title: Outcomes from a Pediatric Primary Care Weight Management Program: Steps to Growing Up Healthy.
abstract: OBJECTIVE
  To examine the efficacy of Steps to Growing Up Healthy, an obesity prevention intervention in preschool-age, urban-dwelling minority children.
  
  
  METHODS
  Thirty-two pediatric primary care clinicians used a brief (3- to 5-minute) evidence-based behavior change intervention with low-income mothers of children aged 2-4 years during each regularly scheduled clinic visit over a 12-month period to target 4 specific obesogenic behaviors (milk consumption, juice and sugar-sweetened beverage consumption, television/screen time, and physical activity). A written contract, self-monitoring calendar, and telephone follow-up at 5-7 days after the clinic visit reinforced the intervention. Body mass index (BMI) percentile over 12 months and obesogenic behaviors were compared with those of a sex- and age-matched historical control group drawn from the same clinic.
  
  
  RESULTS
  Between January 2009 and November 2012, 418 mother-child dyads (82% Hispanic and 18% African American; mean child age, 35.8 ± 8.6 months; 21% overweight and 21% obese children) participated (218 in the control group and 200 in the intervention group). At 12 months, BMI percentile decreased by 0.33 percentile in the intervention group, compared with a mean increase of 8.75 percentile in the control group (P < .001). In participants with an initial BMI <85th percentile, BMI percentile did not change over time in the intervention group but increased in the control group (from the 48th ± 21 to 63th ± 29 percentile; P < .01). At 12 months, consumption of juice and milk were decreased in the intervention group (P < .001).
  
  
  CONCLUSIONS
  A brief, evidence-based intervention targeting 4 behaviors, coupled with a written contract and telephone follow-up, decreased the rate of increase in BMI percentile in young children, especially in normal weight children.
authors.affiliation: Department of Pediatrics, University of Connecticut Health Center, Farmington, CT; Children's Center for Community Research, Connecticut Children's Medical Center, Hartford, CT.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Cloutier
authors.affiliation: Children's Center for Community Research, Connecticut Children's Medical Center, Hartford, CT.
authors.forename: James
authors.initials: J
authors.lastname: Wiley
authors.affiliation: Department of Allied Health Sciences, University of Connecticut, Storrs, CT.
authors.forename: Tania
authors.initials: T
authors.lastname: Huedo-Medina
authors.affiliation: Department of Pediatrics, University of Connecticut Health Center, Farmington, CT; Children's Center for Community Research, Connecticut Children's Medical Center, Hartford, CT.
authors.forename: Christine McCauley
authors.initials: CM
authors.lastname: Ohannessian
authors.affiliation: Children's Center for Community Research, Connecticut Children's Medical Center, Hartford, CT.
authors.forename: Autherene
authors.initials: A
authors.lastname: Grant
authors.affiliation: Department of Psychology, University of Connecticut, Storrs, CT.
authors.forename: Dominica
authors.initials: D
authors.lastname: Hernandez
authors.affiliation: Department of Psychology, University of Connecticut, Storrs, CT.
authors.forename: Amy A
authors.initials: AA
authors.lastname: Gorin
mesh_terms: D000328:Adult; D001741:Black or African American; D015992:Body Mass Index; D002675:Child, Preschool; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D054525:Minority Health; D009035:Mothers / Q000523:psychology; D062405:Motivational Interviewing; D063766:Pediatric Obesity / Q000208:ethnology / Q000517:prevention & control*; D011203:Poverty / Q000208:ethnology / Q000523:psychology; D011320:Primary Health Care; D014504:Urban Health