Improving access to first-line treatment for pediatric obesity: Lessons from the dissemination of SmartMoves

Authors

Emily Benjamin Finn, Section of General Pediatrics, Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA.
Caroline V. Keller, Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Marissa A. Gowey, Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Mary Savoye, Section of Pediatric Endocrinology, Diabetes, and Metabolism, Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA.
Stephanie Samuels, Section of Pediatric Endocrinology, Diabetes, and Metabolism, Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA.
Abby F. Fleisch, Center for Interdisciplinary and Population Health Research, MaineHealth Institute for Research, Westbrook, Maine, USA.
Victoria W. Rogers, The Barbara Bush Children's Hospital at Maine Medical Center, Portland, Maine, USA.

Document Type

Article

Publication Date

9-2024

Institution/Department

Center for Interdisciplinary and Population Health Research; Pediatrics

Journal Title

Obesity (Silver Spring, Md.)

MeSH Headings

Humans; Pediatric Obesity (therapy); Child; Health Services Accessibility; United States; COVID-19 (epidemiology); Health Behavior; Surveys and Questionnaires; Adolescent; Life Style

Abstract

OBJECTIVE: The increasing prevalence of and inequities in childhood obesity demand improved access to effective treatment. The SmartMoves curriculum used in Bright Bodies, a proven-effective, intensive health behavior and lifestyle treatment (IHBLT), was disseminated to ≥30 US sites from 2003 to 2018. We aimed to identify barriers to and facilitators of IHBLT implementation/sustainment. METHODS: We surveyed and interviewed key informants about experiences acquiring/implementing SmartMoves. In parallel, we analyzed and then integrated survey findings and themes from interviews using the constant comparative method. RESULTS: Participants from 16 sites (53%) completed surveys, and 12 participants at 10 sites completed interviews. The 11 sites (63%) that implemented SmartMoves varied in both use of training opportunities/materials and fidelity to program components. In interviews, demand for obesity programming, organizational priorities, and partnerships facilitated implementation. Seven sites discontinued SmartMoves prior to the COVID-19 pandemic. Funding insecurity and insufficient staffing emerged as dominant barriers to implementation/sustainment discussed by all interviewees, and some also noted participants' competing demands and the program's fit with population as challenges. CONCLUSIONS: System- and organizational-level barriers impeded sustainment of an evidence-based IHBLT program. Adequate funding could enable sufficient staffing and training to promote fidelity to the intervention's core functions and adaptation to fit local populations/context.

First Page

1745

Last Page

1756

Recommended Citation

Finn, Emily Benjamin; Keller, Caroline V.; Gowey, Marissa A.; Savoye, Mary; Samuels, Stephanie; Fleisch, Abby F.; and Rogers, Victoria W., "Improving access to first-line treatment for pediatric obesity: Lessons from the dissemination of SmartMoves" (2024). MaineHealth Maine Medical Center. 3780.
https://knowledgeconnection.mainehealth.org/mmc/3780