Testing the JOIN for ME Program in Low-Income Communities: Rhode Island CORD 3.0.

Abstract

Background: Dissemination of evidence-based intensive health behavior and lifestyle treatments (IHBLTs) to families from low-income communities was the primary objective of the CDC Childhood Obesity Research Demonstration (CORD) 3.0 projects. The goal of RI CORD 3.0 was to adapt and test the effectiveness and context for remote implementation of an IHBLT, JOIN for ME. Methods: Children aged 6-12 years with body mass index (BMI) >85th percentile and a caregiver (N = 111) were recruited through a federally qualified health center (FQHC) or community setting and participated in an immediate or 4-month delay condition. Child and caregiver weight status, Family Nutrition and Physical Activity (FNPA), and child weight-related quality of life were assessed at baseline, 4 months, and at the end of the 10-month remotely delivered intervention. Program acceptability and intervention fidelity were assessed to inform subsequent implementation. Results: Analyses comparing active and delayed treatment groups at 4 months showed significant improvements in FNPA for the active treatment group compared with delayed group. Groups did not differ significantly on child or caregiver weight status. Ten-month treatment effects in the combined sample showed significant effects of time on child relative weight status, with children who initiated the program demonstrating decreases of 2.90% median BMI, 3.89%BMIp95, and 0.16 zBMI units. Session attendance and food security at baseline were related to greater changes in weight status. Conclusions: The adapted version of the JOIN for ME was successfully implemented and shown to be associated with significant, modest changes in child weight status.