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 - Shankar, Viswanathan
AU - Conlon, Beth A.
AU - Mossavar-Rahmani, Yasmin
AU - Isasi, Carmen R.
AU - Martin, Sarah N.
AU - Ginsberg, Mindy
AU - Matthan, Nirupa R.
AU - Lichtenstein, Alice H.
N1 - Funding Information:
This study was make possible with funding from the National Institute of Diabetes Digestive and Kidney Diseases (5R18DK075981 and P30DK111022), the National Heart Lung and Blood Institute (5R01HL101236) and National Center for Advancing Translational Sciences (NCATS) Clinical Translation Scientific Award (CTSA) (UL1 TR001073, TL1 TR001072, KL2 TR001071of the National Institutes of Health (NIH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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
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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 -