Clinical effectiveness of the Massachusetts Childhood Obesity Research Demonstration initiative among low-income children

Autor: Neil Kamdar, Jessica L. Barrett, Elsie M. Taveras, Shikha Anand, Meghan Perkins, Jennifer A. Woo Baidal, Kirsten K. Davison, Candace C. Nelson, Thomas Land, Jo-Ann Kwass, Steven L. Gortmaker
Rok vydání: 2017
Předmět:
Zdroj: Obesity. 25:1159-1166
ISSN: 1930-7381
DOI: 10.1002/oby.21866
Popis: Objective To examine the extent to which a clinical intervention resulted in reduced BMI z scores among 2- to 12-year-old children compared to routine practice (treatment as usual [TAU]). Methods The Massachusetts Childhood Obesity Research Demonstration (MA-CORD) project is a multifaceted initiative to prevent childhood obesity among low-income children. At the federally qualified community health centers (FQHCs) of two communities (Intervention Site #1 and #2), the following were implemented: (1) pediatric weight management training, (2) electronic decision supports for clinicians, (3) on-site Healthy Weight Clinics, (4) community health worker integration, and (5) healthful clinical environment changes. One FQHC in a demographically matched community served as the TAU site. Using electronic health records, we assessed BMI z scores and used linear mixed models to examine BMI z score change over 2 years in each intervention site compared to a TAU site. Results Compared to children in the TAU site (n = 2,286), children in Intervention Site #2 (n = 1,368) had a significant decline in BMI z scores following the start of the intervention (−0.16 units/y; 95% confidence interval: −0.21 to −0.12). No evidence of an effect was found in Intervention Site #1 (n = 111). Conclusions The MA-CORD clinical interventions were associated with modest improvement in BMI z scores in one of two intervention communities compared to a TAU community.
Databáze: OpenAIRE
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