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- Title
Efficacy of a Community- Versus Primary Care-Centered Program for Childhood Obesity: TX CORD RCT.
- Authors
Butte, Nancy F.; Hoelscher, Deanna M.; Barlow, Sarah E.; Pont, Stephen; Durand, Casey; Vandewater, Elizabeth A.; Liu, Yan; Adolph, Anne L.; Pérez, Adriana; Wilson, Theresa A.; Gonzalez, Alejandra; Puyau, Maurice R.; Sharma, Shreela V.; Byrd‐Williams, Courtney; Oluyomi, Abiodun; Huang, Terry; Finkelstein, Eric A.; Sacher, Paul M.; Kelder, Steven H.
- Abstract
<bold>Objective: </bold>This randomized controlled trial was conducted to determine comparative efficacy of a 12-month community-centered weight management program (MEND2-5 for ages 2-5 or MEND/CATCH6-12 for ages 6-12) against a primary care-centered program (Next Steps) in low-income children.<bold>Methods: </bold>Five hundred forty-nine Hispanic and black children (BMI ≥ 85th percentile), stratified by age groups (2-5, 6-8, and 9-12 years), were randomly assigned to MEND2-5 (27 contact hours)/MEND/CATCH6-12 (121.5 contact hours) or Next Steps (8 contact hours). Primary (BMI value at the 95th percentile [%BMIp95 ]) and secondary outcomes were measured at baseline, 3 months (Intensive Phase), and 12 months (Transition Phase).<bold>Results: </bold>For age group 6-8, MEND/CATCH6-12 resulted in greater improvement in %BMIp95 than Next Steps during the Intensive Phase. Effect size (95% CI) was -1.94 (-3.88, -0.01) percentage points (P = 0.05). For age group 9-12, effect size was -1.38 (-2.87, 0.16) percentage points for %BMIp95 (P = 0.07). MEND2-5 did not differentially affect %BMIp95 . Attendance averaged 52% and 22% during the Intensive and Transition Phases. Intervention compliance was inversely correlated to change in %BMIp95 during the Intensive Phase (P < 0.05). In the Transition Phase, %BMIp95 was maintained or rebounded in both programs (P < 0.05).<bold>Conclusions: </bold>MEND/CATCH6-12 was more efficacious for BMI reduction at 3 months but not 12 months compared to Next Steps in underserved children. Intervention compliance influenced outcomes, emphasizing the need for research in sustaining family engagement in low-income populations.
- Subjects
TREATMENT of childhood obesity; PRIMARY care; HEALTH programs; REGULATION of body weight; BODY mass index; COMMUNITY health services; COMPARATIVE studies; INFORMATION services; RESEARCH methodology; MEDICAL cooperation; PRIMARY health care; RESEARCH; EVALUATION research; RANDOMIZED controlled trials
- Publication
Obesity (19307381), 2017, Vol 25, Issue 9, p1584
- ISSN
1930-7381
- Publication type
journal article
- DOI
10.1002/oby.21929