Family-Based Behavioral Treatment for Childhood Obesity Adapted to Align with the MOHealthNet Medicaid Benefit: Results of the Missouri Childhood Obesity Research Demonstration Study.

Creator(s)

• Meredith Dreyer, Children's Mercy Kansas CityFollow
• Alyssa M. Button
• Amanda E. Staiano
• Lisa C. Nelson
• Jordan A. Carlson, Children's Mercy HospitalFollow
• Kelsey Dean, Children's Mercy HospitalFollow
• Sarah E. Bullard
• Lawrence T. Monocello
• Robbie Beyl
• R Robinson Welch
• Sarah Hampl, Children's Mercy Kansas CityFollow
• Denise E. Wilfley
• MO CORD Research Group

Document Type

Article

Publication Date

6-2026

Identifier

DOI: 10.1177/21532176261450310

Abstract

BACKGROUND: This study leveraged a novel Missouri Medicaid (MOHealthNet) benefit to adapt and implement evidence-based family-based behavioral treatment (FBT) within health care settings in alignment with policy requirements.

METHODS: In a nonrandomized matched-comparison trial, 108 parent-child dyads participated in FBT, and 92 dyads attended at least one session. Licensed Clinical Social Workers or Registered Dietitian Nutritionists offered 26-33 FBT hours delivered virtually over 6-12 months to Medicaid-insured patients in an urban and rural pediatric health system in Missouri. The matched-comparison group included 186 participants. The Reach, Effectiveness, Adoption, Implementation, and Maintenance framework (RE-AIM) framework was used to evaluate effectiveness (primary) and reach (secondary) and explore adoption, implementation, and maintenance.

RESULTS: Children in the FBT group reduced their percent over median body mass index (BMI) compared with the matched comparison group (mean reduction: -3.9 ± 1.4, d = -0.42). Within the FBT group, participants also demonstrated improvements in coping with teasing, health-related quality of life, and family health habits (all p < 0.05). Families rated the program as highly acceptable. Reach data indicated enrolled patients had similar BMI, sex, and ethnic backgrounds compared with eligible but non-enrolled patients (ps > 0.301).

CONCLUSIONS: Data demonstrate the feasibility of adopting and implementing FBT within health care systems and inform efforts to support maintenance. FBT reached a diverse population of families receiving Medicaid in pediatric primary care settings and was associated with greater improvements in youth weight outcomes compared with a matched comparison group. Adaptations made to align with the benefit may have reduced the magnitude of effects; however, this policy provides an opportunity to deliver FBT within primary care settings and expand access.

Journal Title

Child Obes

Volume

22

Issue

4

First Page

211

Last Page

222

MeSH Keywords

Humans; Medicaid; Female; Male; Missouri; United States; Child; Pediatric Obesity; Behavior Therapy; Family Therapy; Adolescent

PubMed ID

42261973

Keywords

Medicaid; adoption; behavioral health; family-based treatment; obesity treatment; reach

Recommended Citation

Dreyer Gillette ML, Button AM, Staiano AE, et al. Family-Based Behavioral Treatment for Childhood Obesity Adapted to Align with the MOHealthNet Medicaid Benefit: Results of the Missouri Childhood Obesity Research Demonstration Study. Child Obes. 2026;22(4):211-222. doi:10.1177/21532176261450310