Abstract
Background: Implementing evidence-based recommendations for treating pediatric overweight and obesity is challenging in low-resource settings. We conducted a randomized controlled trial to evaluate the effects of implementing the American Academy of Pediatrics overweight/obesity recommendations using a Standard Care approach alone or with the addition of an enhanced program in a safety-net pediatric primary care setting (located in Bronx, New York, United States). Methods: In a 12-month trial, families of children (age 7-12years; body mass index ≥85th American percentile for age and sex; 74% self-identified as Hispanic/Latino; n=360) were randomly assigned to receive Standard Care Alone or Standard Care + Enhanced Program. An English/Spanish bilingual staff provided the Standard Care Alone consisting of quarterly semi-structured pediatrician visits targeting family-based behavioral changes. The Standard Care + Enhanced Program was enriched with eight Skill-Building Core and monthly Post-Core Support sessions. Results: The mean body mass index Z-score declined in both arms (P<0.01) with no significant difference between the Standard Care Alone (0.12kg [SE: 0.03]) and Standard Care + Enhanced Program (0.15kg [SE: 0.03]) arm (P=0.15). Compared to the Standard Care Alone, the Standard Care + Enhanced Program resulted in significantly greater improvements in total cholesterol (P=0.05), low-density lipoprotein cholesterol (P=0.04), aspartate aminotransferase (P=0.02), and alanine transaminase (P=0.03) concentrations. Conclusions: Safety-net primary care settings can provide efficacious pediatric weight management services. Targeted family-based behavioral counseling helps overweight/obese children achieve a modest body mass index Z-score improvement. A more intensive lifestyle intervention program may improve some metabolic parameters. Trial registration:ClinicalTrials.govIdentifier: NCT00851201. Registered 23 February 2009.
| Original language | English (US) |
|---|---|
| Article number | 12 |
| Journal | International Journal of Behavioral Nutrition and Physical Activity |
| Volume | 15 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 22 2018 |
Fingerprint
Keywords
- Family-based intervention
- Safety net care
- Weight management
ASJC Scopus subject areas
- Medicine (miscellaneous)
- Physical Therapy, Sports Therapy and Rehabilitation
- Nutrition and Dietetics
Cite this
Embedding weight management into safety-net pediatric primary care : Randomized controlled trial. / Wylie-Rosett, Judith; Groisman-Perelstein, Adriana E.; Diamantis, Pamela M.; Jimenez, Camille C.; Viswanathan, Shankar; Conlon, Beth A.; Mossavar-Rahmani, Yasmin; Isasi, Carmen R.; Martin, Sarah N.; Ginsberg, Mindy S.; Matthan, Nirupa R.; Lichtenstein, Alice H.
In: International Journal of Behavioral Nutrition and Physical Activity, Vol. 15, No. 1, 12, 22.01.2018.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Embedding weight management into safety-net pediatric primary care
T2 - Randomized controlled trial
AU - Wylie-Rosett, Judith
AU - Groisman-Perelstein, Adriana E.
AU - Diamantis, Pamela M.
AU - Jimenez, Camille C.
AU - Viswanathan, Shankar
AU - Conlon, Beth A.
AU - Mossavar-Rahmani, Yasmin
AU - Isasi, Carmen R.
AU - Martin, Sarah N.
AU - Ginsberg, Mindy S.
AU - Matthan, Nirupa R.
AU - Lichtenstein, Alice H.
PY - 2018/1/22
Y1 - 2018/1/22
N2 - Background: Implementing evidence-based recommendations for treating pediatric overweight and obesity is challenging in low-resource settings. We conducted a randomized controlled trial to evaluate the effects of implementing the American Academy of Pediatrics overweight/obesity recommendations using a Standard Care approach alone or with the addition of an enhanced program in a safety-net pediatric primary care setting (located in Bronx, New York, United States). Methods: In a 12-month trial, families of children (age 7-12years; body mass index ≥85th American percentile for age and sex; 74% self-identified as Hispanic/Latino; n=360) were randomly assigned to receive Standard Care Alone or Standard Care + Enhanced Program. An English/Spanish bilingual staff provided the Standard Care Alone consisting of quarterly semi-structured pediatrician visits targeting family-based behavioral changes. The Standard Care + Enhanced Program was enriched with eight Skill-Building Core and monthly Post-Core Support sessions. Results: The mean body mass index Z-score declined in both arms (P<0.01) with no significant difference between the Standard Care Alone (0.12kg [SE: 0.03]) and Standard Care + Enhanced Program (0.15kg [SE: 0.03]) arm (P=0.15). Compared to the Standard Care Alone, the Standard Care + Enhanced Program resulted in significantly greater improvements in total cholesterol (P=0.05), low-density lipoprotein cholesterol (P=0.04), aspartate aminotransferase (P=0.02), and alanine transaminase (P=0.03) concentrations. Conclusions: Safety-net primary care settings can provide efficacious pediatric weight management services. Targeted family-based behavioral counseling helps overweight/obese children achieve a modest body mass index Z-score improvement. A more intensive lifestyle intervention program may improve some metabolic parameters. Trial registration:ClinicalTrials.govIdentifier: NCT00851201. Registered 23 February 2009.
AB - Background: Implementing evidence-based recommendations for treating pediatric overweight and obesity is challenging in low-resource settings. We conducted a randomized controlled trial to evaluate the effects of implementing the American Academy of Pediatrics overweight/obesity recommendations using a Standard Care approach alone or with the addition of an enhanced program in a safety-net pediatric primary care setting (located in Bronx, New York, United States). Methods: In a 12-month trial, families of children (age 7-12years; body mass index ≥85th American percentile for age and sex; 74% self-identified as Hispanic/Latino; n=360) were randomly assigned to receive Standard Care Alone or Standard Care + Enhanced Program. An English/Spanish bilingual staff provided the Standard Care Alone consisting of quarterly semi-structured pediatrician visits targeting family-based behavioral changes. The Standard Care + Enhanced Program was enriched with eight Skill-Building Core and monthly Post-Core Support sessions. Results: The mean body mass index Z-score declined in both arms (P<0.01) with no significant difference between the Standard Care Alone (0.12kg [SE: 0.03]) and Standard Care + Enhanced Program (0.15kg [SE: 0.03]) arm (P=0.15). Compared to the Standard Care Alone, the Standard Care + Enhanced Program resulted in significantly greater improvements in total cholesterol (P=0.05), low-density lipoprotein cholesterol (P=0.04), aspartate aminotransferase (P=0.02), and alanine transaminase (P=0.03) concentrations. Conclusions: Safety-net primary care settings can provide efficacious pediatric weight management services. Targeted family-based behavioral counseling helps overweight/obese children achieve a modest body mass index Z-score improvement. A more intensive lifestyle intervention program may improve some metabolic parameters. Trial registration:ClinicalTrials.govIdentifier: NCT00851201. Registered 23 February 2009.
KW - Family-based intervention
KW - Safety net care
KW - Weight management
UR - http://www.scopus.com/inward/record.url?scp=85040863084&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85040863084&partnerID=8YFLogxK
U2 - 10.1186/s12966-017-0639-z
DO - 10.1186/s12966-017-0639-z
M3 - Article
C2 - 29357894
AN - SCOPUS:85040863084
VL - 15
JO - International Journal of Behavioral Nutrition and Physical Activity
JF - International Journal of Behavioral Nutrition and Physical Activity
SN - 1479-5868
IS - 1
M1 - 12
ER -