Section of Endocrinology, Diabetes, and Metabolism, Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA.
Yale University School of Public Health, Yale Center for Analytical Sciences, New Haven, Connecticut, USA.
Obesity (Silver Spring). 2023 Jan;31(1):203-213. doi: 10.1002/oby.23627. Epub 2022 Dec 10.
This study aimed to examine the extent to which Bright Bodies, a high-intensity, family-based pediatric weight management intervention, improved BMI for participants since publication of the randomized controlled trial establishing efficacy in 2007 and to describe adaptations to the program.
For participants enrolled from 2008 to 2018, linear mixed-effects models were used to estimate monthly change in BMI expressed as percentage of the 95th percentile (%BMIp95) during participants' first beginner-level program.
The sample included 396 youth individuals (mean age: 11.7 [SD 2.8] years, 61.6% female, 37.1% non-Hispanic Black, 26.3% Hispanic or Latino, 53.8% with public insurance, 80.1% with severe obesity). Across the 11 years, participants' %BMIp95 reduced on average by 1.63% (95% CI: 1.44%-1.82%) per month during their first program (mean duration: 10 weeks) after adjusting for age, sex, season and year, starting %BMIp95, race and ethnicity, and insurance category. Greater reduction in %BMIp95 was associated with male versus female sex, spring/fall versus winter seasons, enrollment in 2008 to 2018 versus 2015 to 2018, and higher starting %BMIp95 (p value for all <0.001). Adaptations since 2007 included pragmatic changes to increase engagement and address funding shortages.
These results suggest sustained clinical effectiveness of Bright Bodies in the context of real-world adaptations.
本研究旨在考察 Bright Bodies 干预措施的效果,该措施是一种高强度、以家庭为基础的儿科体重管理干预措施,自 2007 年公布证明其疗效的随机对照试验以来,该措施对参与者的 BMI 有何影响,并描述该计划的调整。
对于 2008 年至 2018 年期间入组的参与者,使用线性混合效应模型来估计参与者在首次参加初级计划期间 BMI 的每月变化,以第 95 百分位的百分比(%BMIp95)表示。
该样本包括 396 名青少年个体(平均年龄:11.7 [2.8] 岁,61.6%为女性,37.1%为非西班牙裔黑人,26.3%为西班牙裔或拉丁裔,53.8%有公共保险,80.1%为严重肥胖)。在 11 年期间,参与者在首次计划(平均持续时间:10 周)期间,其 %BMIp95 每月平均降低 1.63%(95%CI:1.44%-1.82%),调整年龄、性别、季节和年份、起始 %BMIp95、种族和民族以及保险类别后得出。与女性相比,男性的 %BMIp95 降低更大,春季/秋季与冬季相比,2008 年至 2018 年与 2015 年至 2018 年相比,以及更高的起始 %BMIp95(所有 p 值均 <0.001)。自 2007 年以来的调整包括增加参与度和解决资金短缺的务实变化。
这些结果表明,在现实世界调整的背景下,Bright Bodies 具有持续的临床效果。