Efficacy of a Community- Versus Primary Care–Centered Program for Childhood Obesity: TX CORD RCT

Nancy F. Butte, Deanna M. Hoelscher, Sarah E. Barlow, Stephen Pont, Casey Durand, Elizabeth A. Vandewater, Yan Liu, Anne L. Adolph, Adriana Pérez, Theresa A. Wilson, Alejandra Gonzalez, Maurice R. Puyau, Shreela V. Sharma, Courtney Byrd-Williams, Abiodun Oluyomi, Terry Huang, Eric A. Finkelstein, Paul M. Sacher, Steven H. Kelder

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Abstract

Objective: This randomized controlled trial was conducted to determine comparative efficacy of a 12-month community-centered weight management program (MEND2-5 for ages 2-5 or MEND/CATCH6-12 for ages 6-12) against a primary care-centered program (Next Steps) in low-income children. Methods: Five hundred forty-nine Hispanic and black children (BMI ≥ 85th percentile), stratified by age groups (2-5, 6-8, and 9-12 years), were randomly assigned to MEND2-5 (27 contact hours)/MEND/CATCH6-12 (121.5 contact hours) or Next Steps (8 contact hours). Primary (BMI value at the 95th percentile [%BMIp95]) and secondary outcomes were measured at baseline, 3 months (Intensive Phase), and 12 months (Transition Phase). Results: For age group 6-8, MEND/CATCH6-12 resulted in greater improvement in %BMIp95 than Next Steps during the Intensive Phase. Effect size (95% CI) was −1.94 (−3.88, −0.01) percentage points (P = 0.05). For age group 9-12, effect size was −1.38 (−2.87, 0.16) percentage points for %BMIp95 (P = 0.07). MEND2-5 did not differentially affect %BMIp95. Attendance averaged 52% and 22% during the Intensive and Transition Phases. Intervention compliance was inversely correlated to change in %BMIp95 during the Intensive Phase (P < 0.05). In the Transition Phase, %BMIp95 was maintained or rebounded in both programs (P < 0.05). Conclusions: MEND/CATCH6-12 was more efficacious for BMI reduction at 3 months but not 12 months compared to Next Steps in underserved children. Intervention compliance influenced outcomes, emphasizing the need for research in sustaining family engagement in low-income populations.

Original languageEnglish (US)
Pages (from-to)1584-1593
Number of pages10
JournalObesity
Volume25
Issue number9
DOIs
StatePublished - Sep 1 2017

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ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology
  • Nutrition and Dietetics

Cite this

Butte, N. F., Hoelscher, D. M., Barlow, S. E., Pont, S., Durand, C., Vandewater, E. A., Liu, Y., Adolph, A. L., Pérez, A., Wilson, T. A., Gonzalez, A., Puyau, M. R., Sharma, S. V., Byrd-Williams, C., Oluyomi, A., Huang, T., Finkelstein, E. A., Sacher, P. M., & Kelder, S. H. (2017). Efficacy of a Community- Versus Primary Care–Centered Program for Childhood Obesity: TX CORD RCT. Obesity, 25(9), 1584-1593. https://doi.org/10.1002/oby.21929