# Creating effective childhood obesity interventions through the study of  positive outliers

> **NIH NIH K23** · MASSACHUSETTS GENERAL HOSPITAL · 2020 · $173,879

## Abstract

Project Summary
 Obesity in childhood is associated with adverse cardio-metabolic outcomes as well as near-term adverse
outcomes, including both physical and psychosocial morbidities. Evidence has shown that improving a child's
body mass index (BMI) can lead to a more favorable cardio-metabolic risk profile and prevent adult obesity.
However, many clinically-based randomized controlled trials (RCT) to improve a child's BMI have had limited
success. Previous trials have used multiple concurrent components to achieve improved BMI status, making it
difficult to know which components were effective. Identifying the most effective components of an intervention
has been recognized by the USPSTF as a major gap in current research. One underused strategy to improve
interventions is to study children in obesity RCTs who have succeeded in decreasing their BMI z-score by ≥0.2
units, hereafter referred to as “positive outliers.” During this 4 year K23 career development award, Dr.
Fiechtner will leverage data from two randomized controlled trials for childhood obesity (STAR N=549 and
Connect for Health = 721) to 1) identify which components of a childhood obesity intervention are most
effective (Aim 1) 2) qualitatively engage parent stakeholders to examine in a detailed manner how their
children achieved success or did not respond and how these lessons may be applied to others in similar
neighborhood contexts (Aim 2); and 3) conduct a pilot study to prospectively test the identified effective
components and strategies in a high-risk population tailoring the intervention to their neighborhood (Aim 3).
Through this training plan she will expand upon a foundation of pediatric gastroenterology, nutrition,
epidemiology and basic biostatistics to develop expertise in 1) advanced biostatics 2) qualitative methods 3)
time series analysis 4) improvement/implementation science and 5) the practical skills necessary to lead a
research team. She will leverage the wealth of resources of Massachusetts General Hospital, Harvard and the
Institute for Healthcare Improvement to conduct the proposed analyses. These studies and trainings will lay the
necessary scientific framework to launch her career as an independent physician scientist with the long-term
goal of creating targeted effective interventions for particularly high-risk groups who are unable to get to a
healthier weight, i.e. those where the “deck is stacked” against them because of cultural or environmental
barriers. This proposal addresses NICHD's mission to ensure all children have the chance to achieve their full
potential for healthy and productive lives.

## Key facts

- **NIH application ID:** 9980929
- **Project number:** 5K23HD090222-03
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Lauren Gehler Fiechtner
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $173,879
- **Award type:** 5
- **Project period:** 2018-08-01 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9980929

## Citation

> US National Institutes of Health, RePORTER application 9980929, Creating effective childhood obesity interventions through the study of  positive outliers (5K23HD090222-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9980929. Licensed CC0.

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