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A randomized, home-based, childhood obesity intervention delivered by patient navigators.

Yun L, Boles RE, Haemer MA, Knierim S, Dickinson LM, Mancinas H, Hambidge SJ, Davidson AJ - BMC Public Health (2015)

Bottom Line: The efficacy of home-based, childhood obesity interventions to reduce a child's body mass index is inconclusive.The primary study outcome measure is change in BMI z-score from baseline to post-intervention period.Informing primary care providers about a child's accomplishments and challenges, allows the clinician to support the health weight effort when seeing families during subsequent clinical visits.

View Article: PubMed Central - PubMed

Affiliation: Denver Public Health, 605 Bannock Street, Denver, CO, 80204, USA. Lourdes.Yun@dhha.org.

ABSTRACT

Background: Although Colorado is perceived as a healthy state, in 2010, 14.1 % of children aged 2-5 were overweight and 9.1 % were obese. Despite the high prevalence of obesity in this population, evidence to support particular strategies to treat obese preschoolers is lacking. The efficacy of home-based, childhood obesity interventions to reduce a child's body mass index is inconclusive. However, this model uniquely provides an opportunity to observe and intervene with the home food and activity environment and engage the entire family in promoting changes that fit each family's unique dynamics.

Methods/design: Eligible participants are children aged 2-5 years who attended a well-child care visit at a Denver Health Community Health Service clinic within 12 months prior to recruitment and on that visit had a body mass index (BMI) >85th percentile-for-age. Participants are randomly recruited at study inception and allocated to the intervention in one of five defined 6-month stepped wedge engagements; the delayed intervention groups serves as control groups until the start of the intervention. The program is delivered by a patient navigator at the family' home and consists of a 16-session curriculum focused on 1) parenting styles, 2) nutrition, and 3) physical activity. At each visit, a portion of curriculum is delivered to guide parents and children in selecting one goal for behavior change in each of three work areas to work on during the following week. The primary study outcome measure is change in BMI z-score from baseline to post-intervention period.

Discussion: This childhood obesity study, innovative for its home-based intervention venue, provides rich data characterizing barriers and facilitators to healthy behavior change within the home. The study population is innovative as it is focused on preschool-aged, Latino children from low-income families; this population has not typically been targeted in obesity management assessments. The home-based intervention is linked to clinical care through update letters and assessment of the program's impact to the child's medical providers. Informing primary care providers about a child's accomplishments and challenges, allows the clinician to support the health weight effort when seeing families during subsequent clinical visits.

Trial registration: ClinicalTrials.gov NCT02024360 Registered December 21, 2013.

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Related in: MedlinePlus

Flow of Children into the Study: Randomization, Recruitment, Enrollment, and Intervention Processes, Denver Health, 2012-2015
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Related In: Results  -  Collection

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Fig1: Flow of Children into the Study: Randomization, Recruitment, Enrollment, and Intervention Processes, Denver Health, 2012-2015

Mentions: Overweight or obese children [9] aged 2–5 years (target n = 300) receiving medical care at one of eight community health clinics of an urban safety net medical system are randomly selected from a population of greater than 2000 eligible overweight or obese children to participate in this 16-session, home based, family-centered curriculum around nutrition, physical activity, and parenting skills. All participants are recruited at baseline and individual children and families are randomized to begin treatment in one of several sequential 25-hour stepped wedge cohorts. Children enrolled at inception but not receiving the intervention until a later start date are considered a control group for the period from recruitment until the intervention begins (Fig. 1).Fig. 1


A randomized, home-based, childhood obesity intervention delivered by patient navigators.

Yun L, Boles RE, Haemer MA, Knierim S, Dickinson LM, Mancinas H, Hambidge SJ, Davidson AJ - BMC Public Health (2015)

Flow of Children into the Study: Randomization, Recruitment, Enrollment, and Intervention Processes, Denver Health, 2012-2015
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4492174&req=5

Fig1: Flow of Children into the Study: Randomization, Recruitment, Enrollment, and Intervention Processes, Denver Health, 2012-2015
Mentions: Overweight or obese children [9] aged 2–5 years (target n = 300) receiving medical care at one of eight community health clinics of an urban safety net medical system are randomly selected from a population of greater than 2000 eligible overweight or obese children to participate in this 16-session, home based, family-centered curriculum around nutrition, physical activity, and parenting skills. All participants are recruited at baseline and individual children and families are randomized to begin treatment in one of several sequential 25-hour stepped wedge cohorts. Children enrolled at inception but not receiving the intervention until a later start date are considered a control group for the period from recruitment until the intervention begins (Fig. 1).Fig. 1

Bottom Line: The efficacy of home-based, childhood obesity interventions to reduce a child's body mass index is inconclusive.The primary study outcome measure is change in BMI z-score from baseline to post-intervention period.Informing primary care providers about a child's accomplishments and challenges, allows the clinician to support the health weight effort when seeing families during subsequent clinical visits.

View Article: PubMed Central - PubMed

Affiliation: Denver Public Health, 605 Bannock Street, Denver, CO, 80204, USA. Lourdes.Yun@dhha.org.

ABSTRACT

Background: Although Colorado is perceived as a healthy state, in 2010, 14.1 % of children aged 2-5 were overweight and 9.1 % were obese. Despite the high prevalence of obesity in this population, evidence to support particular strategies to treat obese preschoolers is lacking. The efficacy of home-based, childhood obesity interventions to reduce a child's body mass index is inconclusive. However, this model uniquely provides an opportunity to observe and intervene with the home food and activity environment and engage the entire family in promoting changes that fit each family's unique dynamics.

Methods/design: Eligible participants are children aged 2-5 years who attended a well-child care visit at a Denver Health Community Health Service clinic within 12 months prior to recruitment and on that visit had a body mass index (BMI) >85th percentile-for-age. Participants are randomly recruited at study inception and allocated to the intervention in one of five defined 6-month stepped wedge engagements; the delayed intervention groups serves as control groups until the start of the intervention. The program is delivered by a patient navigator at the family' home and consists of a 16-session curriculum focused on 1) parenting styles, 2) nutrition, and 3) physical activity. At each visit, a portion of curriculum is delivered to guide parents and children in selecting one goal for behavior change in each of three work areas to work on during the following week. The primary study outcome measure is change in BMI z-score from baseline to post-intervention period.

Discussion: This childhood obesity study, innovative for its home-based intervention venue, provides rich data characterizing barriers and facilitators to healthy behavior change within the home. The study population is innovative as it is focused on preschool-aged, Latino children from low-income families; this population has not typically been targeted in obesity management assessments. The home-based intervention is linked to clinical care through update letters and assessment of the program's impact to the child's medical providers. Informing primary care providers about a child's accomplishments and challenges, allows the clinician to support the health weight effort when seeing families during subsequent clinical visits.

Trial registration: ClinicalTrials.gov NCT02024360 Registered December 21, 2013.

Show MeSH
Related in: MedlinePlus