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Published on: August 21, 2015
A randomized clinical trial comparing delivery of behavioral pediatric obesity treatment using standard and enhanced
Brian E Saelens1, Paula Lozano, Kelley Scholz
1Seattle Children's Research Institute, P.O. Box 5371, M/S: CW8-6, Seattle, WA 98145-5005, USA. brian.saelens@seattlechildrens.org.
Insights
A new motivational approach to pediatric obesity treatment is as effective as the standard method. This self-directed intervention supports autonomy and leads to sustained weight status improvements in children and parents.
Area of Science:
- Pediatric Endocrinology
- Behavioral Science
- Public Health
Background:
- Childhood obesity is a significant public health concern requiring effective family-based interventions.
- Traditional behavioral interventions often rely on prescribed approaches, potentially limiting patient autonomy.
Purpose of the Study:
- To compare the efficacy of a self-directed, autonomy-enhancing intervention with a standard prescribed approach for pediatric obesity.
- To evaluate long-term weight status changes in children and parents.
Main Methods:
- A randomized clinical trial involving 72 overweight/obese children and their parents.
- Interventions were delivered over 20 weeks, with approaches diverging after week 5.
- Anthropometric measurements were assessed at baseline, posttreatment, and up to 2-year follow-up.
Main Results:
- Both self-directed and prescribed interventions showed similar improvements in child BMI z-score and parent BMI.
- Sustained reductions in child and parent weight status were observed at 2-year follow-up.
- No significant differences in weight status changes were found between the two intervention groups.
Conclusions:
- A motivational, autonomy-enhancing intervention is a viable alternative to standard prescribed behavioral family-based treatments for pediatric obesity.
- Empowering families with self-directed approaches can achieve comparable outcomes to traditional methods.
- The findings support the integration of autonomy-supportive strategies in pediatric weight management programs.
Objective:
To examine the efficacy of an adjunct motivational and autonomy-enhancing intervention (self-directed) for behavioral family-based pediatric obesity relative to the standard prescription of uniform behavioral skills use and interventionist goal assignment (prescribed).
Methods:
In this randomized clinical trial, 72 overweight/obese children and their parents/caregivers were assigned to either self-directed or prescribed intervention for 20 weeks, with approaches diverging after week 5. Anthropometric measurements from child and participating parent at baseline, posttreatment, and 3-month, 6-month, 1-year, and 2-year follow-ups were evaluated for change (n = 59 in follow-up analyses).
Results:
The approaches demonstrated similar child body mass index (BMI) z-score and parent BMI change from baseline to posttreatment and throughout follow-up, with child and parent weight status lower than baseline at 2 years after treatment cessation.
Conclusions:
An adjunct motivational and autonomy-enhancing approach to behavioral family-based pediatric obesity treatment is a viable alternative to the standard intervention approach.
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