What is Bull City Fit?
Purpose of Research Study
We propose a three-year project to evaluate the implementation feasibility and effectiveness of the integrated clinic-community model of child obesity treatment. We will engage four communities in North Carolina, facilitate a local clinic-community partnership, support the development of an integrated child obesity treatment program, and monitor outcomes.
Aim 1: To evaluate the implementation feasibility of an integrated clinic-community child obesity treatment program.
We will use the RE-AIM framework to measure fidelity, reach, acceptability, uptake and cost through focus groups, provider and community surveys, and key informant interviews.
Aim 2: To evaluate the integrated program model, including ability to meet the existing child obesity treatment recommendations.
We will conduct a classical program evaluation of each of the four programs by monitoring aggregate referral, enrollment and attendance data, as well as safety and patient satisfaction.
Aim 3: To report patient outcomes associated with participation in the integrated model.
We will measure participant-level outcomes over a 6-month period, including changes in nutrition and physical activity behaviors, quality of life, cardiovascular fitness, and body mass index (BMI).
Despite over 30 years of research, one in three US children remain overweight or obese. However, the obesity-related risk for long-term cardiovascular and metabolic disease is nearly reversible, if children effectively adopt healthier habits and achieve a lower body mass index (BMI) by adulthood.
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.
Duke Children’s Hospital and Durham Parks & Recreation have developed an integrated clinic-community partnership between a child obesity clinic and a Durham Parks and Recreation facility, “Bull City Fit”. An active steering committee of key stakeholders including patients, parents, clinical providers, staff and city leaders informs the operational aspects of the program. In prior research, we have demonstrated the feasibility of recruiting and retaining a group of low-income and racially-diverse participants to the intervention. We have also demonstrated that children who participate in the program demonstrated improved health habits and health-related quality of life. The key question that remains is whether this model will be feasible and effective in diverse communities with limited resources.