Health in overweight children: 2-year follow-up of Finnmark Activity School--a randomised trial

Ane Kokkvoll, Sameline Grimsgaard, Silje Steinsbekk, Trond Flægstad, Inger Njølstad, Ane Kokkvoll, Sameline Grimsgaard, Silje Steinsbekk, Trond Flægstad, Inger Njølstad

Abstract

Objective: To compare a comprehensive lifestyle intervention for overweight children performed in groups of families with a conventional single-family treatment. Two-year follow-up data on anthropometric and psychological outcome are presented.

Design: Overweight and obese children aged 6-12 years with body mass index (BMI) corresponding to ≥27.5 kg/m(2) in adults were randomised to multiple-family (n=48) or single-family intervention (n=49) in a parallel design. Multiple-family intervention comprised an inpatient programme with other families and a multidisciplinary team, follow-up visits in their hometown, weekly physical activity and a family camp. Single-family intervention included counselling by paediatric nurse, paediatric consultant and nutritionist at the hospital and follow-up by a community public health nurse. Primary outcome measures were change in BMI kg/m(2) and BMI SD score after 2 years.

Results: BMI increased by 1.29 kg/m(2) in the multiple-family intervention compared with 2.02 kg/m(2) in the single-family intervention (p=0.075). BMI SD score decreased by 0.20 units in the multiple-family group and 0.08 units in the single-family intervention group (p=0.046). A between-group difference of 2.4 cm in waist circumference (p=0.038) was detected. Pooled data from both treatment groups showed a significant decrease in BMI SD score of 0.14 units and a significant decrease in parent-reported and self-reported Strength and Difficulty Questionnaire total score of 1.9 units.

Conclusions: Two-year outcome showed no between-group difference in BMI. A small between-group effect in BMI SD score and waist circumference favouring multiple-family intervention was detected. Pooled data showed an overall improvement in psychological outcome measures and BMI SD score.

Trial registration number: NCT00872807, http://www.clinicaltrials.gov.

Keywords: Child Psychology; Comm Child Health; Obesity; Outcomes research; School Health.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Figures

Figure 1
Figure 1
Flow of participants* through 24 months of treatment: Finnmark Activity School. *Siblings are not included in the analysis. †Longitudinal analyses include all available data from every subject through withdrawal or study completion.
Figure 2
Figure 2
Body mass index (BMI) kg/m2 and BMI SD score: Finnmark Activity School. Mean (95% CI) changes in body mass index and BMI SD score from baseline to 24 months’ follow-up by intervention group.
Figure 3
Figure 3
Waist circumference: Finnmark Activity School. Mean (95% CI) changes in waist circumference from baseline to 24 months’ follow-up by intervention group.
Figure 4
Figure 4
Parent and self-reported mental health Strengths and Difficulties Questionnaire (SDQ) total score: Finnmark Activity School. Mean (95% CI) changes in SDQ total score from baseline to 24 months’ follow-up by intervention group.

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