CDC’s Childhood Obesity Research Demonstration (CORD) Project 2.0

Photo: Mother serving fresh healthy salad to her son

The foundation of childhood obesity treatment is lifestyle modification. Through visits with medical, nutrition, and behavioral specialists, families enrolled in healthy weight programs gain the knowledge and skills needed for healthy eating and active living.

CORD 2.0 (Funding Period 2016–2018) specifically focuses on clinical and weight management program interventions to improve nutrition and physical activity behaviors of children in working families who are struggling with overweight and obesity. Projects will strengthen clinical-community collaborations to improve obesity screening and counseling services for children in select communities, and when appropriate, refer them to community-based healthy weight programs.

CORD 2.0 focuses on low income children aged 6 to 12 years.

These programs, if effective, will help low-income children improve their obesity-related behaviors, reduce their weight gain, and reduce their risk of developing sleep apnea, joint problems, and diseases such as fatty liver and type 2 diabetes. The projects also will evaluate if these interventions affect parents and other family members at risk of obesity.

CORD grantees are working with state and community partners—such as state Medicaid offices—to make sure these programs are easy to access by low-income families, and identify payment models that balance care and costs.

CORD 2.0 grantees will evaluate their interventions, providing needed information on how value-based childhood healthy weight interventions can be effectively carried out for children from lower income families. Grantees will assess healthy weight program costs as well as identify program strengths and weaknesses from the perspective of providers, attendees and other stakeholders, including state Medicaid offices. This information will be used to determine how similar programs may be developed in a sustainable way and disseminated across primary care practices in the state.

For additional CORD resources and information, please see CORD 1.0.

In 2017, the U.S. Preventive Services Task Force (USPSTF)external icon found that clinicians should screen children ages 6 and over for obesity (using body mass index (BMI) and offer or refer them to family-centered comprehensive intensive, behavioral, interventions (Grade B Recommendation). However, may children and families face barriers in getting to healthy weight programs.

Project Emphasis

CORD 2.0 focuses on low income children aged 6 to 12 years. CORD 2.0 grantees will focus on the role of health care providers, other health care team members, and community partners for management of childhood obesity in the health care and community settings such as the YMCA. Grantees will

  • Implement body mass index screening and quality nutrition and physical activity counseling for all children.
  • Use electronic health systems to enroll children who are overweight and children who have obesity in healthy weight programs.
  • Deliver evidence-based structured behavioral programs (healthy weight programs) that support improved obesity-related behaviors. This includes working with parents to provide skills that will support their children who are overweight or who have obesity.

Publications updated 7/23/2020

Title: Unmet Social Needs and Adherence to Pediatric Weight Management Interventions: Massachusetts, 2017-2019
Authors: Atkins M , Castro I , Sharifi M , Perkins M , O’Connor G , Sandel M , Taveras EM, Fiechtner L.
Journal: Am J Public Health. 2020 Jul;110(S2):S251-S257. doi: 10.2105/AJPH.2020.305772.
Released: July 2020
Link to abstract: icon

Title: Motivational Interviewing and Caregiver Engagement in the Family Check-Up 4 Health.
Authors: Berkel C, Mauricio AM, Rudo-Stern J, Dishion TJ, Smith JD.
Journal: Prev Sci. 2020 Jun 3. doi: 10.1007/s11121-020-01112-8.
Released: June 2020
Link to abstract: icon

Title: Costs of Preparing to Implement a Family-Based Intervention to Prevent Pediatric Obesity in Primary Care: a Budget Impact Analysis.
Authors: Jordan N, Graham AK, Berkel C, Smith JD.
Journal: Prevention Science
Released: January 2019
Link: icon

Title: Rationale and Design of the Clinic and Community Approaches to Healthy Weight Randomized Trial.
Authors: Fiechtner L, Perkins M, Biggs V, Langhans N, Sharifi M, O’Connor G, Price S, Locascio J, Kuhlthau K, Kwass JA, Nelson C, Land T, Longjohn M, Lawson V, Hohman K, Taveras EM.
Journal: Contemporary Clinical Trials.
Released: April 2018
Link: icon

Title: An Individually Tailored Family-Centered Intervention for Pediatric Obesity in Primary Care: Study Protocol of a Randomized Type II Hybrid Effectiveness–Implementation Trial (Raising Healthy Children study).
Authors: Smith JD, Berkel C, Jordan N, Atkins DC, Narayanan SS, Gallo C, Grimm KJ, Dishion TJ, Mauricio AM, Rudo-Stern J, Meachum MK, Winslow E, Bruening MM.
Journal: Implementation Science.
Released: January 2018
Link: icon

Publications updated 7/23/2020

Arizona State University

The Arizona-CORD (AZ CORD) will adapt and implement an existing parenting program called the Family Check-Up (FCU) to address overweight and obesity in young people. The AZ-CORD team will work with three primary care clinics and stakeholders across the state to implement and test Family Checkup 4 Health (FCU4Health).

Massachusetts Department of Health

Massachusetts CORD 2.0 (MA-CORD 2.0) will build on experiences in CORD 1.0 to optimize and test the clinical care of low-income children with a body mass index (BMI) ≥ 85th percentile for age and gender.