Co-Fam project

National guidelines recommend combined lifestyle treatment and family support for younger children and their parents in case of an unhealthy lifestyle and obesity, but evidence-based family support programs are lacking in Sweden for children aged 6-12 years. 

The Co-Fam model combines two evidence-based programs: The universal family support program “A Healthy School Start” provided to all families with children starting school and the targeted parental support program “More and Less” consisting of parental support through group sessions to parents of children with unhealthy behaviours, overweight or obesity. The More and Less program will be adapted to the age group 6-12 years. The goal of Co-Fam is that all children and their parents receive adequate and effective care, thereby, in the long term, decreasing the prevalence of chronic diseases.

The aims of the study are:  

1. To co-design a coherent model of family support for families with children 6-12 years, including universal and targeted components.   
2. Evaluate the Co-Fam model in a randomized controlled trial with outcomes at the individual level, and fidelity and cost at the organizational level.   
3. Explore acceptability and feasibility of the Co-Fam model through interviews with health professionals and parents. 

How will the Co-Fam model be developed?  

The Co-Fam model has been developed through a co-design process including school health care, primary and specialist health care, and parents to ensure that the model suits the needs of all stakeholders. The health care staff and end users (parents) have co-designed processes such as referral criteria, the content of the More and Less program to children aged 6-12 years, follow-up support for families after the More and Less program, as well as how the model can avoid stigmatization of children with a high BMI. 

How will Co-fam be evaluated? 

The model is currently being evaluated in a randomized controlled trial that examines both effectiveness and implementation in a hybrid type 2 study. The program theory with outcomes at the individual- and organization level will be described in a study protocol (to be published).     

Funding 

This project has received funding from the Swedish Heart and Lung Foundation, Norheds Foundation and the Swedish Research Council during the period 2024-2028.  

Recruitment to the Co-Fam study

The study will run from 2025–2027 in Södertälje municipality, where all municipal schools are currently implementing A Healthy School Start during grade 1. Parents who have children with overweight or obesity aged 6–12 years who want support in improving their lifestyle habits are recruited primarily through the school's student health service.

Participants will be randomly assigned to one of two groups:

1. More and Less: A parental support program with 10 group meetings over 10 weeks (digitally or on-site). It discusses everyday situations around food, sedentary lifestyles, routines and conflicts. The group meetings are followed up with phone calls every 6 weeks for a year.
2. Standard treatment for overweight/obesity: Meetings with healthcare personnel on at least 3 occasions during 12 months where an individual treatment plan is developed.