Comparative Effectiveness of Clinical and Community-Based Approaches to Healthy Weight

Details

• Alternative Title:
  Pediatrics
• Personal Author:
  Fiechtner, Lauren ; Perkins, Meghan ; Biggs, Vincent ; Langhans, Nancy ; Sharifi, Mona ; Price, Sarah ; Luo, Man ; Locascio, Joseph J. ; Hohman, Katherine H. ; Hodge, Heather ; Gortmaker, Steven ; Torres, Shioban ; Taveras, Elsie M.
• Description:
  Objectives:
  
  The objective was to evaluate if two, pediatric weight management interventions delivered to Latino, low-income children: one in a health center, the other in a YMCA were effective in reducing Body Mass Index (BMI). We hypothesized that they would be equally effective.
  
  Methods:
  
  Four hundred and seven children ages 6–12 years with a BMI ≥ 85th percentile receiving care at two health centers were randomized to a Healthy Weight Clinic (HWC) at the health center or to a modified Healthy Weight and Your Child (M-HWYC) intervention delivered in YMCAs. Four thousand thirty-seven children receiving care in similar health centers served as the comparison group. First, we completed a non-inferiority test comparing the M-HWYC to the HWC which was supported if the bounds of the 90% CI for the difference in %BMIp95 changes did not contain what we considered a minimally clinically important difference, based on previous data (0.87). Then, using linear mixed models, we assessed yearly changes in BMI among intervention participants compared to comparison sites.
  
  Results:
  
  The mean difference in %BMIp95 between the M-HWYC and the HWC was 0.75 [90% CI: 0.07, 1.43] which did not support non-inferiority. Compared to the comparison sites, per year, children in the HWC had a −0.23 kg/m2 [95% CI: −0.36, −0.10] decrease in BMI and a −1.03 [−1.61, −0.45] %BMIp95 decrease. There was no BMI effect in the M-HWYC.
  
  Conclusions:
  
  We were unable to establish non-inferiority of the M-HWYC. The HWC improved BMI, offering an effective treatment for those disproportionately affected.
  
  Trial Registration:
  
  NCT03012126
  
  
• Subjects:
  Body Mass Index Child Child Health Services Female Health Promotion Hispanic Or Latino Humans Male Pediatric Obesity Poverty Weight Reduction Programs

  More +
• Keywords:
  Childhood Obesity Treatment Community Based Primary Care Randomized Trial
• Source:
  Pediatrics. 148(4)
• Pubmed ID:
  34470816
• Pubmed Central ID:
  PMC8573851
• Document Type:
  Journal Article
• Funding:
  UL1 TR001863/TR/NCATS NIH HHSUnited States/ ; U18 DP006259/DP/NCCDPHP CDC HHSUnited States/ ; K23 HD090222/HD/NICHD NIH HHSUnited States/ ; P30 DK111022/DK/NIDDK NIH HHSUnited States/ ; K08 HS024332/HS/AHRQ HHSUnited States/ ; U18DP006259/ACL/ACL HHSUnited States/ ; K24 DK105989/DK/NIDDK NIH HHSUnited States/
• Volume:
  148
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:572a2535f26c898d16bf2e167de9ee67fb4a5d2614b0ef2afcd14ed6757202993035bcc82782739e4d06a9a1f2f25b15b68dde794f071c2926bb15509fd92662
• Download URL:
  https://stacks.cdc.gov/view/cdc/158054/cdc_158054_DS1.pdf
• File Type:
  [PDF - 915.08 KB ]