Clinical effectiveness of the massachusetts childhood obesity research demonstration initiative among low-income children

Elsie M Taveras, Meghan Perkins, Shikha Anand, Jennifer A Woo Baidal, Candace C Nelson, Neil Kamdar, Jo-Ann Kwass, Steven L Gortmaker, Jessica L Barrett, Kirsten K Davison, Thomas Land, Elsie M Taveras, Meghan Perkins, Shikha Anand, Jennifer A Woo Baidal, Candace C Nelson, Neil Kamdar, Jo-Ann Kwass, Steven L Gortmaker, Jessica L Barrett, Kirsten K Davison, Thomas Land

Abstract

Objective: To examine the extent to which a clinical intervention resulted in reduced BMI z scores among 2- to 12-year-old children compared to routine practice (treatment as usual [TAU]).

Methods: The Massachusetts Childhood Obesity Research Demonstration (MA-CORD) project is a multifaceted initiative to prevent childhood obesity among low-income children. At the federally qualified community health centers (FQHCs) of two communities (Intervention Site #1 and #2), the following were implemented: (1) pediatric weight management training, (2) electronic decision supports for clinicians, (3) on-site Healthy Weight Clinics, (4) community health worker integration, and (5) healthful clinical environment changes. One FQHC in a demographically matched community served as the TAU site. Using electronic health records, we assessed BMI z scores and used linear mixed models to examine BMI z score change over 2 years in each intervention site compared to a TAU site.

Results: Compared to children in the TAU site (n = 2,286), children in Intervention Site #2 (n = 1,368) had a significant decline in BMI z scores following the start of the intervention (-0.16 units/y; 95% confidence interval: -0.21 to -0.12). No evidence of an effect was found in Intervention Site #1 (n = 111).

Conclusions: The MA-CORD clinical interventions were associated with modest improvement in BMI z scores in one of two intervention communities compared to a TAU community.

Trial registration: ClinicalTrials.gov NCT02110615.

Conflict of interest statement

Disclosure: The authors declared no conflict of interest.

© 2017 The Obesity Society.

Figures

Figure 1
Figure 1
Clinical Intervention Components in the MA-CORD Study
Figure 2
Figure 2
Participant Flow for the MA-CORD Clinical Quasi-Experimental Trial

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Source: PubMed

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