Embedding weight management into safety-net pediatric primary care: Randomized controlled trial

Judith Wylie-Rosett, Adriana E. Groisman-Perelstein, Pamela M. Diamantis, Camille C. Jimenez, Shankar Viswanathan, Beth A. Conlon, Yasmin Mossavar-Rahmani, Carmen R. Isasi, Sarah N. Martin, Mindy S. Ginsberg, Nirupa R. Matthan, Alice H. Lichtenstein

Research output: Contribution to journalArticle

1 Citation (Scopus)

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 languageEnglish (US)
Article number12
JournalInternational Journal of Behavioral Nutrition and Physical Activity
Volume15
Issue number1
DOIs
StatePublished - Jan 22 2018

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Safety Management
Primary Health Care
Randomized Controlled Trials
Pediatrics
Weights and Measures
Body Mass Index
Pediatric Obesity
Hispanic Americans
Safety
Standard of Care
Aspartate Aminotransferases
Alanine Transaminase
LDL Cholesterol
Life Style
Counseling
Cholesterol

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 journalArticle

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. / Embedding weight management into safety-net pediatric primary care : Randomized controlled trial. In: International Journal of Behavioral Nutrition and Physical Activity. 2018 ; Vol. 15, No. 1.
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AU - Jimenez, Camille C.

AU - Viswanathan, Shankar

AU - Conlon, Beth A.

AU - Mossavar-Rahmani, Yasmin

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