CORD 1.0 and 2.0 History

Background

CORD 1.0

The first CORD project from 2011 to 2015 focused on children from families with lower incomes. This project researched how to improve children's dietary and physical activity behaviors and ultimately reduce obesity among children from families with lower incomes.

CORD 1.0 was designed to cover various levels of the socioecological model. The projects combined efforts from pediatric health care settings with public health interventions in schools, early care and education centers, and communities.

CORD 1.0's three funded recipients worked in rural and urban communities in Texas, California, and Massachusetts. One evaluation center supported all the sites.

CORD 2.0

Building on research findings from CORD 1.0, CORD 2.0 funded two recipient research teams to focus on implementing the US Preventive Services Task Force (USPSTF) recommendations for child obesity in health care and community settings. Projects enhanced clinical-community collaborations to improve pediatric primary care obesity screening and, when appropriate, refer children with obesity to family healthy weight programs.

CORD 2.0 served children 6 to 12 years from families with lower incomes in Arizona and Massachusetts. CORD 2.0 recipients worked with state and community partners on issues such as access to and costs of family healthy weight programs. Researchers also identified program strengths and weaknesses from the perspective of providers, attendees, and other partners, including state Medicaid offices.

CORD 1.0 project summaries

Key findings

CORD 1.0 researchers found that implementation of the USPSTF recommendation for obesity screening in children and adolescents and referral to intervention in the health care or community settings was feasible. They also found that:

• Parents were satisfied with the program.
• Improvements in children's health occurred in both community and health care settings.
• Prevention interventions cost less than treatment-related interventions.
• Interventions were sustainable.

Recipient activities

Texas

Researchers at the University of Texas tested community and health care-based obesity prevention and treatment programs in Austin and Houston. These programs coordinated care among children from families with lower incomes and who were members of racial and ethnic minority groups. Tested programs included:

• Next Steps
• The Mind, Exercise, Nutrition Do It (MEND) program
• The Coordinated Approach to Child Health school program (CATCH)

California

This CORD project was known as The Imperial County Childhood Obesity Project (ICCOP): An Ecological Approach to Addressing Childhood Obesity. Researchers were from:

• The Institute for Behavioral and Community Health at San Diego State University
• Clínicas de Salud del Pueblo, Inc.
• Imperial County Public Health Department

They implemented interventions in early care and education settings, schools, municipal recreation settings, and Federally Qualified Health Centers (FQHCs) in Brawley Calexico and El Centro, California.

Massachusetts

This collaboration delivered a multidisciplinary clinical intervention called Mass in Motion Kids. Researchers were from the Massachusetts Department of Public Health and Harvard School of Public Health. They partnered with the Special Supplemental Nutrition Program for Women Infants and Children (WIC), early care and education programs, schools, and FQHCs.

CORD 2.0 project summaries

Arizona

Arizona State University implemented an existing parenting program called the Family Check-Up 4 Health (FCU4Health). CORD researchers worked with three primary care clinics. They tested behavioral and physical health effects of FCU4Health in a community with a large number of residents who were Hispanic and had lower incomes.

Massachusetts

The State Department of Health built on experiences in CORD 1.0 to optimize the clinical care of children with overweight or obesity in families with lower incomes. Two communities implemented multidisciplinary Healthy Weight Clinics in Federally Qualified Health Centers and family healthy weight programs in YMCAs.

Select publications

An individually tailored family-centered intervention for pediatric obesity in primary care: Study protocol of a randomized type II hybrid effectiveness-implementation trial

Rationale and design of the Clinic and Community Approaches to Healthy Weight randomized trial

Costs of preparing to implement a family-based intervention to prevent pediatric obesity in primary care: A budget impact analysis

Effects of a Pediatric Weight Management Intervention on Parental Stress

Effects of the Family Check-Up 4 Health on parenting and child behavioral health: A randomized clinical trial in primary care

Resources

Report to Congress on CDC's CORD Project

Healthcare Strategies for Child Obesity