CClinicalTrials.gg
CompletedNCT03304249Updated Sep 13, 2023Results posted

Rural Disparities in Pediatric Obesity: The iAmHealthy Intervention

An interventional study of iAmHealthy Healthy Lifestyles Program and Newsletter in Weight Loss, sponsored by University of Kansas Medical Center. Completed at 1 site in United States. Open to participants aged 5 Years to 10 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2023-09-13.

Sponsored by University of Kansas Medical Center · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
296
Allocation
Randomized
Ages
5 Years to 10 Years
Sex
All
01

Study summary

The purpose of this study is to learn if providing a family-based group program using mobile health technology (iAmHealthy Healthy Lifestyles Program) is effective at improving child weight, nutrition, and physical activity.

Read the detailed description

This is a cluster-randomized study that will test the iAmHealthy Healthy Lifestyles Program versus a standard approach to weight loss in kids current in 2nd thru 4th grade. The iAmHealthy Healthy Lifestyles Program utilizes mobile tools to deliver the weight loss program to kids and families in rural settings. This study will include kids from schools in rural cities/counties, and their parents, and they will be randomly assigned to a group by their school.

The iAmHealthy Healthy Lifestyles Program is a rurally tailored telemedicine intervention. It delivers behavioral, nutritional, and physical activity topics for kids and their families. The total length of the intervention will be about 8 months, which coincides with the length of a typical school year.

02

Conditions studied

  • Weight Loss
03

Who can participate

Ages eligible
5 Years to 10 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  • Family lives in a rural area (city and/or county population less than 20,000)
  • Child Body Mass Index (BMI) >85th and \<99th percentile
  • Child in 2nd thru 4th grade
  • Child and Parent speak English
  • Family is available at times intervention is offered

Exclusion criteria

Exclusion Criteria:

  • Child has physical limitation or receives an injury which significantly limits physical mobility
  • Child has significant medical issue
  • Child and Parents have significant developmental delay or cognitive impairment
  • Child has a sibling who has already enrolled in the program
  • Family moves to a non-participating school
04

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
296 participants (actual)

Study arms

  • Experimental
    iAmHealthy

    Participants randomized to this arm receive the iAmHealthy Healthy Lifestyles Program.

    Behavioral: iAmHealthy Healthy Lifestyles Program

  • Active comparator
    Control

    Participants randomized to this group receive comparable content delivered via a newsletter.

    Other: Newsletter

Interventions

  • BehavioraliAmHealthy Healthy Lifestyles Program

    iAmHealthy is behavioral intervention focused on nutrition, behavior and physical activity that engages parents and children in treatment using mobile health (mHealth) technology. Meetings are approximately one hour. Participants will log in for 8 weekly group sessions, followed by 6 monthly sessions.

  • OtherNewsletter

    Weight loss materials delivered via a newsletter. Each newsletter will cover nutritional, exercise, and behavioral suggestions to improve the child's health. The newsletter will be sent in the mail once a month for 8 months.

05

What researchers measure

Primary outcomes

  1. Child Body Mass Index Z-score (BMIz) at Baseline and Month 8

    Body mass index z-score (BMIz) is the age and sex standardized body mass index for children. To calculate BMIz, the equation BMIz = \[(BMI/M)\^L - 1\] ÷ (L × S) is used where M is the median, L is the power transformation to achieve normality, and S is the coefficient of variation. A z-score of 0 represents the historical population norm. A higher BMIz is indicative of higher fat mass.

    Time frame: Baseline to Month 8

Secondary outcomes

  1. Child Body Mass Index Z-score (BMIz) at Baseline and Month 20

    Body mass index z-score (BMIz) is the age and sex standardized body mass index for children. To calculate BMIz, the equation BMIz = \[(BMI/M)\^L - 1\] ÷ (L × S) is used where M is the median, L is the power transformation to achieve normality, and S is the coefficient of variation. A z-score of 0 represents the historical population norm. A higher BMIz is indicative of higher fat mass.

    Time frame: Baseline to Month 20

  2. Physical Activity - Average Minutes of Moderate to Vigorous Physical Activity Per Day

    Measured using ActiGraph physical activity monitors. Outcome will be calculated as the average (across valid wear days) time spent per day in moderate to vigorous physical activity (MVPA).

    Time frame: Baseline, Month 8, Month 20

  3. Physical Activity - % Time in Sedentary Activity

    Measured using ActiGraph physical activity monitors. Outcome was calculated as the percentage of time time spent in sedentary activity compared to wear time.

    Time frame: Baseline, Month 8, Month 20

  4. Photo-assisted 24 Hour Food Recall (24hr FR) - Servings of Fruits and Vegetables

    The photo assisted 24hr FR is a standardized five-pass method, developed by the US Department of Agriculture for use in national dietary surveillance.

    Time frame: Baseline, Month 8, Month 20

  5. Photo-assisted 24 Hour Food Recall (24hr FR) - Servings of Sugar-sweetened Beverages

    The photo assisted 24hr FR is a standardized five-pass method, developed by the US Department of Agriculture for use in national dietary surveillance/

    Time frame: Baseline, Month 8, Month 20

  6. Photo-assisted 24 Hour Food Recall (24hr FR) - Servings of "Red Foods" (Foods High in Sugar and/or Fat)

    The photo assisted 24hr FR is a standardized five-pass method, developed by the US Department of Agriculture for use in national dietary surveillance.

    Time frame: Baseline, Month 8, Month 20

  7. Parent Body Mass Index (BMI)

    Parent BMI was calculated at three time points.

    Time frame: Baseline, Month 8, Month 20

06

Results

Posted Sep 13, 2023

Participant flow

Participants were recruited across 18 rural schools between 2017 and 2020.

Participant flow — Overall Study
MilestoneiAmHealthyControl
Started128168
8 months118166
Completed104154
Not completed2414
Withdrew: Lost to follow-up810
Withdrew: Withdrawal by subject122
Withdrew: Moved out of district42

Outcome measures

PrimaryChild Body Mass Index Z-score (BMIz) at Baseline and Month 8

Body mass index z-score (BMIz) is the age and sex standardized body mass index for children. To calculate BMIz, the equation BMIz = \[(BMI/M)\^L - 1\] ÷ (L × S) is used where M is the median, L is the power transformation to achieve normality, and S is the coefficient of variation. A z-score of 0 represents the historical population norm. A higher BMIz is indicative of higher fat mass.

Time frame:
Baseline to Month 8
Reported as:
Mean · Z-score
Child Body Mass Index Z-score (BMIz) at Baseline and Month 8
Z-scoreiAmHealthyControl
Baseline1.78 ± 0.541.92 ± 0.47
Month 81.78 ± 0.541.96 ± 0.48
SecondaryChild Body Mass Index Z-score (BMIz) at Baseline and Month 20

Body mass index z-score (BMIz) is the age and sex standardized body mass index for children. To calculate BMIz, the equation BMIz = \[(BMI/M)\^L - 1\] ÷ (L × S) is used where M is the median, L is the power transformation to achieve normality, and S is the coefficient of variation. A z-score of 0 represents the historical population norm. A higher BMIz is indicative of higher fat mass.

Time frame:
Baseline to Month 20
Reported as:
Mean · Z-score
Child Body Mass Index Z-score (BMIz) at Baseline and Month 20
Z-scoreiAmHealthyControl
Baseline1.78 ± 0.541.92 ± 0.47
Month 201.82 ± 0.502.04 ± 0.46
SecondaryPhysical Activity - Average Minutes of Moderate to Vigorous Physical Activity Per Day

Measured using ActiGraph physical activity monitors. Outcome will be calculated as the average (across valid wear days) time spent per day in moderate to vigorous physical activity (MVPA).

Time frame:
Baseline, Month 8, Month 20
Reported as:
Mean · minutes per day
Physical Activity - Average Minutes of Moderate to Vigorous Physical Activity Per Day
minutes per dayiAmHealthyControl
Baseline51.14 ± 22.7252.95 ± 18.99
Month 847.16 ± 18.8249.07 ± 22.49
Month 2044.86 ± 18.8141.37 ± 18.57
SecondaryPhysical Activity - % Time in Sedentary Activity

Measured using ActiGraph physical activity monitors. Outcome was calculated as the percentage of time time spent in sedentary activity compared to wear time.

Time frame:
Baseline, Month 8, Month 20
Reported as:
Mean · percent of time sedentary
Physical Activity - % Time in Sedentary Activity
percent of time sedentaryiAmHealthyControl
Baseline59.14 ± 7.1256.57 ± 6.60
Month 861.14 ± 8.5559.62 ± 9.00
Month 2063.89 ± 8.0963.28 ± 8.11
SecondaryPhoto-assisted 24 Hour Food Recall (24hr FR) - Servings of Fruits and Vegetables

The photo assisted 24hr FR is a standardized five-pass method, developed by the US Department of Agriculture for use in national dietary surveillance.

Time frame:
Baseline, Month 8, Month 20
Reported as:
Mean · servings of fruits and vegetables
Photo-assisted 24 Hour Food Recall (24hr FR) - Servings of Fruits and Vegetables
servings of fruits and vegetablesiAmHealthyControl
Baseline3.27 ± 1.662.68 ± 1.38
Month 83.04 ± 1.682.45 ± 1.41
Month 202.89 ± 1.582.58 ± 1.16
SecondaryPhoto-assisted 24 Hour Food Recall (24hr FR) - Servings of Sugar-sweetened Beverages

The photo assisted 24hr FR is a standardized five-pass method, developed by the US Department of Agriculture for use in national dietary surveillance/

Time frame:
Baseline, Month 8, Month 20
Reported as:
Mean · servings of sugar-sweetened beverages
Photo-assisted 24 Hour Food Recall (24hr FR) - Servings of Sugar-sweetened Beverages
servings of sugar-sweetened beveragesiAmHealthyControl
Baseline1.19 ± 0.891.14 ± 0.99
Month 80.75 ± 0.661.08 ± 0.89
Month 200.93 ± 0.841.21 ± 1.06
SecondaryPhoto-assisted 24 Hour Food Recall (24hr FR) - Servings of "Red Foods" (Foods High in Sugar and/or Fat)

The photo assisted 24hr FR is a standardized five-pass method, developed by the US Department of Agriculture for use in national dietary surveillance.

Time frame:
Baseline, Month 8, Month 20
Reported as:
Mean · servings of red foods
Photo-assisted 24 Hour Food Recall (24hr FR) - Servings of "Red Foods" (Foods High in Sugar and/or Fat)
servings of red foodsiAmHealthyControl
Baseline6.64 ± 2.437.40 ± 3.91
Month 85.12 ± 1.896.28 ± 2.28
Month 205.69 ± 2.006.89 ± 2.31
SecondaryParent Body Mass Index (BMI)

Parent BMI was calculated at three time points.

Time frame:
Baseline, Month 8, Month 20
Reported as:
Mean · kg/m²
Parent Body Mass Index (BMI)
kg/m²iAmHealthyControl
Baseline35.83 ± 9.1433.69 ± 8.81
Month 835.94 ± 9.7333.79 ± 9.32
Month 2035.23 ± 9.0334.31 ± 9.53

Adverse events

Collected over 20 months. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
iAmHealthy0/128 (0%)0/128 (0%)0/128 (0%)
Control0/168 (0%)0/168 (0%)0/168 (0%)

Baseline characteristics

Baseline data collection was focused on child participants.

Age, Continuous
Age, Continuous(years)iAmHealthyControlTotal
Mean8.9880 ± 0.88598.8880 ± 0.84028.9313 ± 0.8587
Sex: Female, Male
Sex: Female, Male(Participants)iAmHealthyControlTotal
Female384684
Male263864
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)iAmHealthyControlTotal
Hispanic or Latino61420
Not Hispanic or Latino5870128
Unknown or Not Reported000
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)iAmHealthyControlTotal
White5574129
Native American011
Asian/Pacific Islander101
Other112
Biracial7815
Eligible for Free or Reduced Lunch
Eligible for Free or Reduced Lunch(Participants)iAmHealthyControlTotal
Eligible363874
Not Eligible284674
Approximate Total Household Income (Before Taxes)
Approximate Total Household Income (Before Taxes)(Participants)iAmHealthyControlTotal
Less than $30,000112435
$30,000 to $69,999272552
$70,000 to $99,999112536
$100,000 to $149,99914721
$150,000 or more134
Body Mass Index Z-Score
Body Mass Index Z-Score(z-score)iAmHealthyControlTotal
Mean1.7767 ± 0.54061.9209 ± 0.47051.8568 ± 0.5062
Child's Grade
Child's Grade(Participants)iAmHealthyControlTotal
2182240
3203353
4262955
07

Study locations

1 site
  • University of Kansas Medical Center
    Kansas City, Kansas 66160, United States
08

References and documents

Publications

  • Forseth B, Davis AM, Bakula DM, Murray M, Dean K, Swinburne Romine RE, Fleming K. Validation of remote height and weight assessment in a rural randomized clinical trial. BMC Med Res Methodol. 2022 Jul 11;22(1):185. doi: 10.1186/s12874-022-01669-8. PubMed 35818033 ↗
  • Davis AM, Beaver G, Dreyer Gillette M, Nelson EL, Fleming K, Swinburne Romine R, Sullivan DK, Lee R, Pettee Gabriel K, Dean K, Murray M, Faith M. iAmHealthy: Rationale, design and application of a family-based mHealth pediatric obesity intervention for rural children. Contemp Clin Trials. 2019 Mar;78:20-26. doi: 10.1016/j.cct.2019.01.001. Epub 2019 Jan 7. PubMed 30630108 ↗

Study documents

  • Protocol and statistical analysis plan · Aug 12, 2020

Documents are hosted by the registry — open the source record to download them.

09

Registry details

Key details

Study ID
NCT03304249
Lead sponsor
University of Kansas Medical Center
Collaborators
National Institute of Nursing Research (NINR)
Responsible party
Sponsor
First posted
Oct 6, 2017
Start date
Oct 13, 2017
Primary completion
Nov 30, 2021
Completion
Jun 20, 2022
Results posted
Sep 13, 2023
Last update
Sep 13, 2023

Study contacts

Ann M Davis, PhD, MPH
principal investigator · University of Kansas Medical Center

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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