Objective To assess rates of overweight/obesity and related health behaviors among rural and urban children using data from the National Health and Nutrition Examination Survey (NHANES). Methods Data were drawn from the 2003–2004 and 2005–2006 NHANES surveys regarding demographic characteristics, weight status, dietary behaviors and physical activity behaviors. Results Significantly more rural children were found to be obese than urban children. Health behavior differences to explain this differential obesity rate were primarily not significant, but multivariate analyses indicate that for rural children meeting physical activity recommendations is protective and engaging in more than 2 hr/day of electronic entertainment promotes obesity. Conclusions There are modifiable health behavior differences between rural and urban children which may account for the significantly higher obesity rates among rural children.

Objective The objective of the current study was to examine the effectiveness of a multidisciplinary weekly family-based behavioral group delivered via telemedicine to rural areas, compared with a standard physician visit intervention. Methods A randomized controlled trial was conducted with 58 rural children and their families comparing a family-based behavioral intervention delivered via telemedicine to a structured physician visit condition. Outcome measures included child body mass index z-score (BMIz), 24-hr dietary recalls, accelerometer data, Child Behavior Checklist, Behavioral Pediatrics Feeding Assessment Scale, and feasibility and fidelity. Results Child BMIz outcomes were not statistically different between the 2 groups (F = 0.023, p = .881). Improvements in BMIz, nutrition, and physical activity were seen for both groups. Conclusions Both telemedicine and structured physician visit may be feasible and acceptable methods of delivering pediatric obesity treatment to rural children.

Objective: The objective of the current study was to examine the feasibility of telemedicine vs. telephone for the delivery of a multidisciplinary weekly family-based behavioural group intervention to treat paediatric obesity delivered to families living in rural areas using a randomized controlled trial methodology. Methods: 103 rural children and their families were recruited. Feasibility measures included participant satisfaction, session attendance and retention. Treatment outcome measures included child Body Mass Index z-score (BMIz), parent BMI, 24-hour dietary recalls, accelerometer data, the child behavior checklist and the behavioral pediatrics feeding assessment scale. Results: Participants were highly satisfied with the intervention both via telemedicine and via telephone. Completion rates were much higher than for other paediatric obesity intervention programmes, and both methodologies were highly feasible. There were no differences in telemedicine and telephone groups on primary outcomes. Conclusion: Both telemedicine and telephone intervention appear to be feasible and acceptable methods of delivering paediatric obesity treatment to rural children.