title: Translational research: are community-based child obesity treatment programs scalable?
abstract: BACKGROUND
  Community-based obesity treatment programs have become an important response to address child obesity; however the majority of these programs are small, efficacy trials, few are translated into real-world situations (i.e., dissemination trials). Here we report the short-term impact of a scaled-up, community-based obesity treatment program on children's weight and weight-related behaviours disseminated under real world conditions.
  
  
  METHODS
  Children age 6-15 years with a body mass index (BMI) ≥ 85th percentile with no co-morbidities, and their parents/carers participated in a twice weekly, 10-week after-school child obesity treatment program between 2009 and 2012. Outcome information included measures of weight and weight-related behaviours. Analyses were adjusted for clustering and socio-demographic variables.
  
  
  RESULTS
  Overall, 2,812 children participated (54.2% girls; M(age) 10.1 (2.0) years; M(attaendance) 12.9 (5.9) sessions). Beneficial changes among all children included BMI (-0.65 kg/m(2)), BMI-z-score (-0.11), waist circumference (-1.8 cm), and WtHtr (-0.02); self-esteem (+2.7 units), physical activity (+1.2 days/week), screen time (-4.8 h/week), and unhealthy foods index (-2.4 units) (all p < 0.001). Children who completed ≥ 75% of the program were more likely to have beneficial changes in BMI, self-esteem and diet (sugar sweetened beverages, lollies/chocolate, hot chips and takeaways) compared with children completing <75% of the program.
  
  
  CONCLUSIONS
  This is one of the few studies to report outcomes of a government-funded, program at scale in a real-world setting, and shows that investment in a community-based child obesity treatment program holds potential to produce short-term changes in weight and weight-related behaviours. The findings support government investment in this health priority area, and demonstrate that community-based models of child obesity treatment are a promising adjunctive intervention to health service provision at all levels of care.
authors.affiliation: Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, NSW, 2006, Australia. louise.hardy@sydney.edu.au.
authors.forename: Louise L
authors.initials: LL
authors.lastname: Hardy
authors.affiliation: Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, NSW, 2006, Australia. seema.mihrshahi@sydney.edu.au.
authors.forename: Seema
authors.initials: S
authors.lastname: Mihrshahi
authors.affiliation: Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, NSW, 2006, Australia. joanne.gale@sydney.edu.au.
authors.forename: Joanne
authors.initials: J
authors.lastname: Gale
authors.affiliation: Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, NSW, 2006, Australia. thanh-binh.nguyen-duy@sydney.edu.au.
authors.forename: Binh
authors.initials: B
authors.lastname: Nguyen
authors.affiliation: Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, NSW, 2006, Australia. louise.baur@sydney.edu.au.|Discipline of Paediatrics and Child Health, The Children's Hospital at Westmead Clinical School, Westmead, NSW, Australia. louise.baur@sydney.edu.au.
authors.forename: Louise A
authors.initials: LA
authors.lastname: Baur
authors.affiliation: Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, NSW, 2006, Australia. bythe.ohara@sydney.edu.au.
authors.forename: Blythe J
authors.initials: BJ
authors.lastname: O'Hara
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D004032:Diet; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D010290:Parents / Q000193:education*; D063766:Pediatric Obesity / Q000628:therapy*; D012572:School Health Services / Q000458:organization & administration*; D012649:Self Concept; D057170:Translational Research, Biomedical; D055105:Waist Circumference