funding or worse.

CORD stands for Childhood Obesity Research Demonstration, and its mission is to prevent and treat childhood obesity by integrating primary care and community-based strategies. It started in 2011 with an evaluation center, and grants for four-year projects made to communities in Texas, California, and Massachusetts.

Originally, it was for children age two to 12 who were covered by the Children’s Health Insurance Program, aka CHIP. The projects involved pediatric health care settings, and public health interventions in schools, early care and education centers, and communities, in 60 locations where Early Care and Education (ECE) takes place.

Then came CORD 2.0, which incorporates increased obesity screening and counseling services for eligible children in the participating communities, who would otherwise face barriers in connecting with healthy weight programs. They are referred to local medical, nutritional, and behavioral specialists, who work with the parents too, teaching skills.

CORD 2.0 focuses on children from 6 to 12, in low-income, working class families. In the current funding period, there are only two grantees — the Massachusetts Department of Public Health and Arizona State University.

The Arizona-CORD will adapt and implement an existing parenting program called the Family Check-Up to address overweight and obesity in young people. The AZ-CORD team will work with three primary care clinics and stakeholders across the state to implement and test Family Checkup 4 Health… CORD-AZ will also conduct a process evaluation that will assess key process outcomes, such as acceptability, feasibility, and fidelity, along with a cost evaluation, which will provide actionable information for sustainability.

Family Checkup 4 Health is described as “an assessment-driven approach that tailors services to meet the needs of families and works to increase motivation to address the behavioral risk factors related to overweight and obese children and their families.” The evidence-based parenting program aims to change behavior, using questionnaires, motivational interviewing, electronic health data, and behavioral observation.

Last year, the U.S. Preventive Services Task Force studied weight management programs, and determined that the better ones provide moderate to high-intensity contact time with professionals, that being defined as 26 to 75 hours over a six-month period. A program carried over from CORD 1.0 is called MEND, which stands for Mind, Exercise, Nutrition, Do It.

Like any good project, this one also gathers information. The government hopes to learn whether value-based childhood weight interventions can work for kids from lower income families, and whether the favored interventions affect parents and family members other than the identified patient.

CORD 2.0 grantees will evaluate their interventions, providing needed information on how Grantees will assess healthy weight program costs as well as identify program strengths and weaknesses from the perspective of providers, attendees and other stakeholders, including state Medicaid offices. This information will be used to determine how similar programs may be developed in a sustainable way and disseminated across primary care practices in the state.

With educational materials, interactive text messages, and links to community resources, support of behavior change is the name of the game in the Massachusetts version, too — and of course, information-gathering.

This nested randomized controlled trial will examine the comparative effects of two pediatric weight management programs… Each of the two intervention groups will receive an intensive 6-month intervention, followed by a 6-month maintenance period that delivers ≥ 27 hours of contact time… Collaboration with the state Medicaid office will ensure the sustainability of the program, which if successful, may provide a new model of obesity care for the population who carries the highest burden of this disease.

(To be continued…)

Your responses and feedback are welcome!

Source: “Childhood Obesity Research Demonstration (CORD) 1.0,” CDC.gov
Source: “Early Care and Education (ECE),” CDC.gov
Source: “CDC’s Childhood Obesity Research Demonstration (CORD) Project 2.0,” CDC.gov
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