Embedding weight management into safety-net pediatric primary care: randomized controlled trial

摘要

BackgroundImplementing 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). MethodsIn 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. ResultsThe mean body mass index Z-score declined in both arms ( P ConclusionsSafety-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.gov Identifier: NCT00851201 . Registered 23 February 2009.