Promoting Healthy Family Behaviors in the Primary Care Setting

Pediatric obesity is an increasingly prevalent problem. Several studies have examined prevention and treatment strategies. The majority of effective studies involved school or community interventions. With health care becoming more collaborative, we hypothesized that a behavioral health specialist may be effective in executing multifaceted interventions with families of at-risk patients.

This is a prospective randomized study, evaluating impact of intervention with a behavioral specialist on lifestyle risk factors for pediatric obesity in children. At-risk behaviors were identified with a screening tool from the Healthy Kids, Healthy Michigan Clinical Decision Tools, based on the 2007 American Academy of Pediatrics guidelines on pediatric obesity. An intervention group received ongoing care from the behavioral specialist over three months, including motivational interviewing and cognitive behavioral therapy. Participants were compared with a control group receiving usual care.

There was no significant difference between the intervention and control group regarding change in number of risk factors. However, both groups had a reduced number of risk factors at follow-up. The control group had a significant change in number of risk factors after the intervention.

There was no statistically significant difference between the two groups. However, it is notable that both groups saw significant decreases in total number of risk factors. The only addition to usual care provided to the control group was use of the screening tool. Our results indicate that the use of a screening tool and brief physician intervention may be an effective means for improving healthy behaviors within families.