title: Treatment outcomes of overweight children and parents in the medical home.
abstract: OBJECTIVE
  To test in the primary care setting the short- and long-term efficacy of a behavioral intervention that simultaneously targeted an overweight child and parent versus an information control (IC) targeting weight control only in the child.
  
  
  METHODS
  Two- to 5-year-old children who had BMI ≥85th percentile and an overweight parent (BMI >25 kg/m2) were randomized to Intervention or IC, both receiving diet and activity education over 12 months (13 sessions) followed by 12-month follow-up (3 sessions). Parents in the Intervention group were also targeted for weight control and received behavioral intervention. Pediatricians in 4 practices enrolled their patients with the assistance of embedded recruiters (Practice Enhancement Assistants) who assisted with treatment too.
  
  
  RESULTS
  A total of 96 of the 105 children randomized (Intervention n = 46; IC n = 50) started the program and had data at baseline. Children in the Intervention experienced greater reductions in percent over BMI (group × months; P = .002) and z-BMI (group × months; P < 0.001) compared with IC throughout treatment and follow-up. Greater BMI reduction was observed over time for parents in the Intervention compared with IC (P < .001) throughout treatment and follow-up. Child weight changes were correlated with parent weight changes at 12 and 24 months (r = 0.38 and 0.26; P < .001 and P = .03).
  
  
  CONCLUSIONS
  Concurrently targeting preschool-aged overweight and obese youth and their parents in primary care with behavioral intervention results in greater decreases in child percent over BMI, z-BMI, and parent BMI compared with IC. The difference between Intervention and IC persists after 12 months of follow-up.
authors: Department of Pediatrics, University at Buffalo, Women and Children's Hospital, Buffalo, New York; tquattrin@upa.chob.edu.
authors: Teresa
authors: T
authors: Quattrin
authors: Department of Pediatrics, University at Buffalo, Women and Children's Hospital, Buffalo, New York;USDA/ARS Grand Forks Human Nutrition Research Center, Grand Forks, North Dakota; and.
authors: James N
authors: JN
authors: Roemmich
authors: Department of Pediatrics, University at Buffalo, Women and Children's Hospital, Buffalo, New York;
authors: Rocco
authors: R
authors: Paluch
authors: Department of Biostatistics, University at Buffalo, Buffalo, New York.
authors: Jihnhee
authors: J
authors: Yu
authors: Department of Pediatrics, University at Buffalo, Women and Children's Hospital, Buffalo, New York;
authors: Leonard H
authors: LH
authors: Epstein
authors: Department of Pediatrics, University at Buffalo, Women and Children's Hospital, Buffalo, New York;
authors: Michelle A
authors: MA
authors: Ecker
mesh_terms: D001521:Behavior Therapy; D015992:Body Mass Index; D002675:Child, Preschool; D005192:Family Health; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D050177:Overweight / Q000628:therapy*; D010353:Patient Education as Topic; D018802:Patient-Centered Care; D016896:Treatment Outcome
keywords: expert committee recommendations; obesity; overweight; patient centered medical home; percent over BMI; preschool children