Abstract
Background: Paediatric obesity is a multifaceted public health problem. Family based behavioural interventions are the recommended approach for the prevention of excess weight gain in children and adolescents, yet few have been tested under “real-world” conditions. Objectives: To evaluate the effectiveness of a family based intervention, delivered in coordination with paediatric primary care, on child and family health outcomes. Methods: A sample of 240 families with racially and ethnically diverse (86% non-White) and predominantly low-income children (49% female) ages 6 to 12 years (M = 9.5 years) with body mass index (BMI) ≥85th percentile for age and gender were identified in paediatric primary care. Participants were randomized to either the Family Check-Up 4 Health (FCU4Health) program (N = 141) or usual care plus information (N = 99). FCU4Health, an assessment-driven individually tailored intervention designed to preempt excess weight gain by improving parenting skills was delivered for 6 months in clinic, at home and in the community. Child BMI and body fat were assessed using a bioelectrical impedance scale and caregiver-reported health behaviours (eg, diet, physical activity and family health routines) were obtained at baseline, 3, 6 and 12 months. Results: Change in child BMI and percent body fat did not differ by group assignment. Path analysis indicated significant group differences in child health behaviours at 12 months, mediated by improved family health routines at 6 months. Conclusion: The FCU4Health, delivered in coordination with paediatric primary care, significantly impacted child and family health behaviours that are associated with the development and maintenance of paediatric obesity. BMI did not significantly differ.
| Original language | English (US) |
|---|---|
| Article number | e12780 |
| Journal | Pediatric Obesity |
| Volume | 16 |
| Issue number | 9 |
| DOIs | |
| State | Published - Sep 2021 |
Funding
The authors wish to thank our collaborators on this cooperative agreement in the Division of Nutrition, Physical Activity, and Obesity at the Centers for Disease Control and Prevention (Brook Belay, Heidi Blanck, Carrie Dooyema, Alyson Goodman, Ann O'Connor and Marissa Sucosky); our dedicated project team at Arizona State University (Martha Serrano, Lizeth Alonso, Kasha Blair, Sarah Hidalgo, Sarah Jimmerson, Monique Lopez, Kirsten Letham, Jon Lipfert, Lizette Trejo, Dania Valle and Jenn Yun-Tein), Northwestern University (Ravi Garg and Andrea Graham), the University of Southern California (Victor Martinez Palacios and Nikolaos Flemotomos) and the University of Washington (Angela Klipsch) our partner healthcare agencies; and the many individuals providing guidance and input as members of our community advisory board. This study is supported by grant U18 DP006255 from the National Center for Chronic Disease Prevention and Health Promotion of the Centers of Disease Control and Prevention, under the Childhood Obesity Research Demonstration Project 2.0 (CORD), awarded to Cady Berkel and Justin Smith. Additional support was provided by grant DA027828 from the National Institute on Drug Abuse, awarded to C. Hendricks Brown, and by the Implementation Research Institute (IRI) at the George Warren Brown School of Social Work, Washington University in St. Louis through grant R25 MH080916 from the National Institute of Mental Health and the Department of Veterans Affairs, Health Services Research & Development Service, Quality Enhancement Research Initiative (QUERI). The opinions expressed herein are the views of the authors and do not necessarily reflect the official policy or position of the Centers for Disease Control and Prevention, the Department of Veterans Affairs, the National Institute on Drug Abuse, the National Institute of Mental Health, or any other part of the US Department of Health and Human Services. As this trial was supported by a cooperative agreement with the Division of Nutrition, Physical Activity, and Obesity at the Centers for Disease Control and Prevention, they were involved in some decisions related to the conduct of the study and protocol modifications. However, they were not involved in the collection, management, analysis, or interpretation of the data; or preparation, review, or approval of the manuscript.
Keywords
- coordinated care
- family check-up 4 health
- hybrid effectiveness-implementation design
- paediatric obesity
- primary care
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Health Policy
- Nutrition and Dietetics
- Public Health, Environmental and Occupational Health
