Treatment outcomes of overweight children and parents in the medical home
Teresa Quattrin, James N Roemmich, Rocco Paluch, Jihnhee Yu, Leonard H Epstein, Michelle A Ecker, Teresa Quattrin, James N Roemmich, Rocco Paluch, Jihnhee Yu, Leonard H Epstein, Michelle A Ecker
Abstract
Objective: To test in the primary care setting the short- and long-term efficacy of a behavioral intervention that simultaneously targeted an overweight child and parent versus an information control (IC) targeting weight control only in the child.
Methods: Two- to 5-year-old children who had BMI ≥85th percentile and an overweight parent (BMI >25 kg/m2) were randomized to Intervention or IC, both receiving diet and activity education over 12 months (13 sessions) followed by 12-month follow-up (3 sessions). Parents in the Intervention group were also targeted for weight control and received behavioral intervention. Pediatricians in 4 practices enrolled their patients with the assistance of embedded recruiters (Practice Enhancement Assistants) who assisted with treatment too.
Results: A total of 96 of the 105 children randomized (Intervention n = 46; IC n = 50) started the program and had data at baseline. Children in the Intervention experienced greater reductions in percent over BMI (group × months; P = .002) and z-BMI (group × months; P < 0.001) compared with IC throughout treatment and follow-up. Greater BMI reduction was observed over time for parents in the Intervention compared with IC (P < .001) throughout treatment and follow-up. Child weight changes were correlated with parent weight changes at 12 and 24 months (r = 0.38 and 0.26; P < .001 and P = .03).
Conclusions: Concurrently targeting preschool-aged overweight and obese youth and their parents in primary care with behavioral intervention results in greater decreases in child percent over BMI, z-BMI, and parent BMI compared with IC. The difference between Intervention and IC persists after 12 months of follow-up.
Trial registration: ClinicalTrials.gov NCT01029834.
Keywords: expert committee recommendations; obesity; overweight; patient centered medical home; percent over BMI; preschool children.
Copyright © 2014 by the American Academy of Pediatrics.
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Source: PubMed