TY - JOUR
T1 - Efficacy of a Community- Versus Primary Care–Centered Program for Childhood Obesity
T2 - TX CORD RCT
AU - Butte, Nancy F.
AU - Hoelscher, Deanna M.
AU - Barlow, Sarah E.
AU - Pont, Stephen
AU - Durand, Casey
AU - Vandewater, Elizabeth A.
AU - Liu, Yan
AU - Adolph, Anne L.
AU - Pérez, Adriana
AU - Wilson, Theresa A.
AU - Gonzalez, Alejandra
AU - Puyau, Maurice R.
AU - Sharma, Shreela V.
AU - Byrd-Williams, Courtney
AU - Oluyomi, Abiodun
AU - Huang, Terry
AU - Finkelstein, Eric A.
AU - Sacher, Paul M.
AU - Kelder, Steven H.
N1 - Publisher Copyright:
© 2017 The Obesity Society
PY - 2017/9
Y1 - 2017/9
N2 - 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.
AB - 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.
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U2 - 10.1002/oby.21929
DO - 10.1002/oby.21929
M3 - Article
C2 - 28703504
AN - SCOPUS:85023632271
SN - 1930-7381
VL - 25
SP - 1584
EP - 1593
JO - Obesity
JF - Obesity
IS - 9
ER -