Comparison of Two Models of Family-Based Treatment for Childhood Obesity: A Pilot Study

Abstract

Background: Family-based weight loss treatment (FBT) for childhood obesity, the current ''gold standard,'' is typically provided in weekly groups for 6 months. Although this program is considered effective, it poses limitations to treatment engagement, due to time commitment and lack of widespread availability. A guided self-help version of FBT (gshFBT; eleven 20-minute sessions and one 1-hour over 5 months) was developed to circumvent such limitations. The current study examined the comparative efficacy of a 5-month FBT and gshFBT program. Methods: Participants included 50 parent-child dyads enrolled in FBT between 2011 and 2013 and 50 parent-child dyads enrolled in gshFBT between 2009 and 2010. Data were collected at baseline, posttreatment, and 6-month follow-up. Noninferiority analyses were conducted to assess comparative efficacy of changes in parent and child weight status, child nutrition, child physical activity, and drop-out. Results: Results indicated that gshFBT was noninferior to FBT in changes in child BMI z-score, overweight parent BMI, child nutritional intake, child vigorous physical activity, and drop-out. Results did not support noninferiority for changes in moderate to vigorous physical activity. Conclusions: gshFBT is less intensive, more flexible, and may be similarly effective to FBT and could reach a greater proportion of the pediatric overweight population. Further research, including a randomized clinical trial, is needed to confirm these results.

High intensity versus low intensity family-based childhood obesity treatment programs: Effectiveness, engagement and implementation outcomes from a randomized controlled trial in medically underserved region

“…Other trials that have examined childhood obesity treatment effects by programs of varying structure and intensity have been mixed, with some observing better effects for high intensity programs [77] and others observing no differences [74][75][76]. Our study ndings on QOL, proportion of participants with BMI improvements, retention, and engagement suggest that a lower intensity program may better t the needs of our intended audience.…”

“…Our study setting and sample is distinct from most other published FBCO treatment trials that were typically conducted in urban academic medical centers or large primary care settings and that include samples with higher SES, less ethnic/minority representation, and a higher proportion of married household [74][75][76][77]. Our concurrent appraisal of reach, effectiveness, and implementation outcomes of two FBCO interventions within a medically underserved region addresses notable gaps in the scienti c literature and helps guide stakeholder decisions pertaining to organizational maintenance of an intervention.…”

Comparative Costs of a Parent‐Only and Parent and Child Treatment for Children with Overweight or Obesity

“…However, emerging data suggest that other less intensive models may be similarly effective. Preliminary data suggest that a guided self-help program (gshFBT), which provides only 5 hours of intervention compared with >30 hours of intervention in FBT, is a promising model to be considered (29,30). Future research is needed to compare the clinical and cost effectiveness of gshFBT compared with PBT and FBT, and to determine whether a parent-only model of gshFBT would be similarly effective.…”

Healthy Lifestyle Management of Pediatric Obesity with a Hybrid System of Customized Mobile Technology: The PediaFit Pilot Project

“…The current orientation for improving adherence to treatments in pediatrics focuses on motivation, problem-solving skills, and reduction of post-treatment influence, resorting to a number of tools including web-based programs [ 6 , 7 ], “exergaming” [ 8 , 9 , 10 ], school interventions [ 11 ], summer camp [ 12 ], parent engagement [ 13 , 14 , 15 ], and automated mobile technology (MT) [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. Studies focused on mobile phone interventions to improve lifestyle and preventing overweight and obesity are attracting interest in both the adult and pediatric population.…”