title: A shared-care model of obesity treatment for 3-10 year old children: protocol for the HopSCOTCH randomised controlled trial.
abstract: BACKGROUND
  Despite record rates of childhood obesity, effective evidence-based treatments remain elusive. While prolonged tertiary specialist clinical input has some individual impact, these services are only available to very few children. Effective treatments that are easily accessible for all overweight and obese children in the community are urgently required. General practitioners are logical care providers for obese children but high-quality trials indicate that, even with substantial training and support, general practitioner care alone will not suffice to improve body mass index (BMI) trajectories. HopSCOTCH (the Shared Care Obesity Trial in Children) will determine whether a shared-care model, in which paediatric obesity specialists co-manage obesity with general practitioners, can improve adiposity in obese children.
  
  
  METHODS
  Randomised controlled trial nested within a cross-sectional BMI survey conducted across 22 general practices in Melbourne, Australia.
  
  
  METHODS
  Children aged 3-10 years identified as obese by Centers for Disease Control criteria at their family practice, and randomised to either a shared-care intervention or usual care.
  
  
  METHODS
  A single multidisciplinary obesity clinic appointment at Melbourne's Royal Children's Hospital, followed by regular appointments with the child's general practitioner over a 12 month period. To support both specialist and general practice consultations, web-based shared-care software was developed to record assessment, set goals and actions, provide information to caregivers, facilitate communication between the two professional groups, and jointly track progress.
  
  
  RESULTS
  Primary - change in BMI z-score. Secondary - change in percentage fat and waist circumference; health status, body satisfaction and global self-worth.
  
  
  CONCLUSIONS
  This will be the first efficacy trial of a general-practitioner based, shared-care model of childhood obesity management. If effective, it could greatly improve access to care for obese children.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry ACTRN12608000055303.
authors.affiliation: Royal Children's Hospital, Parkville, VIC, Australia. melissa.wake@rch.org.au
authors.forename: Melissa
authors.initials: M
authors.lastname: Wake
authors.forename: Kate
authors.initials: K
authors.lastname: Lycett
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Sabin
authors.forename: Jane
authors.initials: J
authors.lastname: Gunn
authors.forename: Kay
authors.initials: K
authors.lastname: Gibbons
authors.forename: Cathy
authors.initials: C
authors.lastname: Hutton
authors.forename: Zoe
authors.initials: Z
authors.lastname: McCallum
authors.forename: Elissa
authors.initials: E
authors.lastname: York
authors.forename: Michael
authors.initials: M
authors.lastname: Stringer
authors.forename: Gary
authors.initials: G
authors.lastname: Wittert
mesh_terms: D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D019033:Delivery of Health Care, Integrated; D058006:General Practice; D006297:Health Services Accessibility; D006776:Hospitals, Pediatric; D006801:Humans; D009765:Obesity / Q000628:therapy*; D010372:Pediatrics; D016896:Treatment Outcome; D014739:Victoria; D061217:Weight Reduction Programs / Q000379:methods / Q000458:organization & administration*