Maintenance Following a Randomized Trial of a Clinic and Home-based Behavioral Intervention of Obesity in
Lori J Stark1, Stephanie Spear Filigno1, Jessica C Kichler1
1Division of Behavioral Medicine and Clinical Psychology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH.
Insights
The Learning about Activity and Understanding Nutrition for Child Health (LAUNCH) intervention effectively reduced weight in preschoolers. However, maintaining these weight loss gains long-term proved challenging, suggesting longer treatment durations may be needed.
Area of Science:
- Pediatric obesity interventions
- Behavioral health research
- Childhood nutrition and activity
Background:
- Childhood obesity is a significant public health concern requiring effective interventions.
- Preschoolers are a critical age group for early intervention to establish healthy habits.
- Long-term maintenance of weight management outcomes in pediatric populations remains a challenge.
Purpose of the Study:
- To evaluate the sustained effectiveness of the LAUNCH intervention for weight management in preschoolers.
- To compare the maintenance of improved weight outcomes between the LAUNCH intervention and motivational interviewing with standard care.
- To assess secondary outcomes including caloric intake, physical activity, and home environment factors.
Main Methods:
- A randomized controlled trial involving children aged 2-5 years with obesity (BMI for age/sex >95th percentile).
- Comparison of a home- and clinic-based behavioral intervention (LAUNCH) against motivational interviewing and standard care.
- Follow-up assessments at 6 and 12 months post-treatment, measuring child/caregiver BMI, caloric intake, and physical activity.
Main Results:
- The LAUNCH intervention demonstrated sustained lower child BMI%50th compared to standard care at 12 months and motivational interviewing at 12 months.
- LAUNCH significantly reduced daily caloric intake and the presence of high-calorie foods in the home at both follow-ups.
- Caloric intake increased by 12% from post-treatment, and caregivers did not maintain improved BMI.
Conclusions:
- The LAUNCH intervention is successful in achieving initial weight reduction in preschoolers.
- Sustaining treatment gains in pediatric weight management beyond 6 months post-intervention is difficult.
- Extended intervention duration may be necessary to achieve optimal and lasting weight management results in young children.
Objective:
To assess maintenance of improved weight outcomes in preschoolers with obesity 6 and 12 months following a randomized clinical trial comparing a home- and clinic-based behavioral intervention (Learning about Activity and Understanding Nutrition for Child Health [LAUNCH]) to motivational interviewing and standard care.
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, were followed 6 and 12 months post-treatment. Child and caregiver weight, height, and caloric intake, child physical activity, and home environment were assessed. The primary outcome was maintenance of greater reduction of percent over the 50th percentile body mass index (BMI%50th) by LAUNCH compared with motivational interviewing and standard care at the 6- and 12-month follow-up.
Results:
Significantly lower child BMI%50th was maintained for LAUNCH compared with motivational interviewing at 12-month follow-up and to standard care at the 6-month follow-up; however, the effect sizes were maintained for comparison with standard care at 12-month follow-up. LAUNCH had significantly lower daily caloric intake compared with motivational interviewing and standard care at both follow-ups and maintained significantly fewer high-calorie foods in the home compared with standard care at 6 and 12 months and compared with motivational interviewing at 12 months. However, caloric intake increased by 12% from post-treatment. LAUNCH caregivers did not maintain improved BMI at follow-up.
Conclusions:
LAUNCH showed success in reducing weight in preschoolers. However, maintaining treatment gains post-treatment is more difficult. Treatment may need to last longer than 6 months to achieve optimal results.
Trial Registration:
Clinicaltrials.gov: NCT01546727.
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