Automated telephone counseling for parents of overweight children: a randomized controlled trial.

摘要

BACKGROUND: Interactive technologies have the potential to increase the reach and frequency of practical clinical interventions that assist the parents of overweight and at-risk children to promote healthy lifestyle behaviors for their families. DESIGN: A practical RCT evaluated the relative effectiveness of three interventions to support parents of overweight or at-risk children to change the home environment to foster more healthful child eating and activity behaviors, thereby reducing child BMI and BMI z-scores. A secondary purpose was to determine the patterns of use and potential dose effect for the highest-intensity intervention. SETTING/PARTICIPANTS: Parent-and-child (aged 8-12 years) dyads (N=220) who received care from Kaiser Permanente Colorado were assigned randomly to one of the three Family Connections (FC) interventions: FC-workbook, FC-group, or FC-interactive voice response (IVR) counseling. MAIN OUTCOME MEASURES: Child BMI z-scores, as well as symptoms of eating disorders and body image, were assessed at baseline, 6 months, and 12 months. RESULTS: The BMI z-scores of children assigned to the FC-IVR intervention were the only ones that decreased from baseline to 6 months (0.07 SD) and from baseline to 12 months (0.08 SD, p<0.05). Children whose parents completed at least six of the ten FC-IVR counseling calls had decreased BMI z-scores to a greater extent than children in the FC-workbook or FC-group interventions at both 6 months (p<0.05) and 12 months (p<0.01). No intervention increased child symptoms of eating disorders or body dissatisfaction at any time point. CONCLUSIONS: This trial demonstrated that automated telephone counseling can support the parents of overweight children to reduce the extent to which their children are overweight. TRIAL REGISTRATION: NCT00433901.