November 2024

NCCOR Releases New Webpage with Insights from the OPUS II Workshop

NCCOR announces a new web resource summarizing key insights from our recent Obesity-Related Policy, Systems, and Environmental Research in the U.S. (OPUS) II workshop. Visit the OPUS II project page to access all workshop recordings, speaker slides, and participant bios.

Building on the foundational insights from the OPUS I workshop, OPUS II convened experts to explore the next generation of community-engaged policy, systems, and environmental (PSE) interventions for childhood obesity prevention. Speakers addressed critical methodological considerations, cutting-edge research approaches, and practical strategies for evaluating PSE interventions. For example, presenters shared insights on using PSE changes to create broader systemic impacts or how to work effectively with communities to identify priorities and design interventions. Many sessions highlighted the importance of implementation science with hands-on stories from various settings—including schools, healthcare facilities, and local neighborhoods—illustrating the real-world application of these strategies.

In addition to the new OPUS II page, the final meeting summary for OPUS I is now available on the NCCOR website. OPUS I examined best practices and known gaps in public health obesity prevention programs.

Click here to view these OPUS II presentations:

Day 1: October 9, 2024

• Keynote: Planning and Engaging Across Sectors and Settings for PSE Interventions, presented by Dr. Erin Hennessy, Tufts University.
• Panel: Building Bridges Across Sectors: Integrating Whole-of-Community Actors in PSE Interventions, moderated by Dr. Jamie Chriqui, University of Illinois Chicago.
• Keynote: Applying Rigorous Designs to the Evaluation of PSE Interventions, by Dr. Amy Carroll-Scott, Drexel University.
• Panel: Making it Happen: Designing, Implementing, and Evaluating PSE Interventions, moderated by Dr. Laurie Whitsel, American Heart Association.

Day 2: October 10, 2024

• Keynote: Adapting, Scaling, and Sustaining Whole-of-Community PSE Interventions, presented by Dr. Terry Huang, CUNY School of Public Health.
• Panel: Making an Impact that Lasts: Ensuring Local Relevance and Sustainability of PSE Interventions, moderated by Dr. Erin Hager, Johns Hopkins University.
• Panel: Integrating Social Drivers in PSE Interventions, moderated by Dr. Kristen Cooksey Stowers, University of Connecticut.

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NCCOR Toolbox: New Scientific Poster Details Methods to Add Sleep Variables to Signature NCCOR Tool

November 2024, NCCOR

A new scientific poster, recently presented at ObesityWeek 2024, outlines how NCCOR added sleep variables to the Catalogue of Surveillance Systems and is now available in the NCCOR Resource Library. It illustrates the 12 new variables added to the CSS and explains how researchers can use the tool to explore the potential intersecting relationship of diet, physical activity, and sleep to support childhood obesity research. Click here to view and download “Investigating the Relationship Between Sleep and Childhood Obesity: Integrating Sleep into the National Collaborative on Childhood Obesity Research’s (NCCOR) Catalogue of Surveillance Systems (CSS).”

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Federal Food Is Medicine Virtual Toolkit

November 2024, NCCOR

Looking to improve community health through food? The U.S. Department of Health and Human Services (HHS) has teamed up with partners to create a Food Is Medicine (FIM) Virtual Toolkit. This online resource center is packed with tools to help communities learn the basics and explore successful models, find new ideas and strategies, and tailor programs to your community’s needs. No matter where you are in your FIM journey, this toolkit can help you make a difference. Visit https://odphp.health.gov/foodismedicine to access the resources and empower your community through the power of food!

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Updated Growth Chart Training Website

November 2024, NCCOR

The CDC has launched an updated version of their Growth Chart Training website. This online resource offers interactive modules designed to help healthcare professionals effectively use pediatric growth charts in their clinical and public health work. By understanding growth charts, you can better assess the health and development of infants, children, and adolescents. The training is completely self-paced and free. The website includes three informative modules covering key aspects of growth chart interpretation, interactive exercises to test your knowledge, and clear explanations and real-world examples. Ready to learn? Visit the CDC Growth Chart Training website today and start improving your skills in just 40 minutes.

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Evidence-Based Recommendations to Mitigate Harms from Digital Food Marketing to Children Ages 2-17

October 2024, Healthy Eating Research

Digital food and beverage marketing is embedded in nearly every platform children use (websites, mobile apps, social media, video sharing, gaming, streaming TV), promoting unhealthy foods and beverages, which is harming children’s health. Healthy Eating Research convened an expert panel to develop evidence-based recommendations for actions to mitigate harms from digital food marketing to children ages 2 to 17. The multidisciplinary expert panel was composed of researchers, advocates, and practitioners in the areas of digital and food marketing, racial and ethnic disparities, children’s privacy, community engagement, children’s media usage, communications, psychology, pediatrics, and digital technology. The panel examined the research on digital marketing and reviewed current policy options to develop recommendations for policies to protect children from harmful and unfair digital food marketing practices and future research needed to address key gaps in the literature. All recommendations focus on the key factors affecting children’s digital environments, including industry-led policies, school-based policies, other physical food environment policies, social environment policies, and government policies.

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Childhood Overweight is Associated with Socio-Economic Vulnerability

November 4, 2024, EurekAlert!

More children have overweight in regions with high rates of single parenthood, low education levels, low income and high child poverty. The pandemic may also have reinforced this trend. This is shown by a study conducted by researchers at Uppsala University and Region Sörmland in collaboration with Region Skåne.

“During and after the pandemic, we see a greater difference between regions in terms of children’s weight. It even looks like it has exacerbated health inequalities,” explains Charlotte Nylander, a researcher at Uppsala University and the Centre for Clinical Research in Region Sörmland, where she is also a Senior Consultant in Child Health Care.

Approximately 85 percent of all Swedish four-year-olds in 2018, 2020 and 2022 were included in the study, which in total comprises over 300,000 individuals. The researchers compiled the regions’ data on overweight in childhood and then linked it to variables available from Statistics Sweden. The regions of Halland and Örebro are not included in the study due to a lack of aggregated data for 2022.

The results show that the prevalence of overweight or obesity has now fallen to the same levels as before the COVID-19 pandemic, i.e. 11.4%. During the pandemic, the prevalence was 13.3 per cent. However, in several regions, including Västernorrland, Gävleborg and Värmland, the figures are significantly higher than the national average (see attached figure).

“We were worried when we saw the peak during the pandemic and wondered what will happen next. But it is good news that it is back to pre-pandemic levels – we are happy about that. However, overweight in childhood is clearly still a concern that we need to work on,” adds Nylander.

She and her research colleagues are concerned that there was such a significant link to socio-economic disadvantage at the regional level. There were more overweight children in regions with many single parents, low education levels, low income and high child poverty.

“Child healthcare is an important public health arena. It is a matter of highlighting socio-economically disadvantaged children in healthcare and providing early advice on lifestyle habits that can help. But we also need to shift responsibility from the individual to society, where major efforts are needed to improve the situation,” notes researcher Mariette Derwig, a Senior Consultant in Child Health Care in Region Skåne.

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Preventing Obesity in Very Young Children Could be in the Palm of Parents’ Hands

November 3, 2024, EurekAlert!

A study co-led by a Johns Hopkins Children’s Center clinician-researcher shows that adding text messaging and other electronic feedback to traditional in-clinic health counseling for parents about feeding habits, playtime and exercise prevents very young children from developing obesity and potentially lifelong obesity-related problems.

Findings from the study, which was co-led by Eliana Perrin, M.D., M.P.H., Bloomberg Distinguished Professor of Primary Care at the Johns Hopkins University Schools of Medicine, Nursing and Public Health, will be published in JAMA and presented at the Obesity Society’s “Obesity Week” in San Antonio, both on Nov. 3. The work stems from decades of research showing that having obesity in early childhood significantly increases the risk of lifetime obesity, cardiovascular disease, diabetes and other serious diseases, particularly in low-income and minority populations.

About 1 in 5 school-aged children were affected by obesity in 2017–18, according to the U.S. Centers for Disease Control and Prevention — rates that have only increased during and since the COVID-19 pandemic. Efforts to reduce the rate have relied heavily on in-person interventions by pediatric providers, with limited success.

In an earlier study, also co-led by Perrin, investigators demonstrated that a “health literacy-informed” primary care-based intervention called the Greenlight Program, which Perrin and colleagues at other medical centers developed for parents, improved healthy growth in newborns until 18 months of age, but found that improvements were not sustained at age 2 years.

In an effort to extend the improvements through 2 years of age, when pediatrics office visits become less frequent, the new study focused on using digital technology to reinforce elements of the Greenlight Program, which previously only consisted of written materials and health counseling during primary care visits.

“We found that parents are eager for more information to help their children grow up healthy, and the vast majority of parents own smartphones,” says Perrin, who is also a general pediatrician at the Harriet Lane Clinic at the Children’s Center.

Building on that knowledge, to conduct the new study, which was co-led by Vanderbilt University and five other academic medical institutions, the researchers recruited nearly 900 parent-infant pairs between October 2019 and January 2022 from newborn nurseries or pediatric primary care clinics at Duke University, University of Miami, New York University/Bellevue Hospital Center, University of North Carolina, Stanford University and Vanderbilt University Medical Center.

At the start of the trial, all babies were 21 days old or younger, born after 34 weeks gestation, at a healthy weight, and with no chronic medical conditions that might affect weight gain.

The participants were about 45% Hispanic, 20% white and nearly 16% Black. More than 55% were considered to have limited health literacy based on the Newest Vital Sign, a widely used health literacy screening tool developed by researchers at the University of Arizona, and nearly 16% reported household food insecurity, meaning limited access to healthy food choices.

The infant-parent pairs were randomly sorted into two groups. Both groups received Greenlight Program education, with counseling on healthy nutrition and behaviors from their primary care providers, along with eight educational booklets matching the child’s age at regular well visits, with guidance and goal-setting tips in English or Spanish on feeding, physical activity, sleep and screen time.

Next, half (449) of the infant-parent pairs received personalized, interactive text messages from a fully automated system to support health behavior goals and also access to a web-based “dashboard” designed to help parents keep track of healthy goals.

Goals (such as fewer sugar-sweetened beverages or less screen time) were texted in English or Spanish every two weeks until 2 years of age. Those texts were followed by five automated check-in messages throughout the two weeks. Parents were asked to self-rate their goal progress.

Based on parents’ responses, the automated digital intervention system then provided immediate feedback, tips for addressing challenges and encouragement based on progress.

The researchers found that children of parents who received the digital intervention as well as personal counseling had healthier weight-for-length growth curves over the first two years of life than children of parents who had counseling only, which resulted in an estimated reduction of 0.33 kg/m at the 24-month time point. Researchers say while this doesn’t sound like a lot, it’s consistent with the U.S. Preventive Services Task Force target for effective obesity trials. Also, obesity prevention for the digital group was significant. Some 7% of the digital intervention group had obesity, compared with nearly 13% of the clinic-only group, which is a nearly 45% adjusted relative reduction.

The researchers conclude that their digital intervention led to healthier weight-for-length paths and reduced the incidence of obesity at 2 years of age when added to in-person health counseling.

The investigators say the digital services were effective in populations that traditionally experience the highest risk of obesity, and “could have significant impact” if implemented on a broader scale.

Moreover, they concluded “the intervention effect” occurred as early as 4 months and sustained throughout the two years. The researchers say this study may be one of the first ever to prevent early childhood obesity, particularly in a large group of diverse participants.

Perrin indicated that research shows most young children with obesity do not outgrow it. “What is kind of exciting from our study is we prevented those children who would have had an unhealthy weight in the first place and helped them have a healthier weight, which sets them up better for health throughout their lives,” she says.

Finally, the researchers say the digital intervention had a greater effect on children from households with food insecurity, on Hispanic and non-Hispanic Black children, and those with lower health literacy. “If we can prevent obesity in these children at greatest risk, we can also create better health equity in the future,” Perrin says.

The researchers hope to be able to follow the patients as they grow up.

Additional authors include William Heerman, Russell Rothman, Jonathan Schildcrout, Aihua Bian, Laura Adams and Evan Sommer from Vanderbilt University Medical Center; Lee Sanders from Stanford University; Kori Flower from University of North Carolina at Chapel Hill; Alan Delamater from University of Miami; Melissa Kay from Wake Forest University; Charles Wood from Duke University; Rachel Gross and H. Shonna Yin from New York University; and other Greenlight investigators.

This work was supported by the Patient-Centered Outcomes Research Institute (AD-2018C1-11238). Study data were collected and managed using REDCap electronic data capture tools hosted at Vanderbilt University Medical Center and supported by the National Center for Advancing Translational Sciences/National Institutes of Health (UL1 TR000445).

The authors affiliated with The Johns Hopkins University did not declare any conflicts of interest under Johns Hopkins University policies.

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A Digital Health Behavior Intervention to Prevent Childhood Obesity

November 3, 2024, EurekAlert!

A health literacy-informed digital intervention improved child weight-for-length trajectory across the first 24 months of life and reduced childhood obesity at 24 months. The intervention was effective in a racially and ethnically diverse population that included groups at elevated risk for childhood obesity.

[Source]

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