title: A pilot randomized controlled trial of a clinic and home-based behavioral intervention to decrease obesity in preschoolers.
abstract: 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.
authors.affiliation: Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA. lori.stark@cchmc.org
authors.forename: Lori J
authors.initials: LJ
authors.lastname: Stark
authors.forename: Stephanie
authors.initials: S
authors.lastname: Spear
authors.forename: Richard
authors.initials: R
authors.lastname: Boles
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kuhl
authors.forename: Megan
authors.initials: M
authors.lastname: Ratcliff
authors.forename: Cindy
authors.initials: C
authors.lastname: Scharf
authors.forename: Christopher
authors.initials: C
authors.lastname: Bolling
authors.forename: Joseph
authors.initials: J
authors.lastname: Rausch
mesh_terms: 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
references.citation: J Pediatr. 2007 Jan;150(1):12-17.e2
references.pmid: 17188605
references.citation: Pediatrics. 2007 Dec;120 Suppl 4:S254-88
references.pmid: 18055654
references.citation: Med Sci Sports Exerc. 2000 Feb;32(2):426-31
references.pmid: 10694127
references.citation: Med Sci Sports Exerc. 2005 Nov;37(11 Suppl):S544-54
references.pmid: 16294117
references.citation: Pediatrics. 2001 May;107(5):1138-46
references.pmid: 11331699
references.citation: Obesity (Silver Spring). 2006 Nov;14(11):2000-6
references.pmid: 17135617
references.citation: Pediatrics. 2007 Dec;120 Suppl 4:S164-92
references.pmid: 18055651
references.citation: Int J Obes (Lond). 2005 Jun;29(6):549-56
references.pmid: 15889112
references.citation: Health Psychol. 2007 Jul;26(4):381-91
references.pmid: 17605557
references.citation: J Paediatr Child Health. 2007 Dec;43(12):806-10
references.pmid: 17803669
references.citation: Child Health Care. 2010 Jan 1;39(1):34
references.pmid: 20174613
references.citation: JAMA. 2002 Oct 9;288(14):1728-32
references.pmid: 12365956
references.citation: J Child Psychol Psychiatry. 1997 Nov;38(8):1051-62
references.pmid: 9413802
references.citation: Appetite. 2001 Jun;36(3):201-10
references.pmid: 11358344
references.citation: Obes Res. 2004 Jan;12(1):58-68
references.pmid: 14742843
references.citation: J Pediatr. 2004 Jul;145(1):20-5
references.pmid: 15238901
references.citation: J Am Coll Nutr. 2004 Apr;23(2):117-23
references.pmid: 15047677
references.citation: Pediatrics. 2006 Sep;118(3):e594-601
references.pmid: 16950951
references.citation: Appetite. 2003 Apr;40(2):155-62
references.pmid: 12781165
references.citation: JAMA. 2006 Apr 5;295(13):1549-55
references.pmid: 16595758
references.citation: Med Care. 1999 Feb;37(2):126-39
references.pmid: 10024117
references.citation: J Am Diet Assoc. 1996 Nov;96(11):1140-4
references.pmid: 8906138
references.citation: Adv Data. 2000 Jun 8;(314):1-27
references.pmid: 11183293
references.citation: Matern Child Nutr. 2005 Jul;1(3):164-8
references.pmid: 16881896
references.citation: Prev Cardiol. 2004 Summer;7(3):116-21
references.pmid: 15249763
references.citation: Int J Obes (Lond). 2006 Jan;30(1):6-13
references.pmid: 16344843
references.citation: Circulation. 2005 Apr 19;111(15):1999-2012
references.pmid: 15837955
references.citation: Int J Obes Relat Metab Disord. 2003 Jul;27(7):834-9
references.pmid: 12821970
references.citation: Acad Pediatr. 2009 Sep-Oct;9(5):322-9
references.pmid: 19560993
references.citation: BMJ. 2005 Jun 11;330(7504):1357
references.pmid: 15908441