By Esha Dhawan
Stanford Children’s Health is developing a new virtual curriculum intended to make its weight-control program accessible to individuals and families outside of the Stanford community.
In its current form, the Pediatric Weight Control Program, developed over 20 years ago, uses behavioral interventions to address childhood obesity by helping families create balanced diet plans and focus on exercise habits. The program functions over a six-month period that involves 90-minute weekly visits by both the parent and child in a group setting and 20-minute personalized sessions with behavior coaches every six to seven weeks.
The program has helped over 80% of participants reach a healthier weight. But the program and many others like it tend to exist only at academic medical centers, which are often not widely accessible to low-income populations.
“Unless you’re lucky enough to live near one of these programs, the whole rest of the country doesn’t have access to care like this,” said project leader Thomas Robinson ’83 M.D. ’88, a professor of pediatrics and medicine at the Stanford School of Medicine.
Children and teenagers from low-income populations are the most likely to be affected by obesity, studies have shown. Overall, pediatric obesity rates have tripled over the last 50 years. Driven largely by social problems, obesity has serious medical consequences, serving as a risk factor for diabetes, early heart disease and even cancer.
“The current CDC estimates are that one in three of today’s young adults who were born in the first decade of the 2000s will have type-two diabetes in their lifetime,” Robinson said.
The new curriculum is funded by a five-year grant by the CDC’s Childhood Obesity Research Demonstration Project 3.0.
Although its release date has not been determined, Robinson projects that the curriculum will not be available for several years. The first two years will involve further development and the creation of materials. The third year will involve beta testing of varying prototype lessons, and the fourth and fifth years will involve implementation trials with partner clinics and providers.
The curriculum aims to make the program deliverable by any instructor, ranging from pediatricians to employers to the YMCA. While its business model is still in development, Stanford Children’s Health intends for a health educator to deliver the weight-control program in a group setting, in order to preserve the credibility that comes from hearing another family speak about their experience with weight loss.
The program will include online materials to help educators deliver the program, and will likely incorporate certification to train educators. According to Robinson, additional education has been a huge barrier to extending weight-control programs in the past because instructors are less likely to incorporate parts of the curriculum with which they have the least experience or feel the least comfortable.
Another barrier that this new curriculum seeks to address is the lack of consistency among insurance companies in covering obesity treatment for children. In its current form at Stanford Children’s Health Menlo Park location, the lack of coverage by insurance companies means that the Pediatric Weight Control Program has functioned largely through grants to serve families who need financial assistance, according to Robinson.
The program’s organizers took inspiration from Silicon Valley to address these obstacles and learn how to scale a program like this one to a greater level.
“When you’re developing the program, you’re thinking about your children and families as your customers,” Robinson said. “Whereas if you’re thinking from a scaling perspective, your customer is the person who’s going to purchase it from or deliver it to you.”
The program has been licensed by the startup Kurbo, which is using much of the program’s content in a direct-to-consumer program over apps and video calls. Kurbo was acquired by WW (previously known as Weight Watchers) and offers guidance directly to consumers through food choices that are categorized as “red,” “yellow” and “green,” measurement tracking and optional live coaching.
For the online curriculum delivered by Stanford Children’s Health, though, the group format of the weight-control program will remain an integral part of how it functions.
“There’s something special about the group, because you get support from the other members of the group,” Robinson said. “You’re not just dealing with an expert or someone who has all the answers — you’re dealing with other families.”
Robinson hopes that the online curriculum will be as effective as the current face-to-face program. The challenge is that a large part of the effectiveness of the program will rely on how motivated the group leader or educator is in its implementation, but the online curriculum has the advantage that technology makes data collection easier than in the program’s current face-to-face form.
Once the program is created, Robinson says there’s no limit to where Stanford Children’s Health wants it to go.
“We’d love to have it available anywhere in the country and probably most parts of the world,” Robinson said. “At this point, English and Spanish is our goal, but there’s no reason this program couldn’t go beyond the U.S.”