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Agenda

Working Group on Future Research Directions in Childhood Obesity Prevention and Treatment

Bethesda Marriott Hotel, 5151 Pooks Hill Road, Bethesda, MD

Day 1, August 21, 2007

8:30 to 8:50 a.m. Welcome and Introductions
  Dr. Elizabeth Nabel, Director, NHLBI
 

Dr. Michael Lauer, Director, Div. of Prevention and Population Science (DPPS), NHLBI

8:50 to 9:00 a.m. Charge to Participants and Working Group Objectives
  Dr. Denise Simons-Morton, Senior Scientific Advisor, DPPS
9:00 to 9:20 a.m. Overview of Pediatric Obesity Prevention Research
  Dr. June Stevens, UNC, Chapel Hill
9:20 to 9:40 a.m. Overview of Pediatric Obesity Treatment Research
  Dr. Stephen Daniels, Children’s Hospital, UC
(10- to 15-min presentation by lead presenter, substantiated by evidence in the literature and presenter’s research experience followed by discussions. (Note, items in bullets are based on list of suggested questions)
PREVENTION PANEL PRESENTATIONS AND DISCUSSIONS
9:40 to 9:55 a.m. Theoretical Models in Childhood Obesity Prevention
  Dr.Robert Klesges, St. Jude’s Children’s Hospital

Many theoretical models (e.g., Social Cognitive Theory) have been used in pediatric obesity studies, but some models have had limited use (e.g. community-based participatory research methods or the socio-ecological model).

  • Have theoretical models provided a sound framework for pediatric obesity prevention research?
  • Which models hold promise in childhood obesity prevention studies?
  • How can behavioral interventions be made more potent?
9:55 to 10:20 a.m. Discussions
  All
  Moderator: Dr. Ken Resnicow, University of Michigan
10:20 to 10:35 a.m. Environmental Interventions
  Dr. James Sallis, San Diego State University

Observational studies have reported significant associations between the built environment and pediatric obesity as well as dietary and physical activity behaviors, but as yet only a few studies have tested interventions that modify the built environment (macro- or micro-) for pediatric obesity prevention.

  • How can we advance built environment research now to test interventions that target the built environment for childhood obesity prevention?
  • How do we characterize the macro- and micro-environments for childhood obesity prevention?
  • What study designs are most promising?
  • Are interventions that modify the built environment a fruitful direction for further research at this time?
10:35 to 11:00 a.m. Discussions
  All
  Moderator: Dr. Alan Delamater, University of Miami School of Medicine
11:00 to 11:15 a.m. Break
11:15 to 11:30 a.m. Multi-level Interventions for Prevention of Childhood Obesity
  Dr. Mary Story, University of Minnesota
  • Do multi-level intervention approaches or interventions in a combination of settings (e.g., school-community, family-community; church-family, school-family-community, Internet-school-family, primary care-community) seem more promising than single-level interventions (e.g., school-based or family-based)?
  • How can multi-level interventions (community- or group-based interventions) be made more potent?
11:30 to 11:55 a.m. Discussions
  All
  Moderator: Dr. Don Williamson, Pennington Biomedical Research Center
11:55 to 12:25 p.m.

Low SES and Minority Issues for Childhood Obesity Prevention and Treatment

  Dr. Shiriki Kumanyika, University of Pennsylvania
  Dr. Amelie Ramirez, University of Texas at San Antonio

Given that the minority and low SES pediatric populations are at high risk for obesity, prevention initiatives could be developed to target those populations.

  • What are some successful ways to recruit, retain and increase participation of minority and low SES pediatric populations in research?
  • How would you approach a weight-loss treatment intervention for obese children in specific racial, ethnic, and low SES populations?
12:25 to 12:35 p.m. Discussions
  All
  Moderator: Dr. Elsie Taveras, Harvard Pilgrim Hospital
12:35 to 1:40 p.m. Lunch and Exercise Breaks
1:40 to 1:55 p.m. Design Issues in Pediatric Obesity Prevention
  Dr. June Stevens, UNC, Chapel Hill
  • Many studies in pediatric obesity interventions show some effects but often not on BMI.
    • What outcomes should we examine? What mediators?
    • What study designs are most promising?
    • What duration of intervention and length of follow-up should we use?
    • What are some promising approaches for long-term (e.g., up to 10 years) interventions and follow-up?
    • How can we make interventions more potent?
1:55 to 2:20 p.m. Discussions
  All
 

Moderator: Dr. Tom Baranowski, Baylor College of Medicine, Children’s Hospital

2:20 to 2:35 p.m. Translation of Promising Childhood Obesity Prevention Research
  Dr. Steve Gortmaker, Harvard School of Public Health
  • What are the key elements of successful pediatric obesity prevention research studies?
  • What is the next phase of research to translate successful approaches to prevent childhood obesity to broader and larger populations?
  • What is the sequence for prevention research and its translation?
2:35 to 3:00 p.m. Discussions
  All
  Moderator: Dr. Eva Obarzanek, NHLBI
3:00 to 3:30 p.m.

Prioritization of Recommendations for Pediatric Obesity Prevention Research

  All
  Moderator: Dr. June Stevens, UNC; Dr. Linda Van Horn, Northwestern Univ.
3:30 to 3:45 p.m. Break
TREATMENT PANEL PRESENTATIONS AND DISCUSSIONS
3:45 to 4:00 p.m. Settings for Pediatric Obesity Treatment and Research
  Dr. Nancy Krebs, University of Colorado School of Medicine
  • Pediatricians currently have little to offer older children who are already obese. A 2005 US Preventive Services review concluded there were no available interventions to treat pediatric obesity.
    • What is the target population to treat the obese child for weight loss (e.g., BMI level, presence of risk factors)?
    • What treatment settings should we use to treat the obese child (e.g., primary care practices, referral centers, community settings) and what are their implications for research?
    • What treatment interventions should we use for which settings?
4:00 to 4:25 p.m. Discussions
  Moderator: Dr. Katherine Cristoffel, Children’s Hospital, Chicago
4:25 to 4:30 pm Gene-environment interaction
  Dr. Struan Grant, The Children's Hospital of Philadelphia
4:30 to 5:00 pm Summary and Adjourn
  Dr. June Stevens and Dr. Stephen Daniels

Day 2, August 22, 2007

8:00 to 8:30 a.m. Summary of Day 1 activities
  Drs. Stevens and Daniels
8:30 to 8:45 a.m. Behavioral and Lifestyle Interventions to Treat Obese Children
  Dr. Myles Faith, Children’s Hospital, Philadelphia, PA
  • Are there effective behavioral paradigms that should be tested to treat the obese child?
  • Should interventions use individual- and group-level approaches? Family-oriented approaches?
8:45 to 9:10 a.m. Discussions
  All
  Moderator: Dr. Meg Zeller, Cincinnati Children’s Hospital, Cincinnati, Ohio
9:10 to 9:25 a.m.

Pharmacologic Treatment of Childhood Obesity: Best Evidence and Future Directions

  Dr. Robert Berkowitz, University of Pennsylvania
  • Very obese children and adolescents are historically the group most difficult to treat, and some data in adults suggest that drug treatment plus lifestyle change may be the most effective way to achieve sustained weight loss.
    • What pharmacologic agents (prescription or over-the-counter) are promising for weight loss in children and adolescents?
    • What is the target population to consider pharmacologic treatment (e.g., BMI level, presence of risk factors)?
    • Should drug and lifestyle treatment be tested independently?
    • What is the outcome measure?
    • What intervention approaches (e.g., group, individuals) should be used with pharmacologic agents in what settings?
9:25 to 9:50 a.m. Discussions
  All
  Moderator: Dr. Kevin Patrick, University of California, San Diego
9:50 to 10:05 a.m. Surgery and Devices to Treat Extremely Obese Adolescent
  Dr.Thomas Inge, Cincinnati Children’s Hospital
  • Pilot studies of surgical interventions for obesity indicate that these can be accomplished in the pediatric population with excellent weight loss and decrease in weight related co-morbidities.
    • What promising surgical approaches and devices are available, and appropriate for adolescents?
    • What are appropriate study designs that would include bariatric surgery or devices and what is an appropriate control group?
    • Should lifestyle behaviors be included in the intervention?
    • What are the long-term consequences of surgery?
10:05 to 10:30 a.m. Discussions
  All
  Moderator: Dr. Robert Lustig, UCSF
10:30 to 10:45 a.m. Break
10:45 to 11:00 a.m. Design Issues in Pediatric Obesity Treatment
  Dr. Linda Collins, Penn State University
  • Excessive weight gain is usually progressive over time. Success with weight loss interventions may vary with the age and stage of development of the child or adolescent as well as with the degree of obesity.
    • What are the ages, stage of development or degree of obesity that will be optimal for a weight loss lifestyle intervention to treat obesity?
    • What study designs are most promising for weight loss treatment?
    • What are the outcomes we should use?
    • What are the duration of intervention and length of follow-up we should use?
11:00 to 11:25 a.m. Discussions
  All
  Moderator: Dr. Mary Horlick, NIDDK
11:25 to 11:40 a.m. Translational Issues in Pediatric Obesity Treatment Research
  Dr. Brian McCrindle, University of Toronto, Canada
  • What are the key elements of successful pediatric obesity treatment studies?
  • What is the next phase of research to translate successful weight loss treatment approaches to broader or larger populations?
  • What resources are needed to have effective broad-based interventions?
  • What is the sequence for treatment research and its translation?
11:40 to 12:05 a.m. Discussions
  All
  Moderator: Dr. Walter Pories, Brody School of Medicine, East Carolina Univ.
12:05 to 12:35 p.m. Prioritization of Pediatric Obesity Treatment Research
  All
  Moderator: Dr. Stephen Daniels, University of Colorado, School of Medicine
  and Dr. Rae-Ellen Kavey, NHLBI
12:35 to 12:50 p.m. Summary and Adjourn (Day 2)
  Dr. Stephen Daniels, University of Colorado, School of Medicine
  Dr. Peter Kaufmann and Dr. Charlotte Pratt, NHLBI

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March 2008

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