Efficacy of a Community- Versus Primary Care-Centered Program for Childhood Obesity: TX CORD RCT

被引:34
作者
Butte, Nancy F. [1 ]
Hoelscher, Deanna M. [2 ]
Barlow, Sarah E. [3 ]
Pont, Stephen [4 ]
Durand, Casey [5 ]
Vandewater, Elizabeth A. [2 ]
Liu, Yan [1 ]
Adolph, Anne L. [1 ]
Perez, Adriana [2 ]
Wilson, Theresa A. [1 ]
Gonzalez, Alejandra [2 ]
Puyau, Maurice R. [1 ]
Sharma, Shreela V. [2 ]
Byrd-Williams, Courtney [2 ]
Oluyomi, Abiodun [2 ]
Huang, Terry [5 ]
Finkelstein, Eric A. [6 ,7 ]
Sacher, Paul M. [8 ]
Kelder, Steven H. [2 ]
机构
[1] Baylor Coll Med, Dept Pediat, Childrens Nutr Res Ctr, USDA ARS, Houston, TX 77030 USA
[2] Univ Texas Hlth Sci Ctr, Sch Publ Hlth, Michael & Susan Dell Ctr Hlth Living, Austin Reg Campus, Austin, TX USA
[3] Univ Texas Southwestern Med Ctr Dallas, GI Practice, Childrens Hlth, Dallas, TX 75390 USA
[4] Univ Texas Austin, Dell Med Sch, Dell Childrens Med Ctr, Texas Ctr Prevent & Treatment Childhood Obes, Austin, TX 78712 USA
[5] CUNY, Ctr Syst & Community Design, Dept Community Hlth & Social Sci, Grad Sch Publ Hlth & Hlth Policy, New York, NY 10021 USA
[6] Duke Univ, Global Hlth Inst, Durham, NC USA
[7] Duke NUS Med Sch, Singapore, Singapore
[8] UCL, Childhood Nutr Res Ctr, London, England
关键词
LIFE-STYLE INTERVENTIONS; BIOELECTRICAL-IMPEDANCE; LOW-INCOME; CHILDREN; METAANALYSIS; OVERWEIGHT; PREVENTION; FAMILIES; DESIGN; BMI;
D O I
10.1002/oby.21929
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
ObjectiveThis 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. MethodsFive hundred forty-nine Hispanic and black children (BMI85th 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). ResultsFor 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). ConclusionsMEND/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.
引用
收藏
页码:1584 / 1593
页数:10
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