A Trial of an Integrated Clinic-community Intervention in Children and Adolescents With Obesity (Hearts and Parks)

The purpose of this study is to evaluate how different types of physical activity and
nutrition education and support (in addition to normal clinical care) affect children's
health. The investigators will be looking at changes in child BMI, physical activity,
nutrition, and overall health. The investigators also hope to better understand biological
differences in metabolism and the microbiome (the bacteria that grows normally on and in the
body) in children with high BMI who are making lifestyle changes.

Inclusion Criteria:

- Child age 5-18 years

- Child body mass index ≥ 95th %ile

- Parent can speak and read in English or Spanish

- Parent ownership of a device that is able to receive and send text messages

Exclusion Criteria:

- Live farther than a 20-mile radius from the Healthy and Fit program site

- Endogenous or genetic cause of obesity

- Taking a medication that causes weight gain

- Participation in a pediatric weight management program within 12 months

- Parent or child significant health problem that would limit participation

- Enrollment is above the max weekly enrollment of 60 participants/week)

- Reported or planned pregnancy

Opt-out Criteria

• Primary care physician opts patient out of study for reasons including: severe obesity,
urgent co-morbidities, parental unwillingness to be contacted by a research assistant, or
at physician clinical judgment.