title: The Health Initiative Program for Kids (HIP Kids): effects of a 1-year multidisciplinary lifestyle intervention on adiposity and quality of life in obese children and adolescents--a longitudinal pilot intervention study.
abstract: BACKGROUND
  Though recent data suggest that multidisciplinary outpatient interventions can have a positive effect on childhood obesity, it is still unclear which program components are most beneficial and how they affect quality of life (QoL). The aim of this study was to determine if a 1-year multidisciplinary, family-centered outpatient intervention based on social cognitive theory would be effective in (i) preventing further increases in BMI and BMI z-score, and (ii) improving QoL in obese children and adolescents.
  
  
  METHODS
  Obese children and adolescents 8-17 years of age and their families participated in this 1-year longitudinal pilot intervention study. The intervention consisted of fifteen 90-minute educational sessions led by a dietitian, exercise specialist, and social worker. Anthropometric measures, body composition, and QoL (Pediatric Quality of Life Inventory 4.0), were assessed at baseline, 3 months, and 12 months. Laboratory values were measured at baseline and 12 months. The primary outcome measures were change in BMI and BMI z-score, secondary outcome measures included change in QoL and body composition. A paired sample t-test was used to assess within-group differences and 95% confidence intervals were reported for the mean differences.
  
  
  RESULTS
  42 obese children and adolescents (21 girls) completed the 1-year intervention (mean age 12.8 ± 3.14 years). Mean baseline BMI was 31.96 ± 5.94 kg/m(2) and BMI z-score was +2.19 ± 0.34. Baseline QoL (self-assessments and parental assessments) was impaired: mean baseline scores were 74.5 ± 16.5 and 63.7 ± 19.4 for physical functioning and 69.0 ± 14.9 and 64.0 ± 18.3 for emotional functioning, respectively. At 12 months, BMI z-score had decreased (-0.07 ± 0.11, 95% CI: -0.11 to -0.04). BMI (0.80 ± 1.57 kg/m(2), 95% CI 0.31 to 1.29) and fat-free mass (4.02 ± 6.27 kg, 95% CI 1.90 to 6.14) increased, but % body fat and waist circumference did not. Both the parent-reported physical (11.3 ± 19.2, 95% CI 4.7 to 17.9) and emotional (7.7 ± 15.7, 95% CI 2.3 to 13.0) functioning QoL scores and the children's self-reported physical (5.3 ± 17.1, 95% CI 0.5 to 11.1) and emotional (7.9 ± 14.3, 95% CI 3.2 to 12.7) functioning scores significantly improved.
  
  
  CONCLUSIONS
  Following a 1-year intervention, the participants' BMI z-scores and QoL improved, while other adiposity-related measures of body composition remained unchanged.
  
  
  BACKGROUND
  UMIN Clinical Trials Registry UMIN000015622 .
authors.affiliation: Department of Pediatrics, Children's Hospital, London Health Sciences Centre, Western University, 800 Commissioners Road East, London, ON, N6A 5W9, Canada. dirk.bock@lhsc.on.ca.|Lawson Health Research Institute, 750 Base Line Road, Suite 300, London, ON, N6C 2R5, Canada. dirk.bock@lhsc.on.ca.
authors.forename: Dirk E
authors.initials: DE
authors.lastname: Bock
authors.affiliation: Department of Pediatrics, Children's Hospital, London Health Sciences Centre, Western University, 800 Commissioners Road East, London, ON, N6A 5W9, Canada. Tracy.Robinson@lhsc.on.ca.
authors.forename: Tracy
authors.initials: T
authors.lastname: Robinson
authors.affiliation: Department of Pediatrics, Children's Hospital, London Health Sciences Centre, Western University, 800 Commissioners Road East, London, ON, N6A 5W9, Canada. Jamie.Seabrook@lhsc.on.ca.|Children's Health Research Institute, 800 Commissioners Road East, London, ON, N6C 2V5, Canada. Jamie.Seabrook@lhsc.on.ca.|Division of Food & Nutritional Sciences, Brescia University College, Western University, 1285 Western Rd, London, ON, N6G 1H2, Canada. Jamie.Seabrook@lhsc.on.ca.
authors.forename: Jamie A
authors.initials: JA
authors.lastname: Seabrook
authors.affiliation: Department of Pediatrics, Children's Hospital, London Health Sciences Centre, Western University, 800 Commissioners Road East, London, ON, N6A 5W9, Canada. Meghan.Rombeek@lhsc.on.ca.
authors.forename: Meghan
authors.initials: M
authors.lastname: Rombeek
authors.affiliation: Department of Pediatrics, Children's Hospital, London Health Sciences Centre, Western University, 800 Commissioners Road East, London, ON, N6A 5W9, Canada. Kambiz.Norozi@lhsc.on.cas.|Division of Pediatric Cardiology and Intensive Care Medicine, Hannover Medical School, Carl-Neuberg Str. 1, 30625, Hannover, Germany. Kambiz.Norozi@lhsc.on.cas.|Lawson Health Research Institute, 750 Base Line Road, Suite 300, London, ON, N6C 2R5, Canada. Kambiz.Norozi@lhsc.on.cas.|Children's Health Research Institute, 800 Commissioners Road East, London, ON, N6C 2V5, Canada. Kambiz.Norozi@lhsc.on.cas.
authors.forename: Kambiz
authors.initials: K
authors.lastname: Norozi
authors.affiliation: Department of Pediatrics, Children's Hospital, London Health Sciences Centre, Western University, 800 Commissioners Road East, London, ON, N6A 5W9, Canada. Guido.Filler@lhsc.on.ca.|Lawson Health Research Institute, 750 Base Line Road, Suite 300, London, ON, N6C 2R5, Canada. Guido.Filler@lhsc.on.ca.|Children's Health Research Institute, 800 Commissioners Road East, London, ON, N6C 2V5, Canada. Guido.Filler@lhsc.on.ca.
authors.forename: Guido
authors.initials: G
authors.lastname: Filler
authors.affiliation: Department of Pediatrics, Children's Hospital, London Health Sciences Centre, Western University, 800 Commissioners Road East, London, ON, N6A 5W9, Canada. rrauch@khrmk.de.|Rems Murr Kliniken, Department of Pediatrics, Winnender Str. 45, 71334, Waiblingen, Germany. rrauch@khrmk.de.
authors.forename: Ralf
authors.initials: R
authors.lastname: Rauch
authors.affiliation: Department of Pediatrics, Children's Hospital, London Health Sciences Centre, Western University, 800 Commissioners Road East, London, ON, N6A 5W9, Canada. Cheril.Clarson@lhsc.on.ca.|Lawson Health Research Institute, 750 Base Line Road, Suite 300, London, ON, N6C 2R5, Canada. Cheril.Clarson@lhsc.on.ca.|Children's Health Research Institute, 800 Commissioners Road East, London, ON, N6C 2V5, Canada. Cheril.Clarson@lhsc.on.ca.
authors.forename: Cheril L
authors.initials: CL
authors.lastname: Clarson
mesh_terms: D050154:Adiposity; D000293:Adolescent; D001521:Behavior Therapy; D015992:Body Mass Index; D002648:Child; D005081:Exercise Therapy; D005190:Family; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009864:Ontario; D063766:Pediatric Obesity / Q000628:therapy*; D010865:Pilot Projects; D015397:Program Evaluation; D011446:Prospective Studies; D011788:Quality of Life