title: Well Baby Group Care: Evaluation of a Promising Intervention for Primary Obesity Prevention in Toddlers.
abstract: BACKGROUND
  Nationally, approximately 24% of preschool children are overweight or obese, with low-income communities disproportionately affected. Few interventions to prevent obesity in children at greatest risk have demonstrated positive results. Therefore, we evaluated the effectiveness of a novel group well-child care intervention for primary obesity prevention at age 2 years.
  
  
  METHODS
  Well Baby Group (WBG) is an alternative to traditional well-child care offered at a federally qualified health center in the South Bronx. Facilitated by a pediatrician and nutritionist, WBG fosters positive dietary behaviors, responsive parenting and feeding practices, and peer support during the first 18 months of life. Multivariable logistic regression was conducted to test the effect of WBG on rates of overweight/obesity at 2 years (BMI-for-age ≥85th percentile) using a nonrandomized comparison group of children receiving traditional care at our center over the same period.
  
  
  RESULTS
  Characteristics of mothers and infants were comparable between intervention (n = 47) and comparison (n = 140) groups. Children enrolled in WBG were significantly less likely to be overweight/obese at 2 years than children receiving traditional well-child care (2.1% vs. 15.0%; OR 0.12; 95% CI 0.02-0.94; p = 0.02). In multivariable regression analysis, WBG remained a significant independent protective factor (OR 0.12; 95% CI 0.02-0.93; p = 0.04), adjusting for birthweight and parity.
  
  
  CONCLUSIONS
  WBG, a replicable model integrated into primary care visits, affords a unique opportunity to intervene consistently and early, providing families in at-risk communities with increased provider time, intensive education, and ongoing support. Further study of group well-child care for primary obesity prevention is warranted to confirm the effectiveness of the model.
authors.affiliation: 1 Community Pediatric Programs, A Partnership of Montefiore and Children's Health Fund , Bronx, NY.
authors.forename: Hildred
authors.initials: H
authors.lastname: Machuca
authors.affiliation: 1 Community Pediatric Programs, A Partnership of Montefiore and Children's Health Fund , Bronx, NY.
authors.forename: Sandra
authors.initials: S
authors.lastname: Arevalo
authors.affiliation: 1 Community Pediatric Programs, A Partnership of Montefiore and Children's Health Fund , Bronx, NY.
authors.forename: Barbara
authors.initials: B
authors.lastname: Hackley
authors.affiliation: 1 Community Pediatric Programs, A Partnership of Montefiore and Children's Health Fund , Bronx, NY.
authors.forename: Jo
authors.initials: J
authors.lastname: Applebaum
authors.affiliation: 1 Community Pediatric Programs, A Partnership of Montefiore and Children's Health Fund , Bronx, NY.
authors.forename: Arielle
authors.initials: A
authors.lastname: Mishkin
authors.affiliation: 2 Department of Epidemiology and Population Health, Albert Einstein College of Medicine , Bronx, NY.
authors.forename: Moonseong
authors.initials: M
authors.lastname: Heo
authors.affiliation: 1 Community Pediatric Programs, A Partnership of Montefiore and Children's Health Fund , Bronx, NY.
authors.forename: Alan
authors.initials: A
authors.lastname: Shapiro
mesh_terms: D000328:Adult; D002675:Child, Preschool; D037001:Directive Counseling / Q000379:methods; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D008297:Male; D009035:Mothers / Q000193:education* / Q000523:psychology; D016487:Parenting; D063766:Pediatric Obesity / Q000453:epidemiology / Q000517:prevention & control*; D011203:Poverty; D011320:Primary Health Care; D011322:Primary Prevention / Q000379:methods; D018570:Risk Assessment; D014481:United States / Q000453:epidemiology; D015430:Weight Gain