OBJECTIVES: To reduce gain in body mass index (BMI) in overweight/mildly obese children in the primary care setting. DESIGN: Randomized controlled trial (RCT) nested within a baseline cross-sectional BMI survey. SETTING: Twenty nine general practices, Melbourne, Australia. PARTICIPANTS: (1) BMI survey: 2112 children visiting their general practitioner (GP) April-December 2002; (2) RCT: individually randomized overweight/mildly obese (BMI z-score <3.0) children aged 5 years 0 months-9 years 11 months (82 intervention, 81 control). INTERVENTION: Four standard GP consultations over 12 weeks, targeting change in nutrition, physical activity and sedentary behaviour, supported by purpose-designed family materials. MAIN OUTCOME MEASURES: Primary: BMI at 9 and 15 months post-randomization. Secondary: Parent-reported child nutrition, physical activity and health status; child-reported health status, body satisfaction and appearance/self-worth. RESULTS: Attrition was 10%. The adjusted mean difference (intervention-control) in BMI was -0.2 kg/m(2) (95% CI: -0.6 to 0.1; P=0.25) at 9 months and -0.0 kg/m(2) (95% CI: -0.5 to 0.5; P=1.00) at 15 months. There was a relative improvement in nutrition scores in the intervention arm at both 9 and 15 months. There was weak evidence of an increase in daily physical activity in the intervention arm. Health status and body image were similar in the trial arms. CONCLUSIONS: This intervention did not result in a sustained BMI reduction, despite the improvement in parent-reported nutrition. Brief individualized solution-focused approaches may not be an effective approach to childhood overweight. Alternatively, this intervention may not have been intensive enough or the GP training may have been insufficient; however, increasing either would have significant cost and resource implications at a population level.
RCT Entities:
OBJECTIVES: To reduce gain in body mass index (BMI) in overweight/mildly obesechildren in the primary care setting. DESIGN: Randomized controlled trial (RCT) nested within a baseline cross-sectional BMI survey. SETTING: Twenty nine general practices, Melbourne, Australia. PARTICIPANTS: (1) BMI survey: 2112 children visiting their general practitioner (GP) April-December 2002; (2) RCT: individually randomized overweight/mildly obese (BMI z-score <3.0) children aged 5 years 0 months-9 years 11 months (82 intervention, 81 control). INTERVENTION: Four standard GP consultations over 12 weeks, targeting change in nutrition, physical activity and sedentary behaviour, supported by purpose-designed family materials. MAIN OUTCOME MEASURES: Primary: BMI at 9 and 15 months post-randomization. Secondary: Parent-reported child nutrition, physical activity and health status; child-reported health status, body satisfaction and appearance/self-worth. RESULTS: Attrition was 10%. The adjusted mean difference (intervention-control) in BMI was -0.2 kg/m(2) (95% CI: -0.6 to 0.1; P=0.25) at 9 months and -0.0 kg/m(2) (95% CI: -0.5 to 0.5; P=1.00) at 15 months. There was a relative improvement in nutrition scores in the intervention arm at both 9 and 15 months. There was weak evidence of an increase in daily physical activity in the intervention arm. Health status and body image were similar in the trial arms. CONCLUSIONS: This intervention did not result in a sustained BMI reduction, despite the improvement in parent-reported nutrition. Brief individualized solution-focused approaches may not be an effective approach to childhood overweight. Alternatively, this intervention may not have been intensive enough or the GP training may have been insufficient; however, increasing either would have significant cost and resource implications at a population level.
Authors: Mona Sharifi; Calvin Franz; Christine M Horan; Catherine M Giles; Michael W Long; Zachary J Ward; Stephen C Resch; Richard Marshall; Steven L Gortmaker; Elsie M Taveras Journal: Pediatrics Date: 2017-11 Impact factor: 7.124
Authors: N Stettler; B H Wrotniak; D L Hill; S K Kumanyika; M S Xanthopoulos; S Nihtianova; J Shults; S S Leff; A Pinto; R I Berkowitz; M S Faith Journal: Pediatr Obes Date: 2014-09-24 Impact factor: 4.000
Authors: Lisa M Klesges; Natalie A Williams; Kara S Davis; Joanna Buscemi; Katherine M Kitzmann Journal: Am J Prev Med Date: 2012-02 Impact factor: 5.043
Authors: Kristine A Madsen; Hannah R Thompson; Lidya Wlasiuk; Emily Queliza; Colin Schmidt; Thomas B Newman Journal: J Child Health Care Date: 2009-10-15 Impact factor: 1.979
Authors: Melissa Wake; Louise A Baur; Bibi Gerner; Kay Gibbons; Lisa Gold; Jane Gunn; Penny Levickis; Zoë McCallum; Geraldine Naughton; Lena Sanci; Obioha C Ukoumunne Journal: BMJ Date: 2009-09-03