1. Preventing Obesity among At-risk Children of Adult Weight Management Patients
(PI: Keeley Pratt; Co-Is: Bradley Needleman, MD; Sabrena Noria, MD, PhD; Colleen Spees, PhD, RD; Christopher Taylor, PhD, RD)
The long-term goal of this integrated, multidisciplinary proposal is to advance the knowledge of how parental weight loss and behavior change achieved during medical weight management programs (WMPs) can be enhanced to be family-based to prevent childhood obesity. The short-term goals is to determine the preliminary effect that parental WMP participation has on children, by enrolling 23 parent-child dyads, where the parent is initiating an outpatient WMP and has a child 7-18 years-old in the home, to track dyadic changes in weight status, weight-related behaviors, and parent-child and family relationships.
Funded by: OARDC SEEDS Grant #OHOA1634
Graduate Research Assistants: Katie VanFossen (2018-2019) and Haley Kiser (2019-2020)
2. Parent-child and Family Factors that Associate with Dietary Change, Weight Loss, and Drop Out among African American Youth in Pediatric Weight Management
(PIs: Keeley Pratt, PhD and Ihuoma Eneli, MD, MS; Co-Is: Jinyu Xu, PhD, RD; Christopher Taylor, PhD, RD)
Guided by Family Systems and Social Cognitive theories, we are using a concurrent mixed methods approach, including surveys and dyadic interviews, to identify parent-child and family factors that associate with youth dietary change, weight loss, and drop-out from treatment at three points (baseline, 3- and 6 months) among Black youth and their parents participating in a pediatric weight management program at Nationwide Children’s Hospital . Evidence generated from this proposal will identify which parent-child and family factors to incorporate into the intervention design and development of a culturally sensitive family approach for more efficient and effective family-based weight management for Black families.
Funded by: OSU CCTS ISP Grant UL1TR002733 from the National Center for Advancing Translational Science
3. Establishing Postoperative Bariatric Resources in the Columbus Community
(PI: Keeley Pratt; Co-Is: Brian Focht, PhD; Andrew Hanks; PhD; Sabrena Noria, MD, PhD)
The main objective of this project is to develop, pilot, and evaluate the utilization of community-based supports and resources for postoperative bariatric surgery patients, in communities with a high prevalence of patients of color, to prevent weight recidivism. The long-term goals of this project are to decrease patient weight recidivism through increased community supports and resources, and to normalize bariatric surgery for treatment of severe obesity in communities of color.
Funded by: OSU Office of Engagement and Outreach; OSU College of Education and Human Ecology BIG Idea Grant
RECENTLY COMPLETED PROJECTS
1. Feasibility and Preliminary Efficacy of Support Figure Attendance at Bariatric Patients’ Clinical Visits
(PIs: Keeley Pratt, PhD and Megan Ferriby Ferber, PhD; Co-Is: Brian Focht, PhD; Bradley Needleman, MD; Sabrena Noria, MD, PhD; Lorraine Wallace, PhD)
The purpose of this study is to examine the feasibility, acceptability, and preliminary efficacy for the inclusion of support figures and romantic partners throughout the bariatric surgery process, from pre-surgery to two months post-surgery. This will be done using a four-arm randomized controlled trial (RCT). Using simple randomization, female patients in romantic relationships will be randomized into partner attended (PA) groups and treatment as usual (PA-TU) groups; patients (female or male) not in romantic relationships will be randomized into support figure attended (SFA) and SFA-TU groups. The goals of this study are to provide preliminary evidence for including support figures/partners in patients’ routine surgery healthcare visits, including the subsequent impact on post-surgery patient and support figure/partner behavior change and weight loss, relationship outcomes, and exploration of barriers to support figure/partner involvement.
ClinicalTrials.gov identifier (NCT number): NCT03642197
Graduate Research Assistant: Megan Ferriby, MS, Doctoral Candidate (doctoral dissertation 2-arm couples RCT)
2. Examining the Impact of Household and Relational Factors on Adult Weight Management Efforts
(OSU PI: Pratt; Wake Forest co-PIs: Callie Brown, MD; Joseph Skelton, MD, MS)
The purpose of this research is to explore the familial and household factors that impact adult weight management patients’ weight loss, health behavior change, and communication about health behavior change. Specifically, the study aims to examine both patients’, and family members’ (i.e. romantic partners and children) perceptions of family relationships (overall, parent-child, and romantic relationships), health behaviors, and the home environment to determine which factors could be potential intervention targets for future weight management programs.
Graduate Research Assistant: Megan Ferriby Ferber (2018-2019)
1. Family Functioning in Pediatric and Adult Weight Management
(OSU PI: Keeley Pratt)
The purpose of this line of inquiry is to determine what role family functioning plays in the prevention and treatment of obesity in youth and adults. For example, does family functioning change over the course of treatment, and if so, how do changes in family functioning associate with patient and family changes in weight status and behaviors? Does family functioning serve as a moderator or a mediator between parent-child dynamics (e.g., parenting styles and practices, feeding styles) and couple dynamics (relationship anxiety and avoidance, relationship satisfaction) and weight status? What is the incidence of families in pediatric and adult weight management that report impaired family functioning, and may benefit from intervention?
Designing clinical algorithms using family functioning as a screener for referral and treatment outcomes:
- Family-based care is recommended for the treatment of youth and adolescent obesity. However, focusing on behaviors isolated to the parent and youth neglects the rest of the family members, and the larger rules, routines, communication, and dynamics in the family. Family-based interventions grounded in family systems theory (FST) target family dynamics to influence weight-related behaviors through higher-level changes in the family. The utility of using FST in childhood obesity treatment has not been extensively conceptualized or applied. Few outcome studies have reported on variables representative of FST, and even fewer FST interventions have been conducted. Because of the lack of detail on the application of FST to childhood obesity treatment, providers are left with little clarity on how to use FST in clinical encounters. We provide the background and evidence for use of FST, detail how families organize around weight-related behaviors that contribute to obesity, and on the basis of their organization, what type of treatment might be beneficial, FST-informed or family-based behavioral interventions. Finally, a suggested family-based clinical algorithm (see below) is provided detailing the use of FST through assessment, intervention, and follow-up that can be refined over time by providers and researchers committed to viewing obesity in the context of the family and family dynamics. (see Pratt & Skelton, 2018)