Childhood Obesity Research Demonstration (CORD) 1.0

Integrating Primary Care and Community-Based Strategies to Prevent and Treat Childhood Obesity

Photo: A doctor placing a stethoscope on a girl's chest.

All children deserve to grow up at a healthy weight. Many research initiatives have studied ways to prevent and manage childhood obesity. Historically, these initiatives had a limited ability to affect the multiple community settings that influence children’s nutrition and physical activity behaviors.

In 2011, with funds authorized from the Children’s Health Insurance Program Reauthorization Act, CDC funded three community grantees and one evaluation center to conduct Childhood Obesity Research Demonstration Projects (CORD 1.0). These 4-year projects were designed to cover various levels of the socioecological modelexternal icon (SEM). 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 targeted communities with a high proportion of children from low-income working families. The three selected grantees worked in both rural and urban communities in Texas, Massachusetts, and California. The CORD 1.0 project funding period ended on September 29, 2015.

Building on what was learned from the first demonstration, CORD 2.0 focuses on improving clinical-community linkages for the prevention and management of childhood obesity. CORD 2.0 tests a model that increases obesity screening and counseling services for eligible children in the selected communities, and refers them to local pediatric weight management programs. Learn more about CORD 2.0.

Publications updated 4/30/2019

Title: Association of parental body mass index(BMI) with child's health behaviors and child's BMI on child's age
Authors: Lee CY, Ledoux TA, Johnston CA, Ayala GX, O'Connor DP
Journal: BMC Obesity
Released: April 2019
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/30984404 external icon

Title: Nutrition provider confidence in the Massachusetts Childhood Obesity Research Demonstration (MA-CORD) study
Authors: Cheng ER, Nelson CC, Leung-Strle P, Colchamiro R, Taveras EM, Baidal JAW
Journal: Preventive Medicine Reports
Relased: January 2019
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/30740295external icon

Title: Impact of the Coordinated Approach to Child Health Early Childhood Program for Obesity Prevention among Preschool Children: The Texas Childhood Obesity Research Demonstration Study
Authors: Sharma SV, Vandewater E, Chuang RJ, Byrd-Williams C, Kelder S, Butte N, Hoelscher DM
Journal: Childhood Obesity
Relased: January 2019
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/30226991external icon

Title: Development and use of an index for measuring implementation of a weight management program in children in primary clinics in Texas.
Authors: Salahuddin M, Barlow SE, Pont SJ, Butte NF, Hoelscher DM.
Journal: BMC Family Practice
Released: December 2018
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/30518321external icon

Title: Behavior modification of diet and parent feeding practices in a community- vs primary care-centered intervention for childhood obesity.
Authors: Wilson TA, Liu Y, Adolph AL, Sacher PM, Barlow SE, Pont S, Sharma S, Byrd-Williams C, Hoelscher DM, Butte NF.
Journal: J Nutr Educ Behav
Released: September 2018
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/?term=Behavior+modification+of+diet+and+parent+feeding+practices+in+a+community-+vs+primary+care-centered external icon

Title: Improvement in primary care provider self-efficacy and use of patient-centered counseling to address child overweight and obesity after practice-based changes: Texas Childhood Obesity Research Demonstration Study.
Authors: Barlow SE, Salahuddin M, Butte NF, Hoelscher DM, Pont SJ.
Journal: Childhood Obesity
Released:September 2018
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/30153036external icon

Title: Racial/Ethnic Differences in the Effectiveness of a Multisector Childhood Obesity Prevention Intervention
Authors: Nelson CC, Colchamiro R, Perkins M, Taveras EM, Leung-Strle P, Kwass J, Woo Baidal JA
Journal: Am J Public Health.
Released: September 2018
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/30024810external icon

Title: Process Evaluation of an Early Care and Education Intervention: The California Childhood Obesity Research Demonstration Study (CA-CORD).
Authors: Lin SF, Binggeli-Vallarta A, Cervantes G, Angulo J, Moody JS, McKenzie TL, Horton LA, Ayala GX
Journal: Health Promot Pract.
Released: July 27, 2018
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/30051727external icon

Title: Associations Between Parent-Perceived Neighborhood Safety and Encouragement and Child Outdoor Physical Activity Among Low-Income Children
Authors: Nicksic NE, Salahuddin M, Butte NF, Hoelscher DM.
Journal: J Phys Act Health.
Released: May 1, 2018
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/29485931external icon

Title: Health Marketing for the Massachusetts Childhood Obesity Research Demonstration Study: A Case Study
Authors: Criss S, Blaine RE, Palamé M, Perkins M, Davison K, Kwass JA, Taveras EM; MA-CORD Study Team.
Journal: Health Promot Pract.
Released: March 1, 2018
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/29566576external icon

Title: Qualitative Examination of Parent Engagement in a Family-Based Childhood Obesity Program
Authors: Schmied EA, Chuang E, Madanat H, Moody J, Ibarra L, Ortiz K, Macias K, Ayala GX.
Journal: Health Promotion Practice
Released: February 22, 2018
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/29448812external icon

Title: Predictors of Severe Obesity in Low-Income, Predominantly Hispanic/Latino Children: The Texas Childhood Obesity Research Demonstration Study.
Authors: Salahuddin M, Pérez A, Ranjit N, Kelder SH, Barlow SE, Pont SJ, Butte NF, Hoelscher DM
Journal: Preventing Chronic Disease
Released: December 28, 2017
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/29283881external icon

Title: Strategies to Recruit a Diverse Low-Income Population to Child Weight Management Programs From Primary Care Practices.
Authors: Barlow SE, Butte NF, Hoelscher DM, Salahuddin M, Pont SJ.
Journal: Preventing Chronic Disease
Released: December 21, 2017
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/29267156external icon

Title: Best Practices and Barriers to Obesity Prevention in Head Start: Differences Between Director and Teacher Perceptions.
Authors: Byrd-Williams C, Dooley EE, Sharma SV, Chuang RJ, Butte N, Hoelscher DM.
Journal: Preventing Chronic Disease
Released: December 21, 2017
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/29267155external icon

Title: Implementation of Multisetting Interventions to Address Childhood Obesity in Diverse, Lower-Income Communities: CDC's Childhood Obesity Research Demonstration Projects.
Authors: Dooyema CA, Belay B, Blanck HM.
Journal: Preventing Chronic Disease
Released: December 21, 2017
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/29267154external icon

Title: Efficacy of a Community- versus Primary Care–Centered Program for Childhood Obesity: TX CORD RCT
Authors: Butte NF, Hoelscher DM, Barlow SE, Pont S, Durand C, Vandewater EA, Liu Y, Adolph AL, Perez A, Wilson TA, Gonzalez A, Puyau MR, Sharma SV, Byrd-Williams C, Oluyomi A, Huang T, Finkelstein EA, Sacher PM, Kelder SH.
Journal: Obesity (Silver Spring)
Released: July 13, 2017
Link to abstract: Efficacy of a community- versus primary care-centered program for childhood obesity: TX CORD RCT.external icon

Title: Clinical effectiveness of the Massachusetts Childhood Obesity Research Demonstration Initiative among Low Income Children
Authors: Taveras EM, Perkins M, Anand S, Woo Baidal JA, Nelson CC, Kamdar N, Kwass JA, Gortmaker SL, Barrett JL, Davison KK, Land T.
Journal: Obesity (Silver Spring)
Released: June 28, 2017
Link to abstract: Clinical effectiveness of the Massachusetts childhood obesity research demonstration initiative among low-income children.external icon

Title: Childhood obesity prevention in the women, infants, and children program: Outcomes of the MA-CORD study.
Authors: Woo Baidal JA, Nelson CC, Perkins M, Colchamiro R, Leung-Strle P, Kwass JA, Gortmaker SL, Davison KK, Taveras EM.
Journal: Obesity (Silver Spring)
Released: June 28, 2017
Link to abstract : https://www.ncbi.nlm.nih.gov/pubmed/28653498external icon

Title: Student obesity prevalence and behavioral outcomes for the Massachusetts childhood obesity research demonstration project.external icon
Authors: Franckle RL, Falbe J, Gortmaker S, Barrett JL, Giles C, Ganter C, Blaine RE, Buszkiewicz J, Taveras EM, Kwass JA, Land T, Davison KK.
Journal: Obesity (Silver Spring)
Released: June 28, 2017
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/28653502external icon

Title : Using School Staff Members to Implement a Childhood Obesity Prevention Intervention in Low-Income School Districts: the Massachusetts Childhood Obesity Research Demonstration (MA-CORD Project), 2012-2014.
Authors : Blaine RE, Franckle RL, Ganter C, Falbe J, Giles C, Criss S, Kwass JA, Land T, Gortmaker SL, Chuang E, Davison KK; MA-CORD Project Group.
Journal : Preventing Chronic Disease
Released : January 12, 2017
Link to abstract : https://www.ncbi.nlm.nih.gov/pubmed/28084989external icon

Title: Factors Affecting Implementation of the California Childhood Obesity Research Demonstration (CA-CORD) Project, 2013.
Authors: Chuang E, Brunner J, Moody J, Ibarra L, Hoyt H, McKenzie TL, Binggeli-Vallarta A, Cervantes G, Finlayson TL, Ayala GX.
Journal: Preventing Chronic Disease
Released: October 20, 2016
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/27763831external icon

Title: Lessons Learned by Community Stakeholders in the Massachusetts Childhood Obesity Research Demonstration (MA-CORD) Project, 2013–2014. Prev
Authors: Ganter C, Aftosmes-Tobio A, Chuang E, Kwass J, Land T, Davison KK, et al.
Journal: Preventing Chronic Disease
Released: January 26, 2017
Link to abstract: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5268744/external icon

Title: Community Stakeholders' Perceptions of Major Factors Influencing Childhood Obesity, the Feasibility of Programs Addressing Childhood Obesity, and Persisting Gaps.
Authors: Ganter C, Aftosmes-Tobio A, Chuang E, Blaine RE, Land T, Davison KK.
Journal: Journal of Community Health
Released: April, 2016
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/26433725external icon

Title: A Cascade of Champions: A Qualitative Study about the MA-CORD Media Competition Implementation.
Authors: Criss S, Tran A, Ganter C, Aftosmes-Tobio A, Gortmaker S, Viswanath K, Kwass JA, Davison KK.
Journal: Int J Environ Res Public Health.
Released: April 5, 2016
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/27058550external icon

Title: Media Competition Implementation for the Massachusetts Childhood Obesity Research Demonstration Study (MA-CORD): Adoption and Reach.
Authors: Criss S, Cheung L, Giles C, Gortmaker S, Viswanath K, Kwass JA, Davison K.
Journal: International Journal of Environmental Research and Public Health.
Released: April 5, 2016
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/27058549external icon

Title: Rationale, Design, and Methods for Process Evaluation in the Childhood Obesity Research Demonstration Project.
Authors: Joseph S, Stevens AM, Ledoux T, O'Connor TM, O'Connor DP, Thompson D.
Journal: Journal of Nutrition Education and Behavior
Released: Dec. 2015
Link to abstract : https://www.ncbi.nlm.nih.gov/pubmed/26298514external icon

Title: Development of the Policy Indicator Checklist: A Tool to Identify and Measure Policies for Calorie-Dense Foods and Sugar-Sweetened Beverages across Multiple Settings.
Authors: Lee RE, Hallett AM, Parker N, Kudia O, Kao D, Modelska M, Rifai H, O'Connor DP.
Journal: American Journal of Public Health
Released: May, 2015
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/25790397external icon

Title: Insufficient Sleep among Elementary and Middle School Students is linked with Elevated Soda Consumption and other Unhealthy Dietary Behaviors.
Authors: Franckle RL, Falbe J, Gortmaker S, Ganter C, Taveras EM, Land T, Davison KK.
Journal: Preventative Medicine
Released: May, 2015
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/25712328external icon

Title: Childhood Obesity Research Demonstration (CORD): the Cross-Site Overview and Opportunities for Interventions Addressing Obesity Community-Wide.
Authors: Foltz JL, Belay B, Dooyema CA, Williams N, Blanck HM.
Journal: Child Obesity
Released: February, 2015
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/25679059external icon

Title: Childhood Obesity Research Demonstration Project: Cross-Site Evaluation Methods.
Authors: O'Connor DP, Lee RE, Mehta P, Thompson D, Bhargava A, Carlson C, Kao D, Layne CS, Ledoux T, O'Connor T, Rifai H, Gulley L, Hallett AM, Kudia O, Joseph S, Modelska M, Ortega D, Parker N, Stevens A; EC-CORD (BETTER Policies) Team.
Journal: Child Obesity
Released: February, 2015
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/25679060external icon

Title: Design of the Massachusetts Childhood Obesity Research Demonstration (MA-CORD) Study
Authors: Taveras EM, Blaine RE, Davison KK, Gortmaker S, Anand S, Falbe J, Kwass JA, Perkins M, Giles C, Criss S, Colchamiro R, Baidal JW, Land T, Smith L, MA-CORD Study Group
Journal: Child Obesity
Released: February, 2015
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/25469676external icon

Title: Evaluation Overview for the Massachusetts Childhood Obesity Research Demonstration (MA-CORD) Project.
Authors: Davison KK, Falbe J, Taveras EM, Gortmaker S, Kulldorff M, Perkins M, Blaine RE, Franckle RL, Ganter C, Baidal JW, Kwass JA, Buszkiewicz J, Smith L, Land T; MA-CORD Study Group.
Journal: Child Obesity
Released: February, 2015
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/25575095external icon

Title: Evaluation Protocol to assess an Integrated Framework for the Implementation of the Childhood Obesity Research Demonstration Project at the California (CA-CORD) and Massachusetts (MA-CORD) Sites.
Authors: Chuang E, Ayala GX, Schmied E, Ganter C, Gittelsohn J, Davison KK.
Journal: Child Obesity
Released: February, 2015
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/25423618external icon

Title: Incorporating Primary and Secondary Prevention Approaches to address Childhood Obesity Prevention and Treatment in a Low-Income, Ethnically Diverse Population: Study Design and Demographic Data from the Texas Childhood Obesity Research Demonstration (TX CORD) Study.
Authors: Hoelscher DM, Butte NF, Barlow S, Vandewater EA, Sharma SV, Huang T, Finkelstein E, Pont S, Sacher P, Byrd-Williams C, Oluyomi AO, Durand C, Li L, Kelder SH.
Journal: Child Obesity
Released: February, 2015
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/25555188external icon

Title: Our Choice/Nuestra Opción: the Imperial County, California, Childhood Obesity Research Demonstration Study (CA-CORD).
Authors: Ayala GX, Ibarra L, Binggeli-Vallarta A, Moody J, McKenzie TL, Angulo J, Hoyt H, Chuang E, Ganiats TG, Gahagan S, Ji M, Zive M, Schmied E, Arredondo EM, Elder JP.
Journal: Child Obesity
Released: February, 2015
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/25584664external icon

Title: The Childhood Obesity Research Demonstration Project: A Team Approach for Supporting a Multisite, Multisector Intervention.
Authors: Williams N, Dooyema CA, Foltz JL, Belay B, Blanck HM.
Journal: Child Obesity
Released: February, 2015
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/25325835external icon

Title: The Childhood Obesity Research Demonstration Project: Linking Public Health Initiatives and Primary Care Interventions Community-wide to Prevent and Reduce Childhood Obesity.
Authors: Blanck HM, Collins JL.
Journal: Child Obesity
Released: February, 2015
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/25679058external icon

Title: The Utility of Geographical Information Systems (GIS) in Systems-Oriented Obesity Intervention Projects: The Selection of Comparable Study Sites for a Quasi-Experimental Intervention Sesign--TX CORD.
Authors: Oluyomi AO, Byars A, Byrd-Williams C, Sharma SV, Durand C, Hoelscher DM, Butte NF, Kelder SH.
Journal: Child Obesity
Released: February, 2015
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/25587670external icon

Title: The Childhood Obesity Research Demonstration Project: A Comprehensive Community Approach to Reduce Childhood Obesity.
Authors: Dooyema CA, Belay B, Foltz JL, Williams N, Blanck HM.
Journal: Child Obesity
Released: October, 2013
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/24094146external icon

Title: Community Stakeholders’ Perceptions of Major Factors Influencing Childhood Obesity, the Feasibility of Programs Addressing Childhood Obesity, and Persisting Gaps.
Authors: Ganter C, Aftosmes-Tobio A, Chuang E, Blaine RE, Land T, Davison KK.
Journal: J Community Health.
Released: April, 2016
Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/26433725external icon

CORD Special Supplements and Collections

Childhood Obesity (2015)
The Childhood Obesity Research Demonstration (CORD) Project http://online.liebertpub.com/toc/chi/11/1external icon

Commentaries

Sekhobo, J. P. (2017), Estimation of WIC effects in multilevel, cross-sector obesity prevention interventionsexternal icon. Obesity, 25: 1157–1158.

Economos, C. D. and Hammond, R. A. (2017), Designing effective and sustainable multifaceted interventions for obesity prevention and healthy communitiesexternal icon. Obesity, 25: 1155–1156.

CORD 1.0

Texas CORD Childhood Obesity Research Demonstration Projectexternal icon 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 eat healthier and be active.

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

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