# The ADAPT Trial: Adapting Evidence-Based Obesity Interventions in Community Settings

> **NIH NIH R01** · VANDERBILT UNIVERSITY MEDICAL CENTER · 2024 · $1,398,068

## Abstract

PROJECT SUMMARY
Evidence-based obesity treatment is inaccessible to most children in the United States. This lack of access is a
source of health inequity, whereby children from rural and minority communities, who have the highest rates of
childhood obesity, are also the least likely to receive an evidence-based intervention. Developing strategies to
improve access to evidence-based obesity interventions could reduce health disparities by improving reach to
these underserved communities. The premise of this study is that using a systematic framework to adapt a
community-based behavioral intervention for childhood obesity that accounts for individual, family, and
community factors will increase reach and effectiveness among low-income, minority, and rural populations.
COACH is a multi-level obesity intervention that supports 1) the individual child through developmentally
appropriate health behavior curriculum, 2) the family by directly addressing parent weight loss and engaging
parents as agents of change for their children, and 3) the community by building the capacity of local
community centers to offer parent-child programming. COACH has been tested in a prior RCT and
demonstrated effectiveness at reducing child BMI at 1-year follow-up. We propose testing the process of
adapting COACH in a cluster-randomized trial. In Aim 1, we will conduct a community readiness assessment
for COACH in 50 community centers serving rural, minority, and low-income families in middle TN. This
assessment was developed and pilot-tested by our team and assesses barriers to study implementation in
multiple domains. In 25 randomly selected community centers, we will use a systematic process to adapt the
intervention protocol based on the assessment results, while maintaining fidelity to COACH’s core
components. In Aim 2, in a cluster-randomized trial, we will test the comparative effectiveness of each
implementation strategy (adaptation vs. original program) on the implementation outcomes of reach, adoption,
implementation, and maintenance. In Aim 3, we will test the comparative effectiveness of the adapted and
original intervention on child BMI-Z at 6-month follow-up. Children with obesity (BMI percentile ≥95th) ages 6-11
and their families (N=750; 15 index children/center) will be recruited from communities served by each center.
This research is innovative because it uses adaptation science as a potential solution to reduce health
disparities in childhood obesity. By testing this intervention in a community resource available to 230 million
Americans (community centers), we will create a scalable obesity intervention that could be implemented in
traditionally underserved populations across the country. This study will also develop and test a theory-based
process for adapting behavioral interventions for both obesity and other health outcomes among diverse rural
and urban communities. This research aligns with the NHLBI’s mission to identify the best strategies for
...

## Key facts

- **NIH application ID:** 10873671
- **Project number:** 5R01HL163437-02
- **Recipient organization:** VANDERBILT UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** William Heerman
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $1,398,068
- **Award type:** 5
- **Project period:** 2023-06-22 → 2028-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10873671

## Citation

> US National Institutes of Health, RePORTER application 10873671, The ADAPT Trial: Adapting Evidence-Based Obesity Interventions in Community Settings (5R01HL163437-02). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10873671. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*