A pilot randomized controlled trial of a behavioral family-based intervention with and without home visits to...

Area of Science:

• Pediatric obesity intervention research
• Behavioral health and family studies
• Public health and preventative medicine

Background:

• Childhood obesity is a growing public health concern requiring effective interventions.
• Current guidelines offer tiered approaches, but intensive strategies may be necessary for severe cases.
• Family-based behavioral treatments are a cornerstone of pediatric weight management.

Purpose of the Study:

• To compare the efficacy of two family-based behavioral interventions for obesity in preschool children against a standard intervention.
• To evaluate a Stage 3 intervention (LAUNCH-clinic) and an intensive intervention exceeding Stage 3 (LAUNCH with home visit [LAUNCH-HV]).
• To assess the impact of these interventions on body mass index z-score (BMIz) in young children.

Main Methods:

• Randomized controlled trial involving 42 preschool children (aged 2-5 years) with BMI percentile ≥95th.
• Interventions included pediatrician counseling (PC), LAUNCH-clinic, and LAUNCH-HV.
• Assessments of BMIz were conducted at baseline, 6 months (posttreatment), and 12 months (follow-up).

Main Results:

• LAUNCH-HV significantly reduced BMIz from pre- to posttreatment compared to PC (p = .007).
• LAUNCH-clinic did not show a statistically significant difference in BMIz reduction compared to PC (p = .08).
• Secondary outcomes mirrored the primary findings, supporting the greater efficacy of the home-visit intervention.

Conclusions:

• Intensive behavioral intervention, specifically LAUNCH-HV incorporating home visitation, is effective in reducing BMIz in obese preschool children.
• Standard pediatrician counseling and less intensive clinic-based interventions may not be sufficient for significant weight management in this population.
• Home-based support is crucial for successful weight management strategies in early childhood obesity.