Maintenance Following a Randomized Trial of a Clinic and Home-based Behavioral Intervention of Obesity in Preschoolers.

Autor: Stark LJ; Division of Behavioral Medicine and Clinical Psychology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH. Electronic address: Lori.Stark@cchmc.org., Filigno SS; Division of Behavioral Medicine and Clinical Psychology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH., Kichler JC; Division of Behavioral Medicine and Clinical Psychology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH., Bolling C; Pediatric Associates, PSC, Crestview Hills, KY., Ratcliff MB; Independent Researcher, Atlanta, GA., Robson SM; Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE., Simon SL; Division of Pulmonary Medicine, Department of Pediatrics, Children's Hospital Colorado, Aurora, CO., McCullough MB; Department of Psychology, Suffolk University, Boston, MA., Clifford LM; Division of Behavioral Medicine and Clinical Psychology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH., Stough CO; Department of Psychology, University of Cincinnati, Cincinnati, OH., Zion C; Division of Behavioral Medicine and Clinical Psychology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH., Mara CA; Division of Behavioral Medicine and Clinical Psychology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH.
Jazyk: angličtina
Zdroj: The Journal of pediatrics [J Pediatr] 2019 Oct; Vol. 213, pp. 128-136.e3. Date of Electronic Publication: 2019 Jun 21.
DOI: 10.1016/j.jpeds.2019.05.004
Abstrakt: Objective: To assess maintenance of improved weight outcomes in preschoolers with obesity 6 and 12 months following a randomized clinical trial comparing a home- and clinic-based behavioral intervention (Learning about Activity and Understanding Nutrition for Child Health [LAUNCH]) to motivational interviewing and standard care.
Study Design: Randomized controlled trial with children between the ages of 2 and 5 years above the 95th percentile for body mass index for age and sex recruited from 27 pediatrician offices across 10 recruitment cycles between March 12, 2012, and June 8, 2015, were followed 6 and 12 months post-treatment. Child and caregiver weight, height, and caloric intake, child physical activity, and home environment were assessed. The primary outcome was maintenance of greater reduction of percent over the 50th percentile body mass index (BMI%50th) by LAUNCH compared with motivational interviewing and standard care at the 6- and 12-month follow-up.
Results: Significantly lower child BMI%50th was maintained for LAUNCH compared with motivational interviewing at 12-month follow-up and to standard care at the 6-month follow-up; however, the effect sizes were maintained for comparison with standard care at 12-month follow-up. LAUNCH had significantly lower daily caloric intake compared with motivational interviewing and standard care at both follow-ups and maintained significantly fewer high-calorie foods in the home compared with standard care at 6 and 12 months and compared with motivational interviewing at 12 months. However, caloric intake increased by 12% from post-treatment. LAUNCH caregivers did not maintain improved BMI at follow-up.
Conclusions: LAUNCH showed success in reducing weight in preschoolers. However, maintaining treatment gains post-treatment is more difficult. Treatment may need to last longer than 6 months to achieve optimal results.
Trial Registration: Clinicaltrials.gov: NCT01546727.
(Copyright © 2019 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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