The GreenLight Study
The GreenLight Study (funded by multiple R01 and supplemental grants through NIH/NICHD and CDC) is a multi-site randomized, controlled trial (PIs: Eliana Perrin, Russell Rothman, Shonna Yin, Lee Sanders, Alan Delamater) to assess the efficacy of a low-literacy/numeracy-oriented intervention designed to promote healthy family lifestyles and to prevent early childhood obesity. The project, conducted at four academic pediatric primary care clinics (University of North Carolina-Chapel Hill, University of Miami, New York University, Vanderbilt University), enrolled over 860 infants at 2 months of age and continues to follow them through age 5.
Pediatric Obesity Microbiome and Metabolism Study (POMMS)
This project has two primary aims:
1) Establish a bio-repository of diverse specimen types to provide investigators access to specimens in order to further research related to metabolism and the microbiome in the pediatric population.
2) Conduct a prospective observational trial to investigate fecal microbiome and metabolomics profiles that characterize obesity treatment response among adolescents. The microbiota and metabolomic profiles of participating children ages 10-18 will be examined before and after receiving treatment for obesity at Healthy Lifestyles. Healthy weight siblings will also be recruited as a baseline comparative.
Families on Track Digital Health Study
Families on Track (PIs: Dori Steinberg, Sarah Armstrong, Gary Bennett) uses a digital health intervention platform to target weight loss among overweight parents of 2-16 year old children with obesity enrolled in the Duke Healthy Lifestyles Program (HL) in order to augment child body mass index reduction. The Interactive Obesity Treatment Approach (iOTA) is utilized to assign personalized behavioral goals, and participants use interactive voice response (IVR) and text messaging to track their goals, receiving personalized feedback immediately.
Children’s Movie Study
The Children’s Movie Study was funded by a multidisciplinary team-building NIH R24 grant [PIs: Eliana Perrin, Andrew Perrin (UNC)] and brought together investigators from 7 departments and 4 schools across UNC Chapel Hill’s campus to evaluate cultural messages about eating, activity, weight, and stigma evident in children’s movies. The study enrolled 114 children ages 9 to 11 and their parents. Both parents and children completed an online questionnaire, after which children attended a small group session on campus to watch a popular children’s movie and participate in a focus group discussion regarding their opinions about the movie and its characters, as well as their home media use and eating behaviors. This project is closed for enrollment and is currently in the data analysis phase, which is coordinated through DCCOR.
Pediatric Obesity Weight Evaluation Registry (POWER)
The Pediatric Obesity Weight Evaluation Registry (POWER) is a data repository for the collection of demographic and clinical data from pediatric weight management programs nationally. POWER serves as a resource to promote research as it relates to the evaluation and management of childhood and adolescent obesity, and can be used to explore various associations between demographics, anthropometrics, clinical measures, and health outcomes. Pediatric Obesity Weight Evaluation Registry as the Co-director for Research.
More information about POWER can be found here: https://www.childrenshospitals.org/Issues-and-Advocacy/Population-Health
Active Recreation through Community-Healthcare Engagement Study (ARCHES)
Current obesity treatment guidelines recommend 26 or more hours of behavior treatment, delivered over a 6-month period in a multidisciplinary weight management clinic. However, this guideline is not feasible in real-world clinic settings where medical visits are costly and poorly reimbursed, and attrition is high, particularly among the most vulnerable children. The National Collaborative on Child Obesity Research has issued a call for research investigating healthcare-community partnerships to improve the effectiveness of child obesity treatment. The World Health Organization supports this approach, and in 2015 modified the chronic disease model to include healthcare-community integration. ARCHES is a three-year project (PI: Sarah Armstrong) that will develop and evaluate an effective, engaging, and scalable community-healthcare treatment option for low-income and racially diverse children. The project engages four communities in North Carolina and facilitates a local clinic-community partnership, supports the development of an integrated childhood obesity treatment program, and evaluates the feasibility of the integrated program model. The effectiveness of the integrated model will also be evaluated, as we will monitor patient outcomes associated with participation.
The Environmental influences on Childhood Health Outcomes (ECHO) Program investigates how exposure to a range of environmental factors in early development influences the health of children and adolescents, with the aim to identify exposures and mechanisms that link the environment in early life to childhood development and health outcomes. ECHO will fund existing pediatric cohorts (one of which includes UNC Chapel Hill, with whom we are collaborating for this project) with a goal of enrolling more than 50,000 children from diverse racial, geographic and socioeconomic backgrounds to become part of the ECHO consortium. These cohort studies will analyze existing data as well as follow the children over time to address the early environmental origins of at least one of ECHO’s health outcome areas. Each cohort will participate with the others to combine data that are collected in a standardized way across the consortium. This project commits to the ECHO Consortium numerous resources from the Extremely Low Gestation Age Newborn (ELGAN) Study. Dr. Perrin has collaborated with the ELGAN team at UNC extensively as a co-investigator, and is continuing her collaboration with the project team via ECHO.
Clinic-Provisioned Baby Bottles
Rapid weight gain during infancy increases the risk of obesity later in childhood. Choices related to type of milk (breast milk, formula, or both), feeding schedule, and feeding container may influence growth trajectories in the first year of life, but given the appropriate concentration on encouraging breast-feeding, little is known about modifiable risk factors for infants who are already exclusively fed formula. A large percentage of infants from low-income populations are exclusively fed formula, and these infants are at increased risk for obesity. In order to evaluate effective preventive interventions for low-income families feeding formula, we must understand the feasibility and acceptability of an intervention to promote use of appropriately sized bottles and healthy formula feeding in young infants. This work has been led by Charles Wood, MD, MPH and funded by an NIH R01 (PIs: Eliana Perrin, Russell Rothman, Shonna Yin, Lee Sanders, Alan Delamater) as well as a “Nutrition in Underserved Areas” Academic Pediatrics Association Young Investigator Award (PI: Charles Wood; Mentor: Eliana Perrin)
Hearts and Parks
This four-year project encompasses four different projects – one each in clinical research, basic science research, population health research, and training – to better understand and treat the health impacts of childhood obesity. The clinical research portion, led by DCCOR Associate Director Dr. Sarah Armstrong, will focus on the effectiveness of Bull City Fit and Healthy Lifestyles, aiming to comprehensively study the program’s impact on weight, physical fitness, quality of life, family engagement and more. The basic science research project aims to examine molecular pathways associated with children’s gut bacteria and examine differences in gut bacteria among children who are overweight compared to those in a healthy weight range, and explore how those differences could influence their obesity risks, response to treatment, and other outcomes. The population health project, led by DCCOR research faculty Dr. Asheley Skinner, will examine obesity treatment programs across the country to evaluate different models and their effectiveness. The training project, also led by Dr. Skinner, will include training for scientific, clinical and population health professionals on issues related to childhood obesity, cardiovascular disease and their prevention and treatment.