New study aims to curb obesity in rural Kansas

Rural Kansas families with elementary school-aged children who want to live a healthier lifestyle have a free opportunity to do so via a new study led by the University of Kansas Medical Center.

Known as iAmHealthy Parents First, the study is the first randomized controlled trial in the world designed to examine the effectiveness of an integrated obesity treatment program for adults and children. The program targets rural areas, which have higher rates of obesity than their urban counterparts and are thus at higher risk for cardiovascular disease, diabetes and various cancers.

“This is the first program that integrates a state-of-the-art, empirically supported adult intervention with a state-of-the-art, empirically supported child intervention,” said Ann M. Davis, Ph.D., MPH, co-principal investigator for the study and director of the Center for Children's Healthy Lifestyles & Nutrition at KU Medical Center and Children's Mercy.

The new study builds on the existing iAmHealthy intervention, a National Institutes of Health-funded program to combat childhood obesity by helping rural Kansas children and their parents or caregivers improve their physical activity and nutrition. iAmHealthy participants attend group meetings and work with a trained psychologist or dietitian via videoconferencing software such as Zoom.

The free program works with children and their parents and caregivers together. “There's a lot of research to show that when we do family-based programs, such as iAmHealthy, the kids who are the most successful have the parents who are the most successful,” Davis said.

iAmHealthy Parents First will test the effectiveness of jumpstarting the iAmHealthy program by adding a separate parents-only portion that precedes the existing family-based one. The parents-only component is directed by co-principal investigator Christie Befort, Ph.D., who is professor of population health at KU School of Medicine and associate director of cancer prevention and control for The University of Kansas Cancer Center.

The parents-only lifestyle component is not new, but it has been adapted to address the unique barriers of parents of young children, including busy schedules, child food preferences and parenting challenges, Befort said.

The researchers hypothesize that implementing a kind of “secure your own mask before assisting your child” approach by allowing parents to focus on their health goals first will boost the success rate of the iAmHealthy program.

“Parents of young children have unique barriers during the phase of life when raising children and managing numerous activities are the primary driver of daily lifestyle routines,” said Befort. “But this phase of life is also a great opportunity to prioritize health lifestyles, rather than postponing that priority until the children are older. Preventing the onset of chronic disease for them and their children is the driving factor.”

Davis and Befort aim to enroll 300 rural Kansas families in the study, which will be randomized into two groups. For three months, parents in the control group will receive newsletters with educational information such as tips for a healthy lifestyle. The adults in the Parents First intervention group will meet via Zoom with a health coach and receive instructions for reducing calories and increasing physical activity. They also will participate in weekly tracking of nutrition and physical activity while receiving feedback and peer support as well as guidance on meal planning for busy families.

At the end of three months, everyone in the study will then receive the family-based iAmHealthy group intervention for six months. Throughout the study, all participants will complete online questionnaires, weigh themselves and measure their physical activity on activity watches provided by the study team.

“We believe that [Parents First] will help more parents be successful, which we believe will help even more kids be successful,” said Davis.