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- Title
Prevention of excess weight gain in paediatric primary care: beverages only or multiple lifestyle factors. The Smart Step Study, a cluster-randomized clinical trial.
- Authors
Stettler, N.; Wrotniak, B. H.; Hill, D. L.; Kumanyika, S. K.; Xanthopoulos, M. S.; Nihtianova, S.; Shults, J.; Leff, S. S.; Pinto, A.; Berkowitz, R. I.; Faith, M. S.
- Abstract
Background Insufficient evidence exists to support obesity prevention in paediatric primary care. Objectives To test a theory-based behaviour modification intervention delivered by trained paediatric primary care providers for obesity prevention. Methods Efficacy trial with cluster randomization (practice level) and a 12-session 12-month sweetened beverages decrease intervention or a comprehensive dietary and physical activity intervention, compared with a control intervention among children ages 8-12 years. Results A low recruitment rate was observed. The increase in body mass index z-score ( BMIz) for the 139 subjects (11 practices) randomized to any of the two obesity interventions (combined group) was less than that of the 33 subjects (five practices) randomized to the control intervention (−0.089, 95% confidence interval [ CI]: −0.170 to −0.008, P = 0.03) with a −1.44 kg weight difference (95% CI: −2.98 to +0.10 kg, P = 0.095). The incidences of obesity and excess weight gain were lower in the obesity interventions, but the number of subjects was small. Post hoc analyses comparing the beverage only to the control intervention also showed an intervention benefit on BMIz (−0.083, 95% CI: −0.165 to −0.001, P = 0.048). Conclusions For participating families, an obesity prevention intervention delivered by paediatric primary care clinicians, who are compensated, trained and continuously supported by behavioural specialists, can impact children's BMIz.
- Subjects
UNITED States; PREVENTION of childhood obesity; ACADEMIC medical centers; BEHAVIOR modification; BEVERAGES; CONFIDENCE intervals; LONGITUDINAL method; MEDICAL appointments; PATIENT education; PRIMARY health care; QUESTIONNAIRES; RESEARCH funding; STATISTICS; ADULT education workshops; DATA analysis; BODY mass index; LIFESTYLES; RANDOMIZED controlled trials; DATA analysis software; DESCRIPTIVE statistics
- Publication
Pediatric Obesity, 2015, Vol 10, Issue 4, p267
- ISSN
2047-6302
- Publication type
Article
- DOI
10.1111/ijpo.260