van Middelkoop Marienke, Ligthart Kelly A M, Paulis Winifred D, van Teeffelen Jolande, Kornelisse Kees, Koes Bart W
Department of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.
Dietician Practice in Primary Care, dietistenpraktijk HRC, Rotterdam, The Netherlands.
Fam Pract. 2017 Nov 16;34(6):702-707. doi: 10.1093/fampra/cmx056.
GPs can refer obese children living in deprived areas to multidisciplinary programmes for a weight loss intervention, though the effectiveness of these local initiatives targeted to this specific group is unknown.
To evaluate the effectiveness of the Kids4Fit intervention in deprived areas on child's weight status.
Design and setting: cohort study, including a waiting list control period. Subjects: children (N = 154) aged 6-12 years, who signed up for the Kids4Fit intervention programme, led by a dietitian, physiotherapist and child psychologist were included. Measurements of standardized body mass index (BMI-z) and waist circumference were taken at start of the waiting list period, at start and at the end of the intervention and after 52 weeks. Mixed model analyses (random effects models) were used, expressed in effect per week [β with 95% confidence interval (CI)], compared to the waiting list expectancy over the 52-week study period.
Mixed model analyses showed a non-significant trend towards a lower BMI-z up to 52 weeks after start of Kids4Fit (β: -0.0024; 95% CI: -0.0053; 0.0004), compared to the waiting list expectancy. A significantly lower waist circumference was found over time compared to the waiting list expectancy (β: -0.0558; 95% CI: -0.0950; -0.0166). No differences were found in lifestyle and health-related quality of life.
A local multidisciplinary intervention programme in deprived areas is effective in reducing waist circumference of obese children, compared to a waiting list expectancy, but no significant changes in lifestyle and quality of life were shown.
全科医生可以将生活在贫困地区的肥胖儿童转介至多学科项目进行减肥干预，不过这些针对这一特定群体的地方举措的有效性尚不清楚。
评估贫困地区的Kids4Fit干预对儿童体重状况的有效性。
设计与设置：队列研究，包括一个候补名单对照期。研究对象：纳入了154名6至12岁的儿童，他们报名参加了由营养师、物理治疗师和儿童心理学家主导的Kids4Fit干预项目。在候补名单期开始时、干预开始时和结束时以及52周后测量标准化体重指数（BMI-z）和腰围。使用混合模型分析（随机效应模型），以每周的效应表示[β，95%置信区间（CI）]，并与52周研究期内的候补名单预期进行比较。
混合模型分析显示，与候补名单预期相比，在Kids4Fit开始后的52周内，BMI-z有降低的趋势，但不显著（β：-0.0024；95%CI：-0.0053；0.0004）。与候补名单预期相比，随着时间推移，腰围显著降低（β：-0.0558；95%CI：-0.0950；-0.0166）。在生活方式和与健康相关的生活质量方面未发现差异。
与候补名单预期相比，贫困地区的一项地方多学科干预项目在降低肥胖儿童腰围方面是有效的，但在生活方式和生活质量方面未显示出显著变化。
