Primary care intervention ineffective for obesity reduction in children

January 01, 0001

Primary care intervention ineffective for obesity reduction in children

These US authors conducted cluster randomized controlled trial to examine the effectiveness of a primary care-based obesity intervention over the first year (6 intervention contacts) of a planned 2-year study. Ten pediatric practices, 5 intervention and 5 usual care, enrolled 475 children aged 2 to 6 years with body mass index (BMI) in the 95th percentile or higher or 85th to less than 95th percentile if at least 1 parent was overweight; 445 (93%) had 1-year outcomes. Intervention practices received primary care restructuring, and families received motivational interviewing by clinicians and educational modules targeting television viewing and fast food and sugar-sweetened beverage intake.

They found: "Compared with usual care, intervention participants had a smaller, nonsignificant change in BMI (-0.21), greater decreases in television viewing (-0.36 h/d), and slightly greater decreases in fast food (-0.16 serving/wk) and sugar-sweetened beverage (-0.22 serving/d) intake. In post hoc analyses, we observed significant effects on BMI among girls (-0.38) but not boys (0.04) and among participants in households with annual incomes of $50,000 or less (-0.93;) but not in higher-income households (0.02)."

The authors concluded: "After 1 year, the High Five for Kids intervention was effective in reducing television viewing but did not significantly reduce BMI."

Back to the drawing board. Public health rather than primary care interventions may be the key.

For the full abstract, click here.

Arch Pediatr Adolesc Med 165(8):714-722, August 2011 © 2011 to the American Medical Association
Randomized Controlled Trial to Improve Primary Care to Prevent and Manage Childhood Obesity-The High Five for Kids Study. Elsie M. Taveras, Steven L. Gortmaker, Katherine H. Hohman, et al. Correspondence to Dr. Taveras: [email protected]

Category: T. Endocrine/Metabolic/Nutritional. Keywords: childhood obesity, primary care, motivational interviewing, patient education, randomized controlled trial, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 23 August 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.