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Translational research: are community-based child obesity treatment programs scalable?

Hardy LL, Mihrshahi S, Gale J, Nguyen B, Baur LA, O'Hara BJ - BMC Public Health (2015)

Bottom Line: Overall, 2,812 children participated (54.2% girls; M(age) 10.1 (2.0) years; M(attaendance) 12.9 (5.9) sessions).Beneficial changes among all children included BMI (-0.65 kg/m(2)), BMI-z-score (-0.11), waist circumference (-1.8 cm), and WtHtr (-0.02); self-esteem (+2.7 units), physical activity (+1.2 days/week), screen time (-4.8 h/week), and unhealthy foods index (-2.4 units) (all p < 0.001).Children who completed ≥ 75% of the program were more likely to have beneficial changes in BMI, self-esteem and diet (sugar sweetened beverages, lollies/chocolate, hot chips and takeaways) compared with children completing <75% of the program.

View Article: PubMed Central - PubMed

Affiliation: Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, NSW, 2006, Australia. louise.hardy@sydney.edu.au.

ABSTRACT

Background: Community-based obesity treatment programs have become an important response to address child obesity; however the majority of these programs are small, efficacy trials, few are translated into real-world situations (i.e., dissemination trials). Here we report the short-term impact of a scaled-up, community-based obesity treatment program on children's weight and weight-related behaviours disseminated under real world conditions.

Methods: Children age 6-15 years with a body mass index (BMI) ≥ 85th percentile with no co-morbidities, and their parents/carers participated in a twice weekly, 10-week after-school child obesity treatment program between 2009 and 2012. Outcome information included measures of weight and weight-related behaviours. Analyses were adjusted for clustering and socio-demographic variables.

Results: Overall, 2,812 children participated (54.2% girls; M(age) 10.1 (2.0) years; M(attaendance) 12.9 (5.9) sessions). Beneficial changes among all children included BMI (-0.65 kg/m(2)), BMI-z-score (-0.11), waist circumference (-1.8 cm), and WtHtr (-0.02); self-esteem (+2.7 units), physical activity (+1.2 days/week), screen time (-4.8 h/week), and unhealthy foods index (-2.4 units) (all p < 0.001). Children who completed ≥ 75% of the program were more likely to have beneficial changes in BMI, self-esteem and diet (sugar sweetened beverages, lollies/chocolate, hot chips and takeaways) compared with children completing <75% of the program.

Conclusions: This is one of the few studies to report outcomes of a government-funded, program at scale in a real-world setting, and shows that investment in a community-based child obesity treatment program holds potential to produce short-term changes in weight and weight-related behaviours. The findings support government investment in this health priority area, and demonstrate that community-based models of child obesity treatment are a promising adjunctive intervention to health service provision at all levels of care.

No MeSH data available.


Related in: MedlinePlus

BMI distribution curves of completers (attended ≥75 % of sessions) at baseline and program completion (n = 1,520)
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Fig1: BMI distribution curves of completers (attended ≥75 % of sessions) at baseline and program completion (n = 1,520)

Mentions: Table 2 shows the mean changes and odds ratios in program outcomes, adjusting for covariates (n = 2,812; mean attendance = 12.9 sessions). Overall, the mean changes in program outcomes were statistically significant and in the desired direction (all p < .001), with the exception of understanding nutrition labels, which showed a 77 % reduction in ‘always’ understanding nutrition labels after attending the program (OR 0.23; 95 % CI 0.20, 0.26). Medium effects sizes (d = .20-.38) were observed for change before and after the program in self-esteem, screen time, physical activity, daily vegetable intake, and a large effect size for change in unhealthy food index (d = .41). Tables 3 and 4 show the mean change in program outcomes according to program attendance (i.e., non-completers vs completers). Compared with non-completers, greater beneficial changes were observed among children who completed the program for BMI, BMI z-score, unhealthy food index, and the frequency of consuming sugar sweetened beverages, lollies/chocolates, potato chips and takeaways. Figure 1 graphically shows the left shift in the BMI distribution curves of completers before and after participating in the program (p < .001).Table 2


Translational research: are community-based child obesity treatment programs scalable?

Hardy LL, Mihrshahi S, Gale J, Nguyen B, Baur LA, O'Hara BJ - BMC Public Health (2015)

BMI distribution curves of completers (attended ≥75 % of sessions) at baseline and program completion (n = 1,520)
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4499906&req=5

Fig1: BMI distribution curves of completers (attended ≥75 % of sessions) at baseline and program completion (n = 1,520)
Mentions: Table 2 shows the mean changes and odds ratios in program outcomes, adjusting for covariates (n = 2,812; mean attendance = 12.9 sessions). Overall, the mean changes in program outcomes were statistically significant and in the desired direction (all p < .001), with the exception of understanding nutrition labels, which showed a 77 % reduction in ‘always’ understanding nutrition labels after attending the program (OR 0.23; 95 % CI 0.20, 0.26). Medium effects sizes (d = .20-.38) were observed for change before and after the program in self-esteem, screen time, physical activity, daily vegetable intake, and a large effect size for change in unhealthy food index (d = .41). Tables 3 and 4 show the mean change in program outcomes according to program attendance (i.e., non-completers vs completers). Compared with non-completers, greater beneficial changes were observed among children who completed the program for BMI, BMI z-score, unhealthy food index, and the frequency of consuming sugar sweetened beverages, lollies/chocolates, potato chips and takeaways. Figure 1 graphically shows the left shift in the BMI distribution curves of completers before and after participating in the program (p < .001).Table 2

Bottom Line: Overall, 2,812 children participated (54.2% girls; M(age) 10.1 (2.0) years; M(attaendance) 12.9 (5.9) sessions).Beneficial changes among all children included BMI (-0.65 kg/m(2)), BMI-z-score (-0.11), waist circumference (-1.8 cm), and WtHtr (-0.02); self-esteem (+2.7 units), physical activity (+1.2 days/week), screen time (-4.8 h/week), and unhealthy foods index (-2.4 units) (all p < 0.001).Children who completed ≥ 75% of the program were more likely to have beneficial changes in BMI, self-esteem and diet (sugar sweetened beverages, lollies/chocolate, hot chips and takeaways) compared with children completing <75% of the program.

View Article: PubMed Central - PubMed

Affiliation: Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, NSW, 2006, Australia. louise.hardy@sydney.edu.au.

ABSTRACT

Background: Community-based obesity treatment programs have become an important response to address child obesity; however the majority of these programs are small, efficacy trials, few are translated into real-world situations (i.e., dissemination trials). Here we report the short-term impact of a scaled-up, community-based obesity treatment program on children's weight and weight-related behaviours disseminated under real world conditions.

Methods: Children age 6-15 years with a body mass index (BMI) ≥ 85th percentile with no co-morbidities, and their parents/carers participated in a twice weekly, 10-week after-school child obesity treatment program between 2009 and 2012. Outcome information included measures of weight and weight-related behaviours. Analyses were adjusted for clustering and socio-demographic variables.

Results: Overall, 2,812 children participated (54.2% girls; M(age) 10.1 (2.0) years; M(attaendance) 12.9 (5.9) sessions). Beneficial changes among all children included BMI (-0.65 kg/m(2)), BMI-z-score (-0.11), waist circumference (-1.8 cm), and WtHtr (-0.02); self-esteem (+2.7 units), physical activity (+1.2 days/week), screen time (-4.8 h/week), and unhealthy foods index (-2.4 units) (all p < 0.001). Children who completed ≥ 75% of the program were more likely to have beneficial changes in BMI, self-esteem and diet (sugar sweetened beverages, lollies/chocolate, hot chips and takeaways) compared with children completing <75% of the program.

Conclusions: This is one of the few studies to report outcomes of a government-funded, program at scale in a real-world setting, and shows that investment in a community-based child obesity treatment program holds potential to produce short-term changes in weight and weight-related behaviours. The findings support government investment in this health priority area, and demonstrate that community-based models of child obesity treatment are a promising adjunctive intervention to health service provision at all levels of care.

No MeSH data available.


Related in: MedlinePlus