{
  "abstract": "Importance: Childhood obesity remains a major concern in the US, with increases in body mass index (BMI) observed during and after the COVID-19 pandemic. Scalable behavioral interventions are needed to support obesity prevention in community settings.\n\nObjective: To evaluate the efficacy of a community-based behavioral intervention (H ₂ GO!) on BMI z scores ( z BMIs) among school-aged children.\n\nDesign, Setting, and Participants: This cluster randomized clinical trial was conducted from September 2020 to June 2025 across 11 Boys & Girls Club sites in Massachusetts. Sites were pair-matched and randomized to intervention or usual care condition. Participants included children aged 8 to 13 years and their parents or caregivers.\n\nIntervention: Twelve group-based sessions delivered in person over 6 weeks by trained Boys & Girls Club staff using behavioral strategies to reduce sugar-sweetened beverage intake and increase water consumption through health sessions, youth-created narratives, and parent-child activities. Comparison sites received usual programming.\n\nMain Outcomes and Measures: Outcomes were assessed at baseline and at 2, 6, and 12 months using intention-to-treat analyses. The primary outcome was 12-month change from baseline in child z BMI, derived from staff-measured height and weight using standardized protocols. Secondary outcomes included child sugar-sweetened beverage and water intake measured using a validated questionnaire.\n\nResults: Among 437 child participants (mean [SD] age, 10.1 [1.2] years; 219 girls [50.1%]), 0.2% were American Indian or Alaska Native, 1.8% were Asian, 15.8% were Black or African American, 42.6% were Hispanic or Latino, and 29.5% were White; 297 (68%) were eligible for free or reduced-price lunch. At baseline, 74 children (16.9%) had overweight, and 161 (36.8%) had obesity. From baseline to 12 months, the mean z BMI did not statistically significantly decrease (−0.11 [95% CI, –0.25 to 0.02]) in the intervention group and did not statistically significantly increase (0.08 [95% CI, –0.04 to 0.20]) in the comparison group; however, the estimated between-group difference in the adjusted mean z BMI change from baseline was statistically significant: −0.19 (95% CI, −0.38 to −0.01; P = .04). Between-group differences in sugar-sweetened beverage and water intake were not significant.\n\nConclusions and Relevance: In this cluster randomized clinical trial, a community-based behavioral intervention was associated with a statistically significant between-group difference in z BMI change among school-aged children. Findings support the potential of community-based behavioral interventions in obesity prevention.\n\nTrial Registration: ClinicalTrials.gov Identifier: NCT04265794",
  "abstract_shown": true,
  "affiliations": [
    "Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts",
    "Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts",
    "Department of Psychiatry, Boston Medical Center, Boston, Massachusetts",
    "Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts",
    "Department of Medicine, University of Connecticut School of Social Work, Hartford",
    "Massachusetts Alliance of Boys & Girls Clubs, Ludlow",
    "Center for Health Data Science, Boston University School of Public Health, Boston, Massachusetts",
    "Department of Population and Quantitative Health Sciences, University of Massachusetts T.H. Chan School of Medicine, Worcester"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Monica L. Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Selenne Alatorre"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Aviva G. Schwarz"
    },
    {
      "affs": [
        3
      ],
      "name": "Janice Weinberg"
    },
    {
      "affs": [
        4
      ],
      "name": "Linda Sprague Martinez"
    },
    {
      "affs": [
        5
      ],
      "name": "Jennifer Aldworth"
    },
    {
      "affs": [
        6
      ],
      "name": "Rabindra Kadel"
    },
    {
      "affs": [
        7
      ],
      "name": "Milagros C. Rosal"
    },
    {
      "affs": [
        7
      ],
      "name": "Stephenie C. Lemon"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6x4t8vgg3x100.bib",
  "cited_by": 0,
  "doi": "10.1001/jamanetworkopen.2026.38188",
  "fulltext_url": null,
  "id": "6x4t8vgg3x100",
  "issns": [
    "2574-3805"
  ],
  "landing_url": "https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2855120",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2739|Obesity, Physical Activity, Diet"
    ]
  ],
  "openalex": "W7221087705",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-09",
  "publisher": "American Medical Association (AMA)",
  "ris": "https://research.draconitic.com/paper/6x4t8vgg3x100.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:46Z",
      "native_id": "10.1001/jamanetworkopen.2026.38188",
      "source": "crossref",
      "url": "https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2855120"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2739|Obesity, Physical Activity, Diet",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "A Community-Based Behavioral Intervention and Body Mass Index in School-Aged Children",
  "title_text": "A Community-Based Behavioral Intervention and Body Mass Index in School-Aged Children",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:46Z",
  "url": "https://research.draconitic.com/paper/6x4t8vgg3x100",
  "venue": "JAMA Network Open",
  "versions": []
}