title: Intervention in overweight children improves body mass index (BMI) and physical activity.
abstract: BACKGROUND
  Childhood obesity is a growing epidemic in family medicine with few clinical treatment options. We implemented and evaluated a group office-visit intervention by family physicians for overweight children and their parents, emphasizing nutrition and physical activity within a resiliency psychosocial model.
  
  
  METHODS
  The intervention lasted for 3 months, with half of the children crossing over to intervention after 6 months in the study. Participants included 35 children who met eligibility criteria of being in third through fifth grades and having a body mass index (BMI) above the 85th percentile. The 3-month, 12-session intervention, "Choices," included topics on nutrition, physical activity, and resiliency. The sessions were developed for delivery by a family physician and a nutritionist who received training in positive psychology and resilience skills. Main outcome measures were BMI z scores for age and sex and z scores for weight by age and sex, as well as qualitative interviews to understand individual and family processes.
  
  
  RESULTS
  The intervention resulted in a significant effect on one primary outcome, BMI z score (-0.138 per 9 months [P = .017]) and a trend toward significance on the weight for age z score (-0.87 per 9 months [P = .09]). The net shift of activity from the low metabolic equivalents (METs) to the high METs had an intervention effect of 2.84 METs (P = .037). Families reported lasting changes in behaviors and attitudes.
  
  
  CONCLUSIONS
  The innovative approach used in this study demonstrated modest efficacy in reducing BMI z score, changing physical activity levels, and possibly shifting family dynamics.
authors.affiliation: Department of Family and Community Medicine, University of Arizona College of Medicine, Tucson, AZ 85719, USA. vsiwik@email.arizona.edu
authors.forename: Violet
authors.initials: V
authors.lastname: Siwik
authors.forename: Randa
authors.initials: R
authors.lastname: Kutob
authors.forename: Cheryl
authors.initials: C
authors.lastname: Ritenbaugh
authors.forename: Luis
authors.initials: L
authors.lastname: Cruz
authors.forename: Janet
authors.initials: J
authors.lastname: Senf
authors.forename: Mikel
authors.initials: M
authors.lastname: Aickin
authors.forename: Scott
authors.initials: S
authors.lastname: Going
authors.forename: Andrew
authors.initials: A
authors.lastname: Shatte
mesh_terms: D000293:Adolescent; D001130:Arizona; D015992:Body Mass Index; D002648:Child; D018592:Cross-Over Studies; D005192:Family Health; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D009043:Motor Activity; D050177:Overweight / Q000517:prevention & control*; D036301:Qualitative Research; D057185:Sedentary Behavior; D011795:Surveys and Questionnaires