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Norris Cotton Cancer Center
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Healthy Families

Pediatric obesity study

This research project, funded by the National Institutes of Health, was conducted in four New Hampshire rural practices. All practices instituted PDA-based screening and enhanced brief counseling at their child's well visit. Clinicians received training in brief motivational interviewing. The PDA assessed the child's eating and activity patterns and parental interest in making changes. The summary report highlighted behavioral risks and provided clinician prompts to tailor counseling to readiness to make changes.

The Healthy Families study sought to:

  • Enhance primary care screening for obesity risk factors and support clinician counseling to address these health behaviors and improve overweight and obese status of children ages 4 to 10 years.
  • Support families after the visit who are ready to make a change in their overweight child's diet or activity through a series of tailored newsletters and child/family activity pages.

PDA-based well-child screening

For this project a parental well-child screening tool was developed to gather data and guide counseling. It takes parents 4 to 5 minutes to complete. To free up time for obesity counseling, it comprehensively assessed the following areas:

  • Parental concerns regarding development/ behavior and common health issues
  • Safety risks
  • Child nutrition and sedentary and physical activity status
  • Family eating and activity behaviors
  • Family psychosocial issues

Research findings

The research project is in the analysis phase. Preliminary results show the following:

  • Among 1,500 families, 55% of families are interested at the visit in making changes for the child to eat healthier and 35% are interested in making changes for the child to be more active.
  • After a PDA-enhanced visit, compared to usual care, clinicians with the PDA were more likely to discuss a variety of obesity-related issues. Also, when discussed, the parents of children of all weights were significantly more likely to plan to changes for the child to eat healthier, be more active, and change family activities.
  • When families of overweight children (greater than 85% BMI) received both the PDA-enhanced screening and tailored supports in the mail after this visit (vs. PDA only) there were significant improvement in BMI-z scores after 6 months.
  • The PDA screening appears to enhance the counseling and prepare families to make a change. Follow-up supports over 6 months are needed to change weight status for overweight children.

Healthy families screener

The Healthy Families PDA-based licensed software is available for a minimal cost to practices interested in changing counseling approaches for parents of children aged 4-10 years. For more information, visit the Healthy Teens Screening Software page, or contact CECH at