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Multidisciplinary Approach to Obesity Management: A Case Report

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Featured Article: Behavior Interventions Addressing Obesity in Rural Settings: The E-FLIP for Kids Trial.

David M Janicke¹, Crystal S Lim², Michael G Perri¹

¹University of Florida.

Journal of Pediatric Psychology

|May 1, 2019

Summary

Behavioral parent-only and family-based interventions showed no significant child weight changes in rural settings. High attendance in parent-only programs correlated with better results, but barriers to participation persist.

Keywords:

children obesity randomized controlled trial rural treatment

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Area of Science:

Pediatric obesity interventions
Rural health research
Behavioral health studies

Background:

Childhood obesity is a significant public health concern, particularly in underserved rural areas.
Existing behavioral interventions require adaptation for feasibility and accessibility in diverse settings.

Purpose of the Study:

To evaluate the effectiveness of parent-only (PO) and family-based (FB) behavioral interventions versus a health education control condition (HEC) for childhood overweight/obesity in rural settings.
To assess impacts on child weight, dietary intake, glycated hemoglobin, and quality of life.

Main Methods:

A three-armed, randomized controlled trial involving children aged 8-12 years with overweight or obesity and their parents.
Interventions included 20 group contacts over one year, delivered at Cooperative Extension Service offices.
Primary outcome was change in body mass index z-score (BMIz) from baseline to year 2.

Main Results:

No significant differences in child BMIz changes were observed between FB, PO, and HEC groups at year 2.
Parents reported high treatment satisfaction across all conditions.
Attendance dropped significantly from the initial phase to the maintenance phase; higher PO attendance was linked to greater BMIz reduction.

Conclusions:

Standard behavioral interventions may not yield significant weight changes in rural pediatric populations without addressing participation barriers.
Innovative delivery strategies are crucial for improving treatment intensity, feasibility, and acceptability in underserved rural settings.