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

Lori J Stark1, Lisa M Clifford2, Elizabeth K Towner2

  • 1Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Department of Clinical and Health Psychology, University of Florida, Department of Pediatrics, Pediatric Prevention Research Center, Wayne State University School of Medicine, and Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Hospital lori.stark@cchmc.org.

Journal of Pediatric Psychology
|August 1, 2014
PubMed

Insights

Intensive behavioral treatments for childhood obesity, including home visits (LAUNCH-HV), significantly reduced BMI z-scores in preschoolers compared to standard counseling. The LAUNCH-clinic intervention showed no significant difference.

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.
Abstract

Keywords:
home visitsobesitypreschoolerstreatment

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