Outcomes from a Pediatric Primary Care Weight Management Program: Steps to Growing Up Healthy

被引:34
作者
Cloutier, Michelle M. [1 ,2 ]
Wiley, James [2 ]
Huedo-Medina, Tania [3 ]
Ohannessian, Christine McCauley [1 ,2 ]
Grant, Autherene [2 ]
Hernandez, Dominica [4 ]
Gorin, Amy A. [4 ]
机构
[1] Univ Connecticut, Ctr Hlth, Dept Pediat, Farmington, CT 06030 USA
[2] Connecticut Childrens Med Ctr, Childrens Ctr Community Res, Hartford, CT USA
[3] Univ Connecticut, Dept Allied Hlth Sci, Storrs, CT USA
[4] Univ Connecticut, Dept Psychol, Storrs, CT USA
关键词
RANDOMIZED CONTROLLED-TRIAL; SUGAR-SWEETENED BEVERAGES; CHILDHOOD OBESITY; AMERICAN CHILDREN; ENERGY-INTAKE; OVERWEIGHT; PREVALENCE; PREVENTION; 5-YEAR-OLD; ADIPOSITY;
D O I
10.1016/j.jpeds.2015.05.028
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objective To examine the efficacy of Steps to Growing Up Healthy, an obesity prevention intervention in preschool-age, urban-dwelling minority children. Study design Thirty-two pediatric primary care clinicians used a brief (3- to 5-minute) evidence-based behavior change intervention with low-income mothers of children aged 2-4 years during each regularly scheduled clinic visit over a 12-month period to target 4 specific obesogenic behaviors (milk consumption, juice and sugar-sweetened beverage consumption, television/screen time, and physical activity). A written contract, self-monitoring calendar, and telephone follow-up at 5-7 days after the clinic visit reinforced the intervention. Body mass index (BMI) percentile over 12 months and obesogenic behaviors were compared with those of a sex- and age-matched historical control group drawn from the same clinic. Results Between January 2009 and November 2012, 418 mother-child dyads (82% Hispanic and 18% African American; mean child age, 35.8 +/- 8.6 months; 21% overweight and 21% obese children) participated (218 in the control group and 200 in the intervention group). At 12 months, BMI percentile decreased by 0.33 percentile in the intervention group, compared with a mean increase of 8.75 percentile in the control group (P < .001). In participants with an initial BMI <85th percentile, BMI percentile did not change over time in the intervention group but increased in the control group (from the 48th +/- 21 to 63th +/- 29 percentile; P < .01). At 12 months, consumption of juice and milk were decreased in the intervention group (P < .001). Conclusion A brief, evidence-based intervention targeting 4 behaviors, coupled with a written contract and telephone follow-up, decreased the rate of increase in BMI percentile in young children, especially in normal weight children.
引用
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页码:372 / +
页数:7
相关论文
共 38 条
[1]  
[Anonymous], 2013, Applications of motivational interviewing. Motivational interviewing: Helping people change
[2]   Risk factors for overweight in five- to six-year-old Hispanic-American children: A pilot study [J].
Ariza, AJ ;
Chen, EH ;
Binns, HJ ;
Christoffel, KK .
JOURNAL OF URBAN HEALTH-BULLETIN OF THE NEW YORK ACADEMY OF MEDICINE, 2004, 81 (01) :150-161
[3]   Motivational interviewing to improve weight loss in overweight and/or obese patients: a systematic review and meta-analysis of randomized controlled trials [J].
Armstrong, M. J. ;
Mottershead, T. A. ;
Ronksley, P. E. ;
Sigal, R. J. ;
Campbell, T. S. ;
Hemmelgarn, B. R. .
OBESITY REVIEWS, 2011, 12 (09) :709-723
[4]   Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: Summary report [J].
Barlow, Sarah E. .
PEDIATRICS, 2007, 120 :S164-S192
[5]   THE MODERATOR MEDIATOR VARIABLE DISTINCTION IN SOCIAL PSYCHOLOGICAL-RESEARCH - CONCEPTUAL, STRATEGIC, AND STATISTICAL CONSIDERATIONS [J].
BARON, RM ;
KENNY, DA .
JOURNAL OF PERSONALITY AND SOCIAL PSYCHOLOGY, 1986, 51 (06) :1173-1182
[6]   Drowning in a sea of advice: Pediatricians and American Academy of Pediatrics policy statements [J].
Belamarich, Peter F. ;
Gandica, Rachelle ;
Stein, Ruth E. K. ;
Racine, Andrew D. .
PEDIATRICS, 2006, 118 (04) :E964-E978
[7]   The teamlet model of primary care [J].
Bodenheimer, Tbomas ;
Laing, Brian Yoshio .
ANNALS OF FAMILY MEDICINE, 2007, 5 (05) :457-461
[8]  
Bollen K.A., 1990, DIRECT INDIRECT EFFE, V20, P115, DOI DOI 10.2307/271084
[9]  
Chalmers RP, 2012, J STAT SOFTW, V48, P1
[10]   What is the best measure of adiposity change in growing children:: BMI, BMI %, BMI z-score or BMI centile? [J].
Cole, TJ ;
Faith, MS ;
Pietrobelli, A ;
Heo, M .
EUROPEAN JOURNAL OF CLINICAL NUTRITION, 2005, 59 (03) :419-425