Adapting a pediatric weight management program for implementation via telehealth

Project Summary Childhood obesity remains highly prevalent in the United States and is a major contributor to chronic disease. Evidence suggests that obesity in childhood persists into adulthood, predisposing children to cardio-metabolic diseases. Despite national efforts to expand prevention and treatment, racially/ethnically diverse children and those from low-income households have not benefitted equally from such efforts. Children require coordinated and frequent care for weight management, but multiple socioeconomic and geographic barriers, exist for children living in low-income households and perpetuate health disparities. Better solutions are needed to improve access to care and ongoing participation that impact health outcomes. Telehealth is an approach that can improve access, participation, and mitigate barriers, though simply using it is not sufficient to promote equitable access; other barriers may be introduced and result in inequities. The key question is: how can we modify in-person pediatric weight management programs for telehealth to be equitable? The goal of this mixed methods study is to examine telehealth approaches for childhood obesity to understand multi-level factors that impact access and participation in care and adapt a pediatric weight management program for telehealth. For this mentored career development application, we propose leveraging Connect for Health, a study funded by NHLBI and Patient Centered Outcomes Research Institute (PCORI) that is implementing an in-person pediatric weight management program. Guided by implementation science frameworks, we will analyze electronic health record (EHR) data of current telehealth approaches, conduct qualitative interviews, develop targeted telehealth adaptations to Connect for Health, and pilot test the optimized telehealth program. My overarching hypothesis is stakeholder- informed telehealth adaptations will result in equitable access to the Connect for Health pediatric weight management program. As a clinician-scientist, the long-term goal of my research is to optimize pediatric health care delivery by improving health outcomes and access to care through implementation science. I have assembled a mentorship team with expertise in childhood obesity, health equity, and implementation science. Along with my research and training plan, I will develop skills in advanced quantitative analyses, mixed methods design, and implementation science that will enable me to achieve my career goals.