Five‐year follow‐up of a family‐based multidisciplinary program for children with obesity

Abstract

Family-based, multidisciplinary lifestyle interventions are recommended best practice for addressing childhood obesity (1,2); however, long-term follow-up studies assessing outcomes are limited past 2 years. The United States Preventive Services Task Force identified that a minimum of 26 contact hours is required to achieve reductions in BMI standard deviation score (BMISDS) (3). Although −0.1 was originally considered a clinically meaningful BMISDS reduction (4,5), a prospective observation study found a 0.25 to 0.50 reduction in BMISDS was required to achieve improvements in cardiovascular and metabolic outcomes (5). Nonetheless, it has been suggested that a lack of reduction in BMISDS should not be equated with failure to make healthy lifestyle changes (6), and there is growing debate around the sole use of BMISDS as a relevant health indicator (7), especially when determining program success.

Five‐year follow‐up of a clinic‐based sleep intervention for paediatric epilepsy: A randomized clinical trial

“…was comparable with a recent study that aimed to determine 5-year outcomes from a 12-month, family-based lifestyle intervention programme for children with obesity (43%; Wild et al, 2021). In our study, the attrition also did not result in any substantial selection bias at follow-up with respect to children's sleep and epilepsy characteristics over a 5-year period.…”

“…The attrition among the original SHARE participants may result in a lack of power to detect potential long‐term differences in sleep. Nevertheless, the retention rate in our follow‐up study (42%) was comparable with a recent study that aimed to determine 5‐year outcomes from a 12‐month, family‐based lifestyle intervention programme for children with obesity (43%; Wild et al, 2021). In our study, the attrition also did not result in any substantial selection bias at follow‐up with respect to children's sleep and epilepsy characteristics over a 5‐year period.…”

The Impact of a Family-Based Assessment and Intervention Healthy Lifestyle Programme on Health Knowledge and Beliefs of Children with Obesity and Their Families

“…Whānau Pakari was an unblinded randomised clinical trial that assessed the effects of a 12-month healthy lifestyle assessment-and-intervention programme in Taranaki, New Zealand in 2012–2015 [ 13 , 14 , 15 ]. Taranaki is a mixed urban–rural region, where Māori (New Zealand’s Indigenous people) comprise 17% of the population [ 16 ].…”

“…In this study, NZDep2006 is reported in quintiles, with 5 indicating the participant resides in an area with high relative deprivation based on census data, and 1 indicating low deprivation [ 18 ]. Comparisons between the high- and low-intensity trial groups are published elsewhere [ 13 , 14 , 15 ] and are not a focus of the current study. For main analyses, all participants are considered to be one group, the ‘Whānau Pakari cohort’, which is deemed more representative of real-wold clinical service provision.…”

“…By using methods such as home-based assessments and family-centred and community-based interventions, this programme aims to improve access to and acceptability of care for those most affected by obesity and its associated comorbidities (namely Māori and people from the most deprived households). Whānau Pakari has previously been evaluated by a randomised clinical trial [ 13 , 14 , 15 ] that provided the baseline and follow-up data on healthy eating, physical activity and health knowledge used in this study.…”