Engagement in Weight Management for Adolescents from Low-SES Backgrounds

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PROJECT SUMMARY/ABSTRACT Adolescent obesity is a significant public health concern, with 40% of adolescents in the U.S. categorized as overweight or obese. Adolescents from low income backgrounds are at heightened risk for obesity. Hospital- based pediatric weight management programs currently exist across the country and have led to positive changes in weight status and related health outcomes, yet, adolescents from low-income backgrounds are less likely to engage in these programs than their higher-income peers. At present, there is a lack of research investigating the manner in which to best promote increased initiation and engagement in these hospital-based weight management programs for adolescents from low-income backgrounds. The Chronic Care Model (CCM) serves as an important framework for examining the engagement of adolescents from low-income backgrounds in weight management programs, due to the broader focus on the patient and provider interactions to promote improved health outcomes and focus on obesity as a chronic condition. The current study utilizes the CCM framework to examine multiple perspectives (i.e., adolescent, parent, provider) of initiation and ongoing engagement in weight management for adolescents from low-income backgrounds. The overall aims of the study are to 1) better understand barriers and facilitators to weight management initiation and engagement for adolescents from low-income backgrounds through individual provider interviews (1a) and focus groups of parents and adolescents (1b); and 2) identify specific treatment adaptations for existing weight management programs through collaboration with key stakeholders (e.g., physicians, hospital administrators, existing professional networks). This innovative study will have important clinical implications as findings will inform recommendations for targeted adaptations to hospital-based weight management appropriate for adolescents from low-income backgrounds. This highly structured proposed training plan is ideally suited to allow for execution of the proposed research project and necessary training in support of the applicant’s long-term career goals. Specifically, the application will receive training in 1) evidence-based weight management interventions for adolescents from low-income backgrounds; 2) qualitative data methods and analysis; 3) proficiency in conceptual theories of healthcare research implementation; and 4) dissemination, manuscript preparation, and grant writing skills. Training will be guided by an outstanding mentorship team with expertise in adolescent obesity, health disparities in pediatric populations, qualitative methodologies, and implementation science. Therefore, the proposed training and research plans, along with the rich training environment available at The Weight Control and Diabetes Research Center (WCDRC) of The Miriam Hospital and the Department of Psychiatry and Human Behavior (DPHB) of the Alpert Medical School of Brown University will provide the applicant with experiences tailored to help her reach her ultimate goal of becoming an independent investigator focused on adapting and developing interventions to address health disparities within adolescent obesity.