title: Use of a FITLINE to Support Families of Overweight and Obese Children in Pediatric Practices.
abstract: BACKGROUND
  The American Academy of Pediatrics (AAP) recommends a staged approach to pediatric weight management, starting with helping families to make targeted dietary and activity changes. This pilot study evaluated the preliminary efficacy of a pediatric practice-based referral program to support parents in helping their overweight/obese children improve their weight-related behaviors and BMI.
  
  
  METHODS
  A nonrandomized intervention study with contemporaneous control was used. Parents and their children ages 8-12 with BMI ≥85th percentile (N = 37) were recruited from a pediatric practice serving a low-income, multiethnic population. Providers delivered brief intervention and referred families to six weekly FITLINE telephone counseling sessions with a nutritionist who guided parents in helping their child make AAP-recommended changes. Child BMI and parent survey of child diet and physical activity were completed at baseline and 3 months. Medical record data from 44 children matched for age and BMI were collected.
  
  
  RESULTS
  Mean change in BMI from baseline to 3-month follow-up was -0.49 BMI units (standard deviation [SD], 0.95; p = 0.007) for the FITLINE group and 0.35 BMI units (SD, 0.96; p = 0.02) for the control group. Adjusting for baseline BMI, age, and sex, children in the FITLINE condition reduced BMI significantly more than children in the control condition (mean difference = -0.89; p = 0.0003). Significant improvements in many dietary and sedentary behaviors also were noted.
  
  
  CONCLUSIONS
  The FITLINE program reduced short-term BMI and improved dietary and sedentary behaviors. A randomized, controlled trial is warranted to assess the program's efficacy and potential to serve as a model for reducing obesity in pediatric practice.
authors.affiliation: 1 Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School , Worcester, MA.
authors.forename: Lori
authors.initials: L
authors.lastname: Pbert
authors.affiliation: 1 Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School , Worcester, MA.
authors.forename: Susan
authors.initials: S
authors.lastname: Druker
authors.affiliation: 2 Department of Quantitative Health Sciences, University of Massachusetts Medical School , Worcester, MA.
authors.forename: Bruce
authors.initials: B
authors.lastname: Barton
authors.affiliation: 1 Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School , Worcester, MA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Olendzki
authors.affiliation: 1 Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School , Worcester, MA.
authors.forename: Victoria
authors.initials: V
authors.lastname: Andersen
authors.affiliation: 1 Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School , Worcester, MA.
authors.forename: Gioia
authors.initials: G
authors.lastname: Persuitte
authors.affiliation: 3 Department of Pediatrics, University of Massachusetts Medical School , Worcester, MA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Bram
authors.affiliation: 2 Department of Quantitative Health Sciences, University of Massachusetts Medical School , Worcester, MA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Kurtz
authors.affiliation: 4 School of Medicine, Vanderbilt University Medical Center , Nashville, TN.
authors.forename: E Michael
authors.initials: EM
authors.lastname: Powers
authors.affiliation: 1 Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School , Worcester, MA.
authors.forename: Sybil
authors.initials: S
authors.lastname: Crawford
authors.affiliation: 5 Department of Social and Behavioral Sciences, Harvard School of Public Health , Boston, MA.
authors.forename: Alan C
authors.initials: AC
authors.lastname: Geller
mesh_terms: D015992:Body Mass Index; D002648:Child; D037001:Directive Counseling / Q000379:methods*; D005260:Female; D015277:Hotlines; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology*; D063766:Pediatric Obesity / Q000517:prevention & control* / Q000523:psychology; D010372:Pediatrics; D010865:Pilot Projects; D011320:Primary Health Care; D015397:Program Evaluation; D012017:Referral and Consultation; D012944:Social Support