Parra-Medina Deborah, Mojica Cynthia, Liang Yuanyuan, Ouyang Yongjian, Ramos Awilda I, Gomez Ismaela
1 Institute for Health Promotion Research, University of Texas Health Science Center at San Antonio , San Antonio, TX.
2 Department of Epidemiology and Biostatistics, University of Texas Health Science Center at San Antonio , San Antonio, TX.
Child Obes. 2015 Aug;11(4):355-63. doi: 10.1089/chi.2014.0120. Epub 2015 May 7.
US Hispanic children experience a disproportionate burden of overweight and obesity. Comprehensive high-intensity behavioral programs have demonstrated effectiveness in improving weight status among obese children. However, there remains a need to develop more efficient interventions that are feasible in primary care and demonstrate effectiveness in Hispanic children.
The pilot study used a two-group randomized design. Eligible overweight (BMI between the 85th and 94th percentile for age and gender) or obese (BMI ≥95th percentile) Hispanic children and their parents (N=118 child/parent dyads) were recruited from a rural pediatric clinic and randomized to: standard care (SC; n=61 dyads) or behavioral intervention (INT; n=57 dyads). The primary outcomes-weight, waist circumference, and zBMI-were measured at baseline, 2, 6, and 18 weeks. Multivariate logistic regression was used to examine the effect of INT on the likelihood of weight maintenance adjusting for potential confounding variables.
Significantly fewer INT children (68.5%) experienced weight gain, compared to SC children (89.7%; p=0.009). The same pattern was observed for waist circumference, where fewer INT children (44%) experienced an increase in waist circumference, compared to SC children (68.6%; p=0.02). Although a trend of improvement in favor of the INT was observed for zBMI, it was not significant.
This study provides preliminary evidence for the feasibility of a primary-care-based approach to promoting weight maintenance among a high-risk population.
美国西班牙裔儿童超重和肥胖的负担不成比例。全面的高强度行为计划已证明在改善肥胖儿童体重状况方面有效。然而，仍需要开发更有效的干预措施，这些措施在初级保健中可行，并在西班牙裔儿童中显示出效果。
该试点研究采用两组随机设计。从一家农村儿科诊所招募符合条件的超重（年龄和性别的BMI在第85至94百分位之间）或肥胖（BMI≥第95百分位）的西班牙裔儿童及其父母（N = 118对儿童/父母二元组），并随机分为：标准护理（SC；n = 61对二元组）或行为干预（INT；n = 57对二元组）。在基线、第2、6和18周测量主要结局——体重、腰围和zBMI。使用多变量逻辑回归来检验INT对调整潜在混杂变量后体重维持可能性的影响。
与SC组儿童（89.7%）相比，INT组儿童体重增加的比例显著更低（68.5%；p = 0.009）。腰围方面也观察到相同的模式，INT组儿童腰围增加的比例更低（44%），而SC组儿童为68.6%（p = 0.02）。尽管在zBMI方面观察到有利于INT组的改善趋势，但并不显著。
本研究为基于初级保健的方法在高危人群中促进体重维持的可行性提供了初步证据。
