PROJECT SUMMARY/ABSTRACT
Nearly one in five children in the United States are affected by obesity. Beyond the adverse impact on physical,
social, and emotional wellbeing in childhood, children with obesity are at greater risk of obesity in adulthood. A
recent simulation study projects that 57% of today’s children will have obesity at age 35, placing them at higher
risk of cardiometabolic disease, obesity-related cancers, and early mortality. Effective interventions that
prevent and treat obesity in childhood can disrupt these projected trends, improve long-term health and quality
of life, and reduce later health care utilization and costs. Bright Bodies, a high-intensity, family-based
intervention for childhood obesity, was found to have the greatest magnitude of mean reduction in body mass
index among U.S.-based childhood obesity interventions evaluated in the 2017 U.S. Preventive Task Force
Report. There is tremendous potential for population-level impact on obesity outcomes if Bright Bodies is
successfully scaled-up nationally, yet little is known about adoption, implementation, and effectiveness at the
39 sites to which the Bright Bodies curriculum has been disseminated over the last decade. Through this
award, we aim to capitalize on advances in the field of implementation science to conduct an observational
evaluation of the naturalistic dissemination and implementation of the Bright Bodies intervention. The results of
this mixed methods study of historical dissemination sites will be used to optimize the Bright Bodies
implementation package though user-centered design methods. The newly-optimized package will be
prospectively implemented at three heterogenous sites reflecting low-income populations with racial/ethnic,
rural-urban, and geographic diversity. The scientific objectives of the proposed award are to conduct a hybrid
type 2 effectiveness-implementation and cost-effectiveness study in which we will employ multiphase mixed
methods to assess implementation processes and effectiveness outcomes simultaneously while also
examining contextual factors that may mediate and modify implementation impact and effectiveness. To
achieve these aims, we have assembled a transdisciplinary team with expertise in obesity treatment,
implementation science, mixed methods, community engaged research, cost-effectiveness analysis, and user-
centered design. The results from this study will provide an optimized, user-centered implementation package
for Bright Bodies as well as valuable evidence on the implementation and effectiveness of the intervention in
different settings to facilitate broad-scale dissemination and to enhance sustainability.