Jessica Hoffman1, Leah Frerichs2, Mary Story3, Jason Jones4, Kiah Gaskin5, Annie Apple5, Asheley Skinner6, Sarah Armstrong5. 1. School of Medicine, jessica.hoffman@duke.edu. 2. Center for Health Equity Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and. 3. Global Health Institute. 4. Durham Parks and Recreation, Durham, North Carolina. 5. Department of Pediatrics, and. 6. Clinical Research Institute, Duke University, Durham, North Carolina.
Abstract
BACKGROUND AND OBJECTIVES: Effective treatment of childhood obesity remains elusive. Integration of clinical and community systems may achieve effective and sustainable treatment. However, the feasibility and effectiveness of this integrated model are unknown. METHODS: We conducted a randomized clinical trial among children aged 5 to 11 presenting for obesity treatment. We randomized participants to clinical care or clinical care plus community-based programming at a local parks and recreation facility. Primary outcomes were the change in child BMI at 6 months and the intensity of the program in treatment hours. Secondary outcomes included health behaviors, fitness, attrition, and quality of life. RESULTS: We enrolled 97 children with obesity, and retention at 6 months was 70%. Participants had a mean age of 9.1 years and a mean baseline BMI z score of 2.28, and 70% were living in poverty. Intervention participants achieved more treatment hours than controls (11.4 vs 4.4, SD: 15.3 and 1.6, respectively). We did not observe differences in child BMI z score or percent of the 95th percentile at 6 months. Intervention participants had significantly greater improvements in physical activity (P = .010) and quality of life (P = .008). CONCLUSIONS: An integrated clinic-community model of child obesity treatment is feasible to deliver in a low-income and racially diverse population. As compared with multidisciplinary treatment, the integrated model provides more treatment hours, improves physical activity, and increases quality of life. Parks and recreation departments hold significant promise as a partner agency to deliver child obesity treatment.
RCT Entities:
BACKGROUND AND OBJECTIVES: Effective treatment of childhood obesity remains elusive. Integration of clinical and community systems may achieve effective and sustainable treatment. However, the feasibility and effectiveness of this integrated model are unknown. METHODS: We conducted a randomized clinical trial among children aged 5 to 11 presenting for obesity treatment. We randomized participants to clinical care or clinical care plus community-based programming at a local parks and recreation facility. Primary outcomes were the change in child BMI at 6 months and the intensity of the program in treatment hours. Secondary outcomes included health behaviors, fitness, attrition, and quality of life. RESULTS: We enrolled 97 children with obesity, and retention at 6 months was 70%. Participants had a mean age of 9.1 years and a mean baseline BMI z score of 2.28, and 70% were living in poverty. Intervention participants achieved more treatment hours than controls (11.4 vs 4.4, SD: 15.3 and 1.6, respectively). We did not observe differences in child BMI z score or percent of the 95th percentile at 6 months. Intervention participants had significantly greater improvements in physical activity (P = .010) and quality of life (P = .008). CONCLUSIONS: An integrated clinic-community model of childobesity treatment is feasible to deliver in a low-income and racially diverse population. As compared with multidisciplinary treatment, the integrated model provides more treatment hours, improves physical activity, and increases quality of life. Parks and recreation departments hold significant promise as a partner agency to deliver childobesity treatment.
Authors: Robert M Siegel; Matthew Haemer; Roohi Y Kharofa; Amy L Christison; Sarah E Hampl; Lydia Tinajero-Deck; Mary Kate Lockhart; Sarah Reich; Stephen J Pont; William Stratbucker; Thomas N Robinson; Laura A Shaffer; Susan J Woolford Journal: Child Obes Date: 2018-06-07 Impact factor: 2.992
Authors: Sarah C Armstrong; McAllister Windom; Nathan A Bihlmeyer; Jennifer S Li; Svati H Shah; Mary Story; Nancy Zucker; William E Kraus; Neha Pagidipati; Eric Peterson; Charlene Wong; Manuela Wiedemeier; Lauren Sibley; Samuel I Berchuck; Peter Merrill; Alexandra Zizzi; Charles Sarria; Holly K Dressman; John F Rawls; Asheley C Skinner Journal: BMC Pediatr Date: 2020-06-26 Impact factor: 2.125
Authors: Jennie L Hill; Jamie M Zoellner; Wen You; Donna J Brock; Bryan Price; Ramine C Alexander; Madlyn Frisard; Fabiana Brito; Xiaolu Hou; Paul A Estabrooks Journal: BMC Public Health Date: 2019-01-29 Impact factor: 3.295