Title |
Embedding weight management into safety-net pediatric primary care: randomized controlled trial
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Published in |
International Journal of Behavioral Nutrition and Physical Activity, January 2018
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DOI | 10.1186/s12966-017-0639-z |
Pubmed ID | |
Authors |
Judith Wylie-Rosett, Adriana E. Groisman-Perelstein, Pamela M. Diamantis, Camille C. Jimenez, Viswanathan Shankar, Beth A. Conlon, Yasmin Mossavar-Rahmani, Carmen R. Isasi, Sarah N. Martin, Mindy Ginsberg, Nirupa R. Matthan, Alice H. Lichtenstein |
Abstract |
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). In a 12-month trial, families of children (age 7-12 years; 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. The mean body mass index Z-score declined in both arms (P < 0.01) with no significant difference between the Standard Care Alone (0.12 kg [SE: 0.03]) and Standard Care + Enhanced Program (0.15 kg [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. 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. ClinicalTrials.gov Identifier: NCT00851201 . Registered 23 February 2009. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 2 | 67% |
Ireland | 1 | 33% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 2 | 67% |
Practitioners (doctors, other healthcare professionals) | 1 | 33% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 157 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Bachelor | 21 | 13% |
Student > Master | 18 | 11% |
Researcher | 17 | 11% |
Student > Doctoral Student | 10 | 6% |
Student > Postgraduate | 7 | 4% |
Other | 26 | 17% |
Unknown | 58 | 37% |
Readers by discipline | Count | As % |
---|---|---|
Nursing and Health Professions | 30 | 19% |
Medicine and Dentistry | 28 | 18% |
Social Sciences | 9 | 6% |
Psychology | 7 | 4% |
Biochemistry, Genetics and Molecular Biology | 6 | 4% |
Other | 22 | 14% |
Unknown | 55 | 35% |