Professor in the Department of Nutrition
Professor in the Department of Nutrition
Chief, Division of General Academic Pediatrics
Department of Pediatrics
Mass General Hospital for Children
125 Nashua St, Suite 860
Boston, MA 02114
B.S. (Neuroscience), 1993, New York University
M.D. (Medicine), 1997, New York University School of Medicine
M.P.H. (Clinical Effectiveness), 2003, Harvard School of Public Health
Residency, Boston Medical Center
Fellowship, Children’s Hospital Boston
Chief, Division of General Academic Pediatrics, Mass General Hospital for Children
Executive Director, Kraft Center for Community Health
Conrad Taff Professor of Pediatrics in the Field of Nutrition, Harvard Medical School
Ofer and Shelly Nemirosvsky MGH Research Scholar
- Early life origins of obesity
- Obesity prevention and treatment
- Examining racial/ethnic disparities
- Health services research
I have established a record of scholarship in two areas: 1) epidemiologic analyses of risk factors for childhood obesity across the lifecourse, with an emphasis on examining racial/ethnic disparities and 2) translating epidemiologic evidence into clinical and public health innovations to prevent and manage obesity and its sequelae.
A major focus of my research concerns determinants of childhood obesity throughout the lifecourse. I have published extensively on risk factors for childhood obesity in the pregnancy, infancy, and early childhood periods. These have included several influential studies on infant feeding, maternal-child feeding practices, accelerated infant weight gain, and insufficient sleep. I have also examined early life risk factors and the emergence of racial/ethnic disparities in childhood obesity prevalence. In 2010, I was senior author on a study showing increases in racial/ethnic disparities in severe childhood obesity in the US. In addition, I published a study showing racial/ethnic differences in early life risk factors for childhood obesity which was cited in the White House Task Force Report on Childhood Obesity and selected by the Robert Wood Johnson Foundation as one of the most influential studies of 2010. I currently serve as multiple-PI on the Rise & SHINE (Sleep Health in Infancy & Early Childhood) study, an NIH-funded Birth cohort examining the inter-relationship of sleep, feeding, and growth in infants and toddlers.
A second focus of my research is translating observational epidemiology into clinical and public health innovations to prevent and manage obesity among young children and their families. I have been Principal Investigator of several clinical, home, community, and systems-level intervention studies. In addition to the clinical interventions described above, I have also led (1) The First 1,000 Days program, a maternal-child obesity prevention study seeking to implement a systematic improvement in clinical care for pregnant women and families of infants, and (2) the Clinic & Community Approaches to Healthy Weight study, a two-arm randomized controlled trial comparing the effectiveness of two intensive (26+ contact hours) weight management programs for 6-12 year old children with overweight or obesity- one based in the clinical setting and one based at a local YMCA. In recent years my work has focused more on the dissemination and implementation of evidence-informed clinical-community studies that use multi-stakeholder engagement strategies to accelerate the adoption of evidence into practice.
Connect for Health
Connect for Health is a clinical-community intervention to manage overweight and obesity among children ages 2-12 years. Intervention strategies include clinical decision support tools in the electronic health record enhanced with provider training, social- and community-informed text message support for parents, and family educational materials. The original Connect for Health trial was funded by PCORI and showed improvement in child BMI and family-centered outcomes over the one-year study period, with BMI maintenance over two years. Following the results of the trial, Connect for Health was implemented across all 16 Atrius Health practices in eastern Massachusetts. Now with support from PCORI and the NIH, Connect for Health is being widely disseminated across additional practices in Massachusetts, Colorado and South Carolina, specifically targeting pediatric primary care practices that serve low‐income children who have a disproportionately high prevalence of childhood obesity. These studies will evaluate the effectiveness of the implementation and dissemination.
First 1,000 Days
The First 1,000 Days program is a maternal-child obesity prevention program funded by The Boston Foundation. The program begins in pregnancy and follows families through the child’s first two years of life. The program uses a Collective Impact approach to create the infrastructure for sustained, system-wide changes for obesity prevention across early life clinical and public health services. Program components include: 1) staff and provider training; 2) enhanced gestational weight gain and infant overweight tracking; 3) universal screening of adverse health behaviors and socio-contextual factors; 4) universal patient navigation to support individual behavior change and social needs; 5) individualized health coaching for mother-infant pairs at high risk of obesity; and 6) educational materials to support behavior change. First 1,000 Days was implemented in the MGH Chelsea and Revere HealthCare Centers, and DotHouse Health. We are actively seeking funding to develop a toolkit to assist other health centers in implementing the program, and to develop an implementation science center to support the spread and adoption of this and other early-life evidence-based programming.
Funded by the Maternal Child Health Bureau (MCHB), First Heroes is an expansion of the First 1,000 Days program, specifically targeting fathers. This intervention will incorporate and repackage the intervention for new fathers in health centers across Boston to strengthen fathers’ engagement in pregnancy and parenting as a potential strategy for reducing health disparities. The program will focus on behavioral factors associated with obesity such as nutrition, sleep, physical activity, as well as socio-economic supports that are critical to family health. The goals of the program are to: 1) improve perinatal outcomes including infant and parental weight status; 2) reduce prevalence of modifiable obesity-related risk factors and social determinants of health and; 3) close the gap in health disparities. First Heroes is a randomized controlled trial and will evaluate the effectiveness of the intervention compared to an enhanced usual care arm.
Connect for Healthy Weight Pediatric Weight Management Intervention
Connect for Healthy Weight is a CDC-funded dissemination study seeking to package, pilot, and disseminate evidence-based intervention components for low-resource settings. Intervention components are based on the Connect for Health and Clinic & Community Approaches to Healthy Weight studies. MGH is partnering with the American Academy of Pediatrics to package and pilot test the intervention in two FQHCs in rural Mississippi to inform scalability and sustainability. At the end of the grant (2024) we expect to have a publicly available package to facilitate the spread and adoption of a proven-effective weight management intervention among FQHCs.