title: Effectiveness of a once per week delivery of a family-based childhood obesity intervention: a cluster randomised controlled trial.
abstract: BACKGROUND
  The effectiveness of once per week (OPW) delivery of a family-based childhood obesity programme was compared with twice per week (TPW) delivery in achieving health and behavioural outcomes at a population level and in improving programme attendance. Both programmes were delivered over 10-weeks, and the contact hours in the OPW and TPW programmes were 20 and 35-h, respectively.
  
  
  METHODS
  A cluster-randomised controlled trial with stratification by local health district was conducted. Height, weight and global self esteem of participants and parent-reported diet and physical activity were measured at programme commencement and completion and at 6-month follow-up. Attendance was defined as the proportion of total sessions attended.
  
  
  RESULTS
  There were no differences between the OPW and TPW arms in changes from pre-programme baseline for body mass index (BMI) z-score and other health and behaviourial measures at programme completion and at follow-up, except for the increase in physical activity outside of the programme at programme completion (OPW, 3.5 h/week; TPW, 1.9 h/week; p = 0.03). OPW and TPW participants attended 71.2% and 69.2% of the total sessions, respectively. Attendance was the only contributing factor to a positive BMI z-score outcome (β = -2.45, p < 0.01) with no effects of child age and gender, language spoken at home or highest qualification of mother.
  
  
  CONCLUSIONS
  A family-based childhood obesity programme can be delivered OPW with no compromise to health or behavioural outcomes compared with TPW. Higher attendance, as a proportion of available sessions, leads to better outcomes for children.
authors.affiliation: NSW Office of Preventive Health, Liverpool, New South Wales, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Khanal
authors.affiliation: NSW Office of Preventive Health, Liverpool, New South Wales, Australia.
authors.forename: D
authors.initials: D
authors.lastname: Welsby
authors.affiliation: NSW Office of Preventive Health, Liverpool, New South Wales, Australia.
authors.forename: B
authors.initials: B
authors.lastname: Lloyd
authors.affiliation: NSW Office of Preventive Health, Liverpool, New South Wales, Australia.
authors.forename: C
authors.initials: C
authors.lastname: Innes-Hughes
authors.affiliation: Better Health Company, Ashwood, Victoria, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Lukeis
authors.affiliation: NSW Office of Preventive Health, Liverpool, New South Wales, Australia.
authors.forename: C
authors.initials: C
authors.lastname: Rissel
mesh_terms: D015992:Body Mass Index; D002648:Child; D015444:Exercise; D005081:Exercise Therapy / Q000379:methods*; D005190:Family; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010349:Patient Compliance / Q000706:statistics & numerical data*; D063766:Pediatric Obesity / Q000628:therapy*; D013997:Time Factors
keywords: Childhood obesity; Family-based intervention; attendance; population level