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Clinic and Home-Based Behavioral Intervention for Obesity in Preschoolers: A Randomized Trial
Lori J Stark1, Stephanie Spear Filigno1, Christopher Bolling2
1Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH.
Insights
An intensive 6-month behavioral intervention significantly reduced BMIz in preschool children with obesity compared to motivational interviewing and standard care.
Area of Science:
- Pediatric obesity intervention research
- Behavioral health interventions
- Childhood obesity epidemiology
Background:
- Childhood obesity is a significant public health concern.
- Early intervention is crucial for managing obesity in preschool-aged children.
- Existing interventions vary in effectiveness and intensity.
Purpose of the Study:
- To evaluate the effectiveness of the LAUNCH intervention for reducing BMIz in preschool children.
- To compare the LAUNCH intervention against motivational interviewing and standard care.
- To test the hypothesis that LAUNCH reduces BMIz more than control groups.
Main Methods:
- Randomized controlled trial involving 151 children aged 2-5 years with obesity.
- Intervention groups: LAUNCH (behavioral skills), motivational interviewing, or standard care.
- Primary outcome: BMIz at 6 months, assessed by blinded evaluators.
Main Results:
- LAUNCH significantly reduced BMIz compared to motivational interviewing (P<.001).
- LAUNCH also significantly reduced BMIz compared to standard care (P<.004).
- High study completion rate (92%) and no demographic differences between groups.
Conclusions:
- An intensive 6-month behavioral skills-based intervention (LAUNCH) is effective in reducing obesity in preschool-aged children.
- Skills-based behavioral interventions show promise for pediatric obesity management.
- Intensive, multi-component interventions may be necessary for significant obesity reduction in young children.
Objective:
To test the hypotheses that an innovative skills-based behavioral family clinic and home-based intervention (LAUNCH) would reduce body mass index z score (BMIz) compared with motivational interviewing and to standard care in preschool-aged children with obesity.
Study Design:
Randomized controlled trial with children between the ages of 2 and 5 years above the 95th percentile for body mass index for age and sex recruited from 27 pediatrician offices across 10 recruitment cycles between March 12, 2012 and June 8, 2015. Children were randomized to LAUNCH (an 18-session clinic and home-based behavioral intervention), motivational interviewing (delivered at the same frequency as LAUNCH), or standard care (no formal intervention). Weight and height were measured by assessors blinded to participant assignment. The primary outcome, BMIz at month 6 after adjusting for baseline BMIz, was tested separately comparing LAUNCH with motivational interviewing and LAUNCH with standard care using regression-based analysis of covariance models.
Results:
A total of 151 of the 167 children randomized met intent-to-treat criteria and 92% completed the study. Children were 76% White and 57% female, with an average age of 55 months and BMI percentile of 98.57, with no demographic differences between the groups. LAUNCH participants demonstrated a significantly greater decrease in BMIz (mean = -0.32, SD = ±0.33) compared with motivational interviewing (mean = -0.05, SD = ±0.27), P < .001, ω2 = 0.74 and compared with standard care (mean = -0.13, SD = ±0.31), P < .004, ω2 = 0.75.
Conclusions:
In preschool-age children, an intensive 6-month behavioral skills-based intervention is necessary to reduce obesity.
Trial Registration:
Clinicaltrials.gov NCT01546727.
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