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Translating the Recommended Multicomponent Intervention for Childhood Overweight and Obesity into Practice: Implementation Challenges

Abstract

A multicomponent, family-based intervention with ≥ 26 contact hours is recommended for the treatment of childhood overweight and obesity. This intervention utilizes behavioral strategies to improve diet, physical activity, and sedentary behaviors. The evidence-based recommendations for this treatment have predominantly come from randomized trials in which the intervention is implemented by research-trained staff in academic research settings, with the intervention delivered to fairly homogeneous samples that are limited in being inclusive of those experiencing health disparities. Thus, there are challenges in implementing the recommended intervention into practice. In particular, there are implementation challenges related to providers, contact time, and settings that impact all children. Specifically, the structure of the intervention may diminish its ability to be delivered by many types of providers in different settings, limiting overall accessibility. There are implementation challenges affecting children who experience health disparities, as it is not clear how efficacious the recommended intervention is for African American or Latinx children, or children from households with low income. Several strategies to reduce identified implementation challenges, such as reducing contact time and intensity of the dietary intervention, are discussed. However, use of these strategies may reduce the effect size of the weight improvements commonly seen with the recommended intervention. Suggestions for future research regarding implementation, specifically using study designs that enhance the ability to create cost-efficient and adaptive interventions that can generalize to many different children and families, are provided.

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Funding

Support was obtained from the National Institute of Diabetes and Digestive and Kidney Diseases (R01DK121360) for HAR’s and LG’s effort. SMR’s time was supported by an Institutional Development Award (IDeA) Center of Biomedical Research Excellence from the National Institute of General Medical Sciences of the National Institutes of Health under Grant No P20GM113125.

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All authors contributed to the study conception and design. The first full draft of the manuscript was written by Hollie A. Raynor and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Hollie A. Raynor.

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Raynor, H.A., Robson, S.M. & Griffiths, L.A. Translating the Recommended Multicomponent Intervention for Childhood Overweight and Obesity into Practice: Implementation Challenges. J Contemp Psychother (2022). https://doi.org/10.1007/s10879-022-09554-7

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Keywords

  • Childhood obesity
  • Multicomponent intervention
  • Implementation
  • Health disparities