|Quattrin, Teresa -|
|Paluch, Rocco -|
|Yu, Jihnhee -|
|Epstein, Leonard -|
|Ecker, Michelle -|
Submitted to: Pediatrics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: May 20, 2014
Publication Date: August 1, 2014
Citation: Quattrin, T., Roemmich, J.N., Paluch, R., Yu, J., Epstein, L.H., Ecker, M.A. 2014. Treatment outcomes of overweight children and parents in the medical home. Pediatrics. 134 No. 2 290-297. Interpretive Summary: There are few data on how to treat young obese children in Patient Center Medical Home (PCMH) settings such as pediatric clinics. We randomized overweight children age 3-5 y and an overweight parent to behavioral modification Intervention or attention control Usual Care (UC) groups. Study personnel embedded in the PCMH provided dietary and physical/sedentary activity education to all families (12-months of treatment) followed by a 12-month follow-up. Children in the Intervention experienced greater reductions in adiposity compared to the UC throughout the study. Greater BMI reduction over time was also observed in parents in the. Intervention compared to UC (P<0.0001). Changes in child and parent adiposity were correlated during the 12-month active treatment period. Thus, targeting preschool-aged overweight youth and their parents in the PCMH is feasible and leads to sustained decreases in child %OBMI associated with reductions in parent BMI.
Technical Abstract: Background Experience treating young obese children in the Patient Center Medical Home (PCMH) is lacking. We have shown in the PCMH that after 6 months concurrent treatment of overweight children and their overweight parents (Intervention) results in lower % Over Body Mass Index (%OBMI) compared to treating the child only [Information Control (IC)]. This paper presents the long-term results of this 24-month study. Methods Children with BMI >85th percentile and an overweight parent were randomized to Intervention or IC. Study personnel, embedded in the PCMH, delivered dietary and physical/sedentary activity education (12-month treatment) followed by a 12-month follow-up (13 sessions/24 months). The Intervention received behavioral modification. An intention-to-treat analysis was performed on 96 subjects to test changes in child %OBMI as primary end point and parent BMI. A completer’s analysis was also performed. Results Baseline characteristics did not differ between Intervention (n=46) and IC (n=50). Children in the Intervention experienced greater reduction in %OBMI compared to the IC throughout the study (group * months, P=0.002). Greater BMI reduction over time was also observed in parents in the Intervention compared to IC (P<0.0001). Analysis of study completers (n = 70) also demonstrated differences between Intervention and IC. Percent OBMI and parent BMI changes were correlated throughout the study (during the 12-month active treatment period: r = 0.383; P< 0.0001). Conclusions Concurrently targeting preschool-aged overweight youth and their parents in the PCMH is feasible and leads to sustained decreases in child %OBMI associated with reductions in parent BMI.