Comparison of parent-only vs family-based interventions for overweight children in underserved rural settings: outcomes from project STORY

Abstract

Objective: To assess the effectiveness of parent-only vs family-based interventions for pediatric weight management in underserved rural settings.

Design: A 3-arm randomized controlled clinical trial.

Setting: All sessions were conducted at Cooperative Extension Service offices in underserved rural counties.

Participants: Ninety-three overweight or obese children (8-14 years old) and their parent(s).

Intervention: Families were randomized to (1) a behavioral family-based intervention, (2) a behavioral parent-only intervention, or (3) a wait-list control group.

Outcome measure: The primary outcome measure was change in children's standardized body mass index (BMI).

Results: Seventy-one children completed posttreatment (month 4) and follow-up (month 10) assessments. At the month 4 assessment, children in the parent-only intervention demonstrated a greater decrease in BMI z score (mean difference [MD], 0.127; 95% confidence interval [CI], 0.027 to 0.226) than children in the control condition. No significant difference was found between the family-based intervention and the control condition (MD, 0.065; 95% CI, -0.027 to 0.158). At month 10 follow-up, children in the parent-only and family-based intervention groups demonstrated greater decreases in BMI z score from before treatment compared with those in the control group (MD, 0.115; 95% CI, 0.003 to 0.220; and MD, 0.136; 95% CI, 0.018 to 0.254, respectively). No difference was found in weight status change between the parent-only and family-based interventions at either assessment.

Conclusions: A parent-only intervention may be a viable and effective alternative to family-based treatment of childhood overweight. Cooperative Extension Service offices have the potential to serve as effective venues for the dissemination of obesity-related health promotion programs.

Figures

Figure 1

Screening, assessment, and intervention participation in Project STORY. BMI indicates body mass index, and WLC, wait-list control.

Figure 2

Mean change in child body mass index (BMI) z score from pretreatment to posttreatment (month 4). BMI is calculated as weight in kilograms divided by height in meters squared. FB indicates family based; PO, parent only; and WLC, wait-list control. Error bars indicate SD.

Figure 3

Change in child body mass index (BMI) z score from pretreatment to follow-up (month 10). BMI is calculated as weight in kilograms divided by height in meters squared. FB indicates family based; PO, parent only; and WLC, wait-list control. Error bars indicate SD.