Literature DB >> 21464376

Randomized controlled trial to improve primary care to prevent and manage childhood obesity: the High Five for Kids study.

Elsie M Taveras1, Steven L Gortmaker, Katherine H Hohman, Christine M Horan, Ken P Kleinman, Kathleen Mitchell, Sarah Price, Lisa A Prosser, Sheryl L Rifas-Shiman, Matthew W Gillman.   

Abstract

OBJECTIVE: To examine the effectiveness of a primary care-based obesity intervention over the first year (6 intervention contacts) of a planned 2-year study.
DESIGN: Cluster randomized controlled trial.
SETTING: Ten pediatric practices, 5 intervention and 5 usual care. PARTICIPANTS: Four hundred seventy-five children aged 2 to 6 years with body mass index (BMI) in the 95th percentile or higher or 85th to less than 95th percentile if at least 1 parent was overweight; 445 (93%) had 1-year outcomes. INTERVENTION: Intervention practices received primary care restructuring, and families received motivational interviewing by clinicians and educational modules targeting television viewing and fast food and sugar-sweetened beverage intake. OUTCOME MEASURES: Change in BMI and obesity-related behaviors from baseline to 1 year.
RESULTS: Compared with usual care, intervention participants had a smaller, nonsignificant change in BMI (-0.21; 95% confidence interval [CI], -0.50 to 0.07; P = .15), greater decreases in television viewing (-0.36 h/d; 95% CI, -0.64 to -0.09; P = .01), and slightly greater decreases in fast food (-0.16 serving/wk; 95% CI, -0.33 to 0.01; P = .07) and sugar-sweetened beverage (-0.22 serving/d; 95% CI, -0.52 to 0.08; P = .15) intake. In post hoc analyses, we observed significant effects on BMI among girls (-0.38; 95% CI, -0.73 to -0.03; P = .03) but not boys (0.04; 95% CI, -0.55 to 0.63; P = .89) and among participants in households with annual incomes of $50 000 or less (-0.93; 95% CI, -1.60 to -0.25; P = .01) but not in higher-income households (0.02; 95% CI, -0.30 to 0.33; P = .92).
CONCLUSION: After 1 year, the High Five for Kids intervention was effective in reducing television viewing but did not significantly reduce BMI.

Entities:  

Mesh:

Year:  2011        PMID: 21464376      PMCID: PMC3881272          DOI: 10.1001/archpediatrics.2011.44

Source DB:  PubMed          Journal:  Arch Pediatr Adolesc Med        ISSN: 1072-4710


  41 in total

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Authors:  S L Gortmaker; A Must; A M Sobol; K Peterson; G A Colditz; W H Dietz
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10.  Childhood Obesity Evidence Base Project: A Systematic Review and Meta-Analysis of a New Taxonomy of Intervention Components to Improve Weight Status in Children 2-5 Years of Age, 2005-2019.

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