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Comparative Effectiveness of Clinical and Community-Based Approaches to Healthy Weight.
- Source :
-
Pediatrics [Pediatrics] 2021 Oct; Vol. 148 (4). Date of Electronic Publication: 2021 Sep 01. - Publication Year :
- 2021
-
Abstract
- Objectives: The objective was to evaluate if 2 pediatric weight management interventions delivered to Hispanic, low-income children (one in a health center the other in a Young Men's Christian Association) were effective in reducing BMI. We hypothesized that they would be equally effective.<br />Methods: A total 407 children aged 6 to 12 years with BMI ≥ 85th percentile receiving care at 2 health centers were randomly assigned to a healthy weight clinic (HWC) at the health center or to a modified Healthy Weight and Your Child (M-HWYC) intervention delivered in Young Men's Christian Associations. A total of 4037 children served as the comparison group. We completed a noninferiority test comparing the M-HWYC with the HWC, which was supported if the bounds of the 90% confidence interval (CI) for the difference in percentage of the 95th percentile (%BMIp <subscript>95</subscript> ) change did not contain what we considered a minimally clinically important difference, on the basis of previous data (0.87). Then, using linear mixed models, we assessed yearly changes in BMI among intervention participants compared with the comparison sites.<br />Results: The mean difference in %BMIp <subscript>95</subscript> between the M-HWYC and the HWC was 0.75 (90% CI: 0.07 to 1.43), which did not support noninferiority. Compared with the comparison sites, per year, children in the HWC had a -0.23 (95% CI: -0.36 to -0.10) decrease in BMI and a -1.03 (95% CI -1.61 to -0.45) %BMIp <subscript>95</subscript> decrease. There was no BMI effect in the M-HWYC.<br />Conclusions: We were unable to establish noninferiority of the M-HWYC. The HWC improved BMI, offering an effective treatment of those disproportionately affected.<br />Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.<br /> (Copyright © 2021 by the American Academy of Pediatrics.)
Details
- Language :
- English
- ISSN :
- 1098-4275
- Volume :
- 148
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Pediatrics
- Publication Type :
- Academic Journal
- Accession number :
- 34470816
- Full Text :
- https://doi.org/10.1542/peds.2021-050405