title: Two-year follow-up of a primary care-based intervention to prevent and manage childhood obesity: the High Five for Kids study.
abstract: The obesity epidemic has spared no age group, even young infants. Most childhood obesity is incident by the age of 5 years, making prevention in preschool years a priority.
  
  
  
  To examine 2-year changes in age- and sex-specific BMI z-scores and obesity-related behaviours among 441 of the 475 originally recruited participants in High Five for Kids, a cluster randomized controlled trial in 10 paediatric practices.
  
  
  
  The intervention included a more intensive 1-year intervention period (four in-person visits and two phone calls) followed by a less intensive 1-year maintenance period (two in-person visits) among children who were overweight or obese and age 2-6 years at enrolment. The five intervention practices restructured care to manage these children including motivational interviewing and educational modules targeting television viewing and intakes of fast food and sugar-sweetened beverages.
  
  
  
  After 2 years, compared with usual care, intervention participants had similar changes in BMI z-scores (-0.04 units; 95% CI -0.14, 0.06), television viewing (-0.20 h/d; -0.49 to 0.09) and intakes of fast food (-0.09 servings/week; -0.34 to 0.17) and sugar-sweetened beverages (-0.26 servings/day; -0.67 to 0.14).
  
  
  
  High Five for Kids, a primarily clinical-based intervention, did not affect BMI z-scores or obesity-related behaviours after 2 years.
authors.affiliation: Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
authors.forename: Sheryl L
authors.initials: SL
authors.lastname: Rifas-Shiman
authors.affiliation: Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA.
authors.forename: Elsie M
authors.initials: EM
authors.lastname: Taveras
authors.affiliation: Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Steven L
authors.initials: SL
authors.lastname: Gortmaker
authors.affiliation: Healthy Living Department, YMCA of the USA, Chicago, IL, USA.
authors.forename: Katherine H
authors.initials: KH
authors.lastname: Hohman
authors.affiliation: Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Horan
authors.affiliation: Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
authors.forename: Ken P
authors.initials: KP
authors.lastname: Kleinman
authors.affiliation: Harvard Vanguard Medical Associates, Watertown, MA, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Mitchell
authors.affiliation: Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Price
authors.affiliation: Child Health Evaluation and Research Unit, Division of General Pediatrics, University of Michigan Health System, Ann Arbor, MI, USA.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Prosser
authors.affiliation: Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Gillman
mesh_terms: D001628:Beverages; D015992:Body Mass Index; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D057140:Fast Foods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D062405:Motivational Interviewing / Q000379:methods*; D050177:Overweight / Q000517:prevention & control* / Q000628:therapy; D063766:Pediatric Obesity / Q000517:prevention & control* / Q000628:therapy; D011320:Primary Health Care / Q000379:methods*; D013690:Television
keywords: Behaviours; childhood; intervention; obesity