Sherwood Nancy E, Levy Rona L, Seburg Elisabeth M, Crain A Lauren, Langer Shelby L, JaKa Meghan M, Kunin-Batson Alicia, Jeffery Robert W
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
UW School of Social Work (SSW), Seattle, WA, USA.
Pediatr Obes. 2019 Aug;14(8):e12523. doi: 10.1111/ijpo.12523. Epub 2019 Mar 14.
Pediatric primary care is an important setting for addressing obesity prevention.
The Healthy Homes/Healthy Kids 5-10 randomized controlled trial evaluated the efficacy of an obesity prevention intervention integrating pediatric primary care provider counseling and parent-targeted phone coaching.
Children aged 5 to 10 years with a BMI between the 70th and 95th percentile and their parents were recruited from pediatric primary care clinics. Participants received well-child visit provider counseling about obesity and safety/injury prevention and were then randomized to a 14-session phone-based obesity prevention (OP; n = 212) or safety and injury prevention contact control (CC; n = 209) intervention. The primary outcome was 12 and 24-month child BMI percentile.
There was no overall significant treatment effect on child BMI percentile. Caloric intake was significantly lower among OP compared with CC participants at 12 months (P < .005). In planned subgroup analyses, OP condition girls had significantly lower BMI percentile (P < .05) and BMI z-score (P < .02) at 12 and 24 months relative to CC girls and were less likely to be overweight (38.0% vs 53.0%, P < .01) or (obese 3.4% vs 8.8%, P < .10) at follow-up.
An obesity prevention intervention integrating brief provider counseling and parent-targeted phone counseling did not impact 12 and 24-month BMI status overall but did have a significant impact on BMI in girls.
儿科初级保健是预防肥胖的重要场所。
“健康家庭/健康儿童5 - 10”随机对照试验评估了一种预防肥胖干预措施的效果，该措施整合了儿科初级保健提供者咨询和针对家长的电话指导。
从儿科初级保健诊所招募了年龄在5至10岁、BMI处于第70至95百分位之间的儿童及其家长。参与者在儿童健康检查时接受了关于肥胖以及安全/伤害预防的提供者咨询，然后被随机分配到一个为期14节的基于电话的肥胖预防（OP；n = 212）或安全与伤害预防对照（CC；n = 209）干预组。主要结局指标是12个月和24个月时儿童的BMI百分位。
对儿童BMI百分位没有总体显著的治疗效果。在12个月时，OP组参与者的热量摄入显著低于CC组（P <.005）。在计划的亚组分析中，相对于CC组女孩，OP组女孩在12个月和24个月时的BMI百分位（P <.05）和BMI z评分（P <.02）显著更低，并且在随访时超重（38.0%对53.0%，P <.01）或肥胖（3.4%对8.8%，P <.10）的可能性更小。
整合简短的提供者咨询和针对家长的电话咨询的肥胖预防干预措施总体上并未影响12个月和24个月时的BMI状况，但对女孩的BMI有显著影响。
