Randomised controlled trial and economic evaluation of the 'Families for Health' programme to reduce obesity in children.

Autor: Robertson, Wendy, Fleming, Joanna, Kamal, Atiya, Hamborg, Thomas, Khan, Kamran A., Griffiths, Frances, Brown, Sarah Stewart, Stallard, Nigel, Petrou, Stavros, Simkiss, Douglas, Harrison, Elizabeth, Sung Wook Kim, Thorogood, Margaret, Stewart-Brown, Sarah, Kim, Sung Wook
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Zdroj: Archives of Disease in Childhood; May2017, Vol. 102 Issue 5, p416-426, 11p, 1 Diagram, 6 Charts, 2 Graphs
Abstrakt: Objective: Evaluating effectiveness and cost-effectiveness of 'Families for Health V2' (FFH) compared with usual care (UC).Design: Multicentre randomised controlled trial (RCT) (investigators blinded, families unblinded) and economic evaluation. Stratified randomisation by family; target of 120 families.Setting: Three National Health Service Primary Care Trusts in West Midlands, England.Participants: Overweight or obese (≥91st or ≥98th centile body mass index (BMI)) children aged 6-11 years and their parents/carers, recruited March 2012-February 2014.Interventions: FFH; a 10-week community-based family programme addressing parenting, lifestyle change and social and emotional development. UC; usual support for childhood obesity at each site.Main Outcome Measures: Primary outcomes were 12-months change in children's BMI z-score and incremental cost per quality-adjusted life-year gained (QALY). Secondary outcomes included changes in children's physical activity, fruit and vegetable consumption and quality of life, parents' BMI and mental well-being, family eating/activity, parent-child relationships and parenting style.Results: 115 families (128 children) were randomised to FFH (n=56) or UC (n=59). There was no significant difference in BMI z-score 12-months change (0.114, 95% CI -0.001 to 0.229, p=0.053; p=0.026 in favour of UC with missing value multiple imputation). One secondary outcome, change in children's waist z-score, was significantly different between groups in favour of UC (0.15, 95% CI 0.00 to 0.29). Economic evaluation showed that mean costs were significantly higher for FFH than UC (£998 vs £548, p<0.001). Mean incremental cost-effectiveness of FFH was estimated at £552 175 per QALY.Conclusions: FFH was neither effective nor cost-effective for the management of obesity compared with UC.Trial Registration Number: ISRCTN45032201. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index