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Childhood Obesity Research Demonstration Project (CORD)

photo of a girl eating a sandwichImplementing Strategies Across the Community to Help Families with Childhood Obesity

CORD grantees are working in six rural and urban communities in Texas, Massachusetts, and California. These success stories feature inspiring examples of successful adoption of healthy life styles; improving diet, increasing exercise and losing weight. Find out how the "CORD/Mass in Motion" initiative, "Our Choice/Nuestra Opción" and the "Mind, Exercise, Nutrition… Do it!" (MEND) program empower children and adults to become more physically fit and healthier, and more…

In 2011, with funds from the Affordable Care Act, CDC provided funding to 4 grantees to conduct a 4-year Childhood Obesity Research Demonstration project (CORD), which aims to improve children’s nutrition and physical activity behaviors in the places where they live, learn, and play. The CORD project funding period ends on September 29, 2015. Completion of the individual site evaluations is expected by Winter 2015. A summary report on the findings, including the cross site evaluation, is planned to be available by Spring 2017.

Currently, many research initiatives have only focused on one or two settings for obesity prevention such as the school setting or focused only at one level such as the individual but not the family. The project goal is to find out if interventions in the pediatric health care setting combined with public health interventions in schools, early care and education centers, and communities can reduce obesity in low-income children by

  • Increasing children’s physical activity and consumption of fruits, vegetables, and healthier beverages.
  • Ensuring children get enough sleep.
  • Decreasing children’s screen time and consumption of sugary drinks and energy-dense foods.

The interventions were designed to cover various levels of the socioecological model (SEM), which is a framework that recognizes the multiple influences on child eating and physical activity across all levels and sectors within their environment.

CORD targeted communities with a high proportion of children aged 2–12 years who are eligible for the Children’s Health Insurance Program (CHIP), which provides low-cost health insurance to more than 7 million children from working families. In the United States, rates of childhood obesity are high overall, but for minority and low-income communities, they are even higher.

Project Grantees

Each grantee’s project builds on existing community efforts to reduce childhood obesity rates. The three grantees are developing and putting into action programs across multiple settings in selected communities. They will evaluate the interventions using common measures across all sites in addition to site-specific measures at

  • The University of Texas Health Science Center at Houston.
  • San Diego State University.
  • Massachusetts State Department of Public Health.

The University of Houston serves as the evaluation center for the project.

Intervention Settings

CORD grantees are working in six rural and urban communities in Texas, Massachusetts, and California, all of which have high percentages of low-income residents, high childhood obesity rates, and ethnically diverse populations. Community health workers serve as a link between health care and public health activities in each community.

The grantees are working with partners to carry out interventions in the following settings:

Fifteen health care centers are participating in CORD interventions. The interventions include provider training, using electronic medical records, improving care coordination, and developing educational materials and community resource lists. Community health workers provide patient education (including parenting practices and recipe planning) and help link families to community resources such as physical activity options at local parks and YMCAs and referrals to Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) offices. CORD interventions aimed at health care providers teach them how to use motivational interviewing with families to set nutrition and physical activity goals as part of the Obesity Chronic Care Model).

Seventy-five schools are participating in CORD interventions. These interventions include evidence-based programs such as CATCH, SPARK, Eat Well Keep Moving, and Planet Health. Grantees are working with school administrators, staff, and various other stakeholders such as wellness committees and champions to promote healthy eating and activity throughout the school day. They do this through improvements in school policies, systems, and environments such as those in CDC's School Health Guidelines. In addition, grantees are engaging children through media and social marketing campaigns to promote healthy behaviors.

Interventions are currently taking place in 60 early care and education centers. Grantees are training child care providers on curriculums such as CATCH Early Childhood and SPARK, and providing technical assistance and support. Child care providers are reviewing their policies and environments using the Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) tool and identifying areas for improvements.

Interventions in the six selected communities include activities such as working with restaurants to provide healthier children's menu options and efforts in local park and recreation centers to increase children's active participation in park programs. Grantees are helping families connect with ongoing community childhood obesity prevention efforts and bolstering the work of community coalitions.

The grantees have also developed programs for families with children who are overweight or obese. Health care providers can refer children to these programs that can include visits to behavioral therapists, registered dieticians, nurses, doctors, community health workers, or group education sessions. Many of the education sessions are held in convenient community settings with childcare to help busy families attend. These programs can help children and their families learn skills to improve their nutrition and physical activity behaviors.

CDC will release the overall findings after the completing a cross-site evaluation.

For Additional Information

The Childhood Obesity Research Demonstration (CORD) Project: A Comprehensive Community Approach To Reduce Childhood Obesity This article explains how the research project was conceived and developed.

CORD: A Supplement to the Journal, Childhood Obesity A special issue of research articles related to the CORD Project.

Learn More About Specific CORD Projects and Grantees.

Texas CORD Childhood Obesity Research Demonstration Project at the University of Texas at Austin, is designed to test community-based obesity prevention and treatment programs in Austin and Houston. Review some of the project details at this website. Learn about the of University of Texas’s efforts to help children and their families to eat healthier and be active.

The Imperial County Childhood Obesity Project (ICCOP): An Ecological Approach to Addressing Childhood Obesity in Imperial County a project of the Institute for Behavioral and Community Health at San Diego State University and its partners, Clínicas de Salud del Pueblo, Inc. and the Imperial County Public Health Department. Read about ICCOP’s research plan.

Harvard (CORD) Childhood Obesity Research Demonstration Project is a partnership between the Harvard School of Public Health, Massachusetts Department of Public Health Massachusetts in collaboration with local partners in addressing childhood obesity in CORD.