BACKGROUND: Pediatric obesity continues to be a national health crisis. Parents play a critical role in obesity interventions. Digital health interventions, such as personal activity trackers, can help better engage parents in pediatric obesity interventions and improve outcomes. OBJECTIVE: This study aimed to (1) assess the feasibility and acceptability of implementing personal activity trackers as part of a comprehensive family-based lifestyle intervention for pediatric obesity (BodyWorks) in a Federally Qualified Health Center; (2) evaluate the impact of personal activity trackers on parents' engagement, participant anthropometrics, and the overall program; and (3) examine the associations between steps per day and usage (minutes) with body composition outcomes. METHODS: A total of 158 families were randomized to the control (BodyWorks) or intervention (BodyWorks plus physical activity tracker) arm. Mean levels of weight-by-height outcomes, including BMI, BMI z scores, and BMI percent of the 95th percentile, were compared between the 2 groups. RESULTS: There were no differences between study arms at baseline. After adjustment, there was a significant group difference in children's BMI z scores from baseline to the postintervention time point (p for interaction = 0.01). CONCLUSIONS: Families in the intervention group that completed the program had slightly better weight outcomes than the controls. Engaging parents through digital health interventions may be an effective way to enhance existing pediatric obesity intervention programs.

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