A pilot randomized controlled trial of a clinic and home-based behavioral intervention to decrease obesity in preschoolers.
We evaluated the efficacy of a 6-month clinic and home-based behavioral intervention (Learning about Activity and Understanding Nutrition for Child Health; LAUNCH) to reduce obesity in preschool children ≥95th BMI percentile compared to enhanced standard of care (Pediatrician Counseling; PC). LAUNCH was a family-based behavioral intervention that taught parents to use child behavior management strategies to increase healthy eating and activity for their children and themselves. PC presented the same diet and activity recommendations, but was delivered in a one-time PC session. Eighteen children aged 2-5 years (mean 4.71 ± 1.01) with an average BMI percentile of 98 (±1.60) and an overweight parent were randomized to LAUNCH or PC. Assessments were conducted at baseline, 6 months (end of LAUNCH treatment) and 12 months (6 months following LAUNCH treatment). LAUNCH showed a significantly greater decrease on the primary outcomes of child at month 6 (post-treatment) BMI z (-0.59 ± 0.17), BMI percentile (-2.4 ± 1.0), and weight gain (-2.7 kg ± 1.2) than PC and this difference was maintained at follow-up (month 12). LAUNCH parents also had a significantly greater weight loss (-5.5 kg ± 0.9) at month 6 and 12 (-8.0 kg ± 3.5) than PC parents. Based on the data from this small sample, an intensive intervention that includes child behavior management strategies to improve healthy eating and activity appears more promising in reducing preschool obesity than a low intensity intervention that is typical of treatment that could be delivered in primary care.
Stark
Lori J
LJ
Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA. lori.stark@cchmc.org
Spear
Stephanie
S
Boles
Richard
R
Kuhl
Elizabeth
E
Ratcliff
Megan
M
Scharf
Cindy
C
Bolling
Christopher
C
Rausch
Joseph
J
D000328:Adult; D000553:Ambulatory Care; D001521:Behavior Therapy; D002652:Child Behavior / Q000502:physiology; D002675:Child, Preschool; D003376:Counseling; D005260:Female; D006699:Home Care Services; D006801:Humans; D008297:Male; D009035:Mothers; D009765:Obesity / Q000628:therapy*; D010371:Pediatric Nursing / Q000193:education; D010865:Pilot Projects; D016896:Treatment Outcome
J Pediatr. 2007 Jan;150(1):12-17.e2
17188605
Pediatrics. 2007 Dec;120 Suppl 4:S254-88
18055654
Med Sci Sports Exerc. 2000 Feb;32(2):426-31
10694127
Med Sci Sports Exerc. 2005 Nov;37(11 Suppl):S544-54
16294117
Pediatrics. 2001 May;107(5):1138-46
11331699
Obesity (Silver Spring). 2006 Nov;14(11):2000-6
17135617
Pediatrics. 2007 Dec;120 Suppl 4:S164-92
18055651
Int J Obes (Lond). 2005 Jun;29(6):549-56
15889112
Health Psychol. 2007 Jul;26(4):381-91
17605557
J Paediatr Child Health. 2007 Dec;43(12):806-10
17803669
Child Health Care. 2010 Jan 1;39(1):34
20174613
JAMA. 2002 Oct 9;288(14):1728-32
12365956
J Child Psychol Psychiatry. 1997 Nov;38(8):1051-62
9413802
Appetite. 2001 Jun;36(3):201-10
11358344
Obes Res. 2004 Jan;12(1):58-68
14742843
J Pediatr. 2004 Jul;145(1):20-5
15238901
J Am Coll Nutr. 2004 Apr;23(2):117-23
15047677
Pediatrics. 2006 Sep;118(3):e594-601
16950951
Appetite. 2003 Apr;40(2):155-62
12781165
JAMA. 2006 Apr 5;295(13):1549-55
16595758
Med Care. 1999 Feb;37(2):126-39
10024117
J Am Diet Assoc. 1996 Nov;96(11):1140-4
8906138
Adv Data. 2000 Jun 8;(314):1-27
11183293
Matern Child Nutr. 2005 Jul;1(3):164-8
16881896
Prev Cardiol. 2004 Summer;7(3):116-21
15249763
Int J Obes (Lond). 2006 Jan;30(1):6-13
16344843
Circulation. 2005 Apr 19;111(15):1999-2012
15837955
Int J Obes Relat Metab Disord. 2003 Jul;27(7):834-9
12821970
Acad Pediatr. 2009 Sep-Oct;9(5):322-9
19560993
BMJ. 2005 Jun 11;330(7504):1357
15908441