# Implementation of Decision Support for the Management of Obesity in a National Pediatric Primary Care Research Network

> **NIH NIH R01** · YALE UNIVERSITY · 2020 · $884,209

## Abstract

PROJECT SUMMARY/ABSTRACT
Nearly 1 in 3 children and adolescents – 23 million youth – in the United States are affected by overweight or
obesity, and low-income, racial/ethnic minority and rural children are disproportionately impacted. Beyond the
adverse impact of obesity on physical, social, and emotional wellbeing in childhood, children with obesity are at
greater risk of obesity in adulthood, placing them at higher risk of obesity-related cancers, cardiometabolic
disease, and early mortality. Despite guidance from the US Preventive Services Task Force and expert
committees, pediatric primary care clinicians often do not follow available guidance for managing children with
obesity. Electronic health records (EHRs) have the potential to improve clinicians' diagnosis and management
of obesity by providing tools such as reminders and clinical decision support. We have demonstrated that an
intervention package, consisting of EHR-based decision support for pediatricians and educational materials for
parents, improved BMI among children in two clinical trials at a multisite group practice in Massachusetts. We
have previously estimated, using a simulation model of the U.S. population, that high-fidelity dissemination and
implementation of this intervention package among pediatric primary care practices with fully functional EHRs
over 10 years has the potential to reach 2 million children with obesity and avert 43,000 cases of obesity at 10
years. However, little is known regarding the effectiveness of the intervention in various pediatric primary care
settings, particularly those serving children from populations disproportionately impacted by obesity, or regarding
the specific factors that influence the successful adoption and implementation of these tools. In partnership with
a national practice-based research network, we aim to capitalize on advances in the field of Implementation
Science to apply and evaluate this intervention for childhood obesity among a sample of 84 primary care
practices affiliated with three health systems serving children with racial/ethnic, socio-economic, rural-urban, and
geographic diversity. The scientific objectives of the proposed award are (1) to optimize a stakeholder-informed
intervention and implementation package tailored to site-specific context among a national sample of
participating practices, (2) to evaluate the impact of the intervention and implementation facilitation package in
improving obesity-related care delivery and children’s BMI, and (3) to rigorously examine what works where and
why among participating practice sites. To achieve these aims, we have assembled a transdisciplinary team with
expertise is obesity, implementation science, clinical informatics, mixed methods, multi-site interventions, and
user-centered design. We will apply a Hybrid Type 2 effectiveness-implementation study design wherein we will
employ mixed methods in our formative and summative evaluation plan. To facilitate broad-scal...

## Key facts

- **NIH application ID:** 10047650
- **Project number:** 1R01MD014853-01A1
- **Recipient organization:** YALE UNIVERSITY
- **Principal Investigator:** Mahnoosh Sharifi
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $884,209
- **Award type:** 1
- **Project period:** 2020-08-22 → 2025-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10047650

## Citation

> US National Institutes of Health, RePORTER application 10047650, Implementation of Decision Support for the Management of Obesity in a National Pediatric Primary Care Research Network (1R01MD014853-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10047650. Licensed CC0.

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