Ruth Bernstein1,2, E Getzoff3, K Gelfand3, M Demeule-Hayes4, A Scheimann5. 1. Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA. rbernstein@miami.edu. 2. Department of Pediatric Psychology and Neuropsychology, Mt. Washington Pediatric Hospital, Baltimore, MD, USA. rbernstein@miami.edu. 3. Department of Pediatric Psychology and Neuropsychology, Mt. Washington Pediatric Hospital, Baltimore, MD, USA. 4. Department of Weigh Smart, Mt. Washington Pediatric Hospital, Baltimore, MD, USA. 5. Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Abstract
PURPOSE: Interventions to address childhood obesity demonstrate moderate effects at best. Previous research has focused on factors of the intervention that influence success. Yet, effective overweight and obesity interventions require an interaction between family and individual factors. It is vital to characterize those who are successful vs. those who are not within treatment based on these factors. METHODS: This study utilized data from an existing multidisciplinary (i.e., nutrition, physical therapy, psychology, and medicine) group treatment for children with overweight and obesity. Children (N = 113) were given the Behavior Assessment System for Children, the Pediatric Quality of Life Inventory, and completed an interview at baseline, then height and weight were measured at 6 months and 12 months post-intervention. Latent class analysis was used to determine how family and individual characteristics and behavior interact and group together to characterize individuals who lose weight vs. do not lose weight during treatment. RESULTS: The four-cluster model was the best fit for the data. The four identified groups delineated one for whom treatment was successful, and three for whom treatment was not successful. Those three were differentiated by families who appeared to have inconsistent engagement with treatment, families who appeared to not be engaged with treatment, and families who had baseline risk factors that likely require a significantly higher level of treatment. CONCLUSION: Characterizing the differences between those who successfully respond to this treatment from those who were unsuccessful can help identify those most likely to benefit from treatment. Future research and treatment considerations should include treatment modifications for nonresponders. LEVEL OF EVIDENCE: Level III, longitudinal cohort study.
PURPOSE: Interventions to address childhood obesity demonstrate moderate effects at best. Previous research has focused on factors of the intervention that influence success. Yet, effective overweight and obesity interventions require an interaction between family and individual factors. It is vital to characterize those who are successful vs. those who are not within treatment based on these factors. METHODS: This study utilized data from an existing multidisciplinary (i.e., nutrition, physical therapy, psychology, and medicine) group treatment for children with overweight and obesity. Children (N = 113) were given the Behavior Assessment System for Children, the Pediatric Quality of Life Inventory, and completed an interview at baseline, then height and weight were measured at 6 months and 12 months post-intervention. Latent class analysis was used to determine how family and individual characteristics and behavior interact and group together to characterize individuals who lose weight vs. do not lose weight during treatment. RESULTS: The four-cluster model was the best fit for the data. The four identified groups delineated one for whom treatment was successful, and three for whom treatment was not successful. Those three were differentiated by families who appeared to have inconsistent engagement with treatment, families who appeared to not be engaged with treatment, and families who had baseline risk factors that likely require a significantly higher level of treatment. CONCLUSION: Characterizing the differences between those who successfully respond to this treatment from those who were unsuccessful can help identify those most likely to benefit from treatment. Future research and treatment considerations should include treatment modifications for nonresponders. LEVEL OF EVIDENCE: Level III, longitudinal cohort study.
Authors: Lauren VanderBroek-Stice; Monika K Stojek; Steven R H Beach; Michelle R vanDellen; James MacKillop Journal: Appetite Date: 2017-01-10 Impact factor: 3.868
Authors: A E Feldstein; P Charatcharoenwitthaya; S Treeprasertsuk; J T Benson; F B Enders; P Angulo Journal: Gut Date: 2009-07-21 Impact factor: 23.059