PROJECT SUMMARY Nearly 1 in 5 children in the United States are affected by obesity, with even higher rates among children of racial and ethnic minority groups, of low socioeconomic status, and living in rural communities. Obesity is a significant public health concern because it increases a child’s risk for health conditions within every organ system, including diabetes, cardiovascular disease, and mental health problems. Traditional lifestyle behavior interventions have not been as effective when implemented in communities of color, low-income communities, and rural communities. Guided by the Clinical and Community Integration Framework, which emphasizes the integration of community and healthcare systems to drive family engagement and empowerment in treating obesity, our work has demonstrated the importance of addressing psychosocial needs and leveraging technology to improve care for families of children with obesity. We have assembled a research team, with complimentary and relevant areas of expertise, to refine and test a multi-component intervention, Mobile Integrated Care for Childhood Obesity (MICCO). MICCO combines evidence-based approaches previously developed and tested by our research team, each delivered through a mobile app platform integrated with the electronic health record. Components will include: (1) coordinating social services in the community to meet families’ psychosocial needs, (2) integrating care from obesity specialists using telehealth, and (3) providing media-based psychoeducational tools to promote self-management of lifestyle behavior change. Community-engaged and qualitative research methods will be employed to refine MICCO to be community-centered and family-friendly (Aim 1). The refined intervention will be tested in a randomized controlled trial with 184 families of children 4-12 years of age with obesity, recruited from rural primary care practices, to determine the impact of the intervention on child adiposity and family engagement in treatment over six months (Aim 2) and disparities in these outcomes by race, ethnicity, and socioeconomic status (Aim 3). This study will inform a R01 application in Year 2 to expand the concept to a multi-site RCT to test the effectiveness of MICCO’s integrated, community-centered, and technologically state- of-the-art approach in improving the reach and relevance of childhood obesity treatments to families in underserved rural communities, increasing the likelihood of a positive impact on obesity outcomes and inequities in child health.