Clinical-Community Interventions for Improving Childhood Obesity

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childhood obesity

A recent study reports that novel intervention methods that incorporate both clinical and community resources improve BMI and family-centered outcomes for childhood obesity.

 

The burden of childhood obesity can never be overstated and even though there has been a decline in its prevalence in the United States, it still has a great impact on families, communities and the country as a whole. Several approaches, clinical and community-based or a combination of both, have been used to combat childhood obesity with varying outcomes. Improvements in obesity related behaviors are affected by social and environmental factors and it is recommended that these factors be considered when designing management strategies.

In a study published in JAMA Pediatrics, Taveras and colleagues (2017) used two intervention methods that leveraged both clinical and community resources to determine their effectiveness in improving childhood obesity. A total of 721 children aged 2- 12 years with body mass index (BMI) measurements classified as overweight or obese were randomized to either an enhanced primary care group in which participants received clinical decision support tools for pediatric weight management, parent educational materials, a Neighborhood Resource Guide, and monthly text messages (n = 361) or an enhanced primary care plus individual health coaching group which included twice-weekly text messages and telephone or video contacts every other month as well as linkage of families to neighborhood resources (n = 360). Outcome data were collected at baseline and 1 year and comprised participants’ BMI, parent reported outcomes of their children’s quality of life and parental resource empowerment.

At 1 year, both groups showed improvement in BMI with 9.3% of children in the enhanced primary care group and 11.6% of children in the enhanced primary care plus coaching group having BMI scores that were below the overweight or obese range. Although the enhanced primary care plus coaching group showed more improvement than the enhanced primary care group, this difference was not statistically significant. To eliminate the possibility that the improvement in both intervention groups could be as a result of an underlying temporal trend towards improvement, trends in participants’ BMI the year prior to enrollment were determined and found to be increasing. While parents reported child’s quality of life in the enhanced health care plus coaching group showed significant improvement compared to those in the enhanced health care group alone, there was no statistical difference in the increase in parental resource empowerment between the two groups.

This study found that both enhanced primary care and enhanced primary care plus coaching resulted in improvements in outcomes of childhood obesity. Although these results reflect a typical primary care setting, they may not be representative of smaller pediatric care practices.

 

Written By: Asonga T. Folefoc

 
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