title: An adaptation of family-based behavioral pediatric obesity treatment for a primary care setting: group health family wellness program pilot.
abstract: OBJECTIVE
  To assess the feasibility and acceptability of family-based group pediatric obesity treatment in a primary care setting, to obtain an estimate of its effectiveness, and to describe participating parents' experiences of social support for healthy lifestyle changes.
  
  
  METHODS
  We adapted an evidence-based intervention to a group format and completed six 12- to 16-week groups over 3 years. We assessed program attendance and completion, changes in child and parent body mass index (BMI; calculated as weight in kilograms divided by height in meters squared), and changes in child quality of life in a single-arm before-and-after trial. Qualitative interviews explored social support for implementing healthy lifestyle changes.
  
  
  RESULTS
  Thirty-eight parent-child pairs enrolled (28% of the 134 pairs invited). Of those, 24 (63%) completed the program and another 6 (16%) attended at least 4 sessions but did not complete the program. Children who completed the program achieved a mean change in BMI Z-scores (Z-BMI) of -0.1 (0.1) (p < 0.001) and significant improvement in parent-reported child quality of life (mean change = 8.5; p = 0.002). Mean BMI of parents changed by -0.9 (p = 0.003). Parents reported receiving a wide range of social support for healthy lifestyle changes and placed importance on the absence or presence of support.
  
  
  CONCLUSIONS
  A pilot group program for family-based treatment of pediatric obesity is feasible and acceptable in a primary care setting. Change in child and parent BMI outcomes and child quality of life among completers were promising despite the pilot's low intensity. Parent experiences with lack of social support suggest possible ways to improve retention and adherence.
authors.affiliation: Behavioral Health Specialist at the Seattle Children's Research Institute, a Masters candidate in Advanced Practice Nursing-Family Psychiatric Mental Health at Seattle University, and a former Research Associate at Group Health Research Institute in Seattle, WA. kriggs@uw.edu.
authors.forename: Karin R
authors.initials: KR
authors.lastname: Riggs
authors.affiliation: Senior Investigator at Group Health Research Institute and Assistant Medical Director of Preventive Care at Group Health in Seattle, WA. lozano.p@ghc.org.
authors.forename: Paula
authors.initials: P
authors.lastname: Lozano
authors.affiliation: Physician Assistant candidate in the MEDEX Physician Assistant Program at the University of Washington School of Medicine and former Senior Research Interventionist at Group Health Research Institute in Seattle, WA. moheal1@uw.edu.
authors.forename: Amy
authors.initials: A
authors.lastname: Mohelnitzky
authors.affiliation: Pediatrician at Group Health in Seattle, WA. rudnick.s@ghc.org.
authors.forename: Sarah
authors.initials: S
authors.lastname: Rudnick
authors.affiliation: Project Manager at Group Health Research Institute in Seattle, WA. richards.je@ghc.org.
authors.forename: Julie
authors.initials: J
authors.lastname: Richards
mesh_terms: D000293:Adolescent; D001521:Behavior Therapy / Q000379:methods*; D015992:Body Mass Index; D002648:Child; D005196:Family Therapy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D063766:Pediatric Obesity / Q000523:psychology / Q000628:therapy*; D010865:Pilot Projects; D036301:Qualitative Research; D011788:Quality of Life; D012944:Social Support; D011795:Surveys and Questionnaires