Childhood Obesity Research Demonstration

In 2010, the Patient Protection and Affordable Care Act (ACA) appropriated funding to the Centers for Disease Control and Prevention (CDC) to conduct four-year community-based childhood obesity demonstration projects in three communities. The National Collaborative on Childhood Obesity Research (NCCOR) served in an advisory capacity during the project development and application phases.

Supporting underserved children ages 2 to 12 years, and their families, who are eligible for the Child Health Insurance Program (CHIP), the Childhood Obesity Research Demonstration (CORD) used the Obesity Chronic Care Model as a conceptual framework and built on an array of existing federal and non-federal initiatives.

CORD aimed to use multiple levels and settings to identify strategies that improve children’s health behaviors and reduce obesity. A central, novel element is involving the children, their parents, other family members, and the communities in which they live, and blending traditional community-based obesity interventions with individual behavioral support. By intervening with community institutions as well as individuals, CORD provided consistent messages about healthy eating and physical activity behaviors to change the environment in which food and physical activity decisions are made. By including a broad spectrum of expertise in its Steering Committee and study workgroups, CORD improved communication and collaboration across agencies and with outside groups, reduce duplication of effort, and strengthen future childhood obesity efforts.

The grantees, which included three research facilities and their clinical and community partners, were selected in September 2011. The grantees were:

  • University of Texas Health Science Center at Houston
  • San Diego State University
  • Massachusetts State Department of Public Health
  • University of Houston (conducted a cross-site evaluation that determined successful strategies and enumerate lessons learned)

Approaches included combining changes in preventive care at doctor visits (obesity screening and counseling) with supportive changes in schools, child care centers, and community venues such as retail food stores and parks. Community health workers provided a bridge between families and community resources in order to inform and educate communities that may be hard-to-reach or have limited English proficiency about disease prevention (including obesity), health insurance enrollment opportunities, and disease management.

When the project concluded in 2015, CDC and the grantees synthesized the project’s findings and provided recommendations about effective, cost-effective, and sustainable strategies to prevent obesity among underserved children.

CORD had a federal steering committee with representatives from a variety of agencies concerned with health, children, and families, including the Centers for Medicare and Medicaid Services, the Health Resources and Services Administration, and the Administration on Children and Families. Using the approach used in the Healthy Communities Study, CDC has reached out to external experts, including NCCOR members, for guidance and advice in planning and carrying out this intervention.

In February 2015, Childhood Obesity released a special issue on CORD including nine articles and an accompanying editorial. The articles describe how CORD builds on existing work, uses stakeholders’ perspectives of problems and feasible solutions, and leverages state and local infrastructure in three states.