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BackgroundDespite the need to identify the causes of disparities in childhood obesity, the existing epidemiologic studies of early life risk factors have several limitations. We report on the construction of the Linked CENTURY database, incorporating CENTURY (Collecting Electronic Nutrition Trajectory Data Using Records of Youth) Study data with birth certificates; and discuss the potential implications of combining clinical and public health data sources in examining the etiology of disparities in childhood obesity.MethodsWe linked the existing CENTURY Study, a database of 269,959 singleton children from birth to age 18 years with measured heights and weights, with each child’s Massachusetts birth certificate, which captures information on their mothers’ pregnancy history and detailed socio-demographic information of both mothers and fathers.ResultsOverall, 74.2 % were matched, resulting in 200,343 children in the Linked CENTURY Study with 1,580,597 well child visits. Among this cohort, 94.0 % (188,334) of children have some father information available on the birth certificate and 60.9 % (121,917) of children have at least one other sibling in the dataset.Using maternal race/ethnicity from the birth certificate as an indicator of children’s race/ethnicity, 75.7 % of children were white, 11.6 % black, 4.6 % Hispanic, and 5.7 % Asian. Based on socio-demographic information from the birth certificate, 20.0 % of mothers were non-US born, 5.9 % smoked during pregnancy, 76.3 % initiated breastfeeding, and 11.0 % of mothers had their delivery paid for by public health insurance. Using clinical data from the CENTURY Study, 22.7 % of children had a weight-for-length ≥ 95th percentile between 1 and 24 months and 12.0 % of children had a body mass index ≥ 95th percentile at ages 5 and 17 years.ConclusionsBy linking routinely-collected data sources, it is possible to address research questions that could not be answered with either source alone. Linkage between a clinical database and each child’s birth certificate has created a unique dataset with nearly complete racial/ethnic and socio-demographic information from both parents, which has the potential to examine the etiology of racial/ethnic and socioeconomic disparities in childhood obesity.

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Background/Aims: Childhood obesity remains a priority issue for the nation and health systems yet little is known about the effectiveness of pediatric obesity prevention interventions overall and evidence is particularly lacking with regard to prevention in clinical settings. Our aim is to discuss process steps in developing two clinical interventions to prevent obesity and their research designs to evaluate effectiveness. Methods: Two interventions were developed, the first to address early childhood obesity prevention among 0-26 month old children and the second to address prevention among children aged 2-9 years, with intentional overlap to coordinate care. A team, comprised of pediatric clinical operations, clinical innovations, research, eHealth, biostatistics, and external university partners, worked collaboratively to develop each intervention and their respective research designs. Results: Each intervention is delivered at scheduled Well Child Visits with consistent components: 1) parent self-reported data to screen for parenting practices, child behaviors, and home environments; 2) parent engagement via screening and risk prioritization; 3) best practice alerts for providers to aid analytical assessment of risk; 4) primary care provider talking points and a SmartSet of parent educational materials; 5) electronic health record progress note construction; and 6) post-visit education. A cluster randomized design is being used to evaluate the effectiveness of both interventions with 6 clinics assigned to the intervention and 6 matched clinics providing standard care. Process outcomes including intervention fidelity and parent engagement are being examined as well as health outcomes. Data are being collected and will be compared to 12-month indicators to evaluate changes in child weight/ length or BMI-for-age and BMI; child behaviors; and parenting practices. Conclusions: A focus on health system goals, a priority health issue, and principles of the learning health care system engaged internal and external entities to leverage resources and successfully develop and implement pediatric obesity prevention interventions. In addition, two pragmatic trials to examine the implementation and effectiveness of the interventions are underway and will contribute to a gap in the evidence base. Participants were 31-to 78-years-old (M = 57), the majority were female (68 %), white (70%), employed, with some college education. Mean HbA1c preintervention was 9.18. Participants showed significant improvement in prepost measures of HbA1c (change .73%, P = .000), overall mental health (Cohen's-d .69, P = .001), stress (Cohen's-d -.76, P = .001), depression (Cohen's-d .62, P = .001), and anxiety (Cohen's-d .66, P = .001). There was also improvement in two measures of diabetes management: Problem Area in Diabetes Questionnaire (Cohen's-d -.71, P = .002) and the Diabetes Empowerment Scale (Cohen's-d .80, P = .000). Conclusions: These results suggest that MBSR may offer a safe and effective method for helping people better manage d...