Comparative Effectiveness of Clinical and Community-Based Approaches to Healthy Weight

Area of Science:

• Pediatric Endocrinology
• Public Health Nutrition
• Behavioral Medicine

Background:

• Childhood obesity, particularly among low-income Hispanic populations, presents a significant public health challenge.
• Effective, accessible interventions are crucial for managing pediatric weight and preventing associated comorbidities.
• Existing pediatric weight management programs require evaluation for efficacy in diverse, underserved communities.

Purpose of the Study:

• To compare the effectiveness of two pediatric weight management interventions in reducing Body Mass Index (BMI) among Hispanic children.
• To evaluate if a health center-based Healthy Weight Clinic (HWC) is non-inferior to a community-based modified Healthy Weight and Your Child (M-HWYC) program.
• To assess the impact of these interventions on BMI and BMI percentile changes in a low-income pediatric population.

Main Methods:

• A randomized controlled trial involving 407 Hispanic children (aged 6-12 years) with BMI at or above the 85th percentile.
• Interventions included a Healthy Weight Clinic (HWC) at a health center and a modified Healthy Weight and Your Child (M-HWYC) program at a Young Men's Christian Association (YMCA).
• Non-inferiority testing was conducted by comparing the change in %BMIp95 between interventions, with a comparison group of 4037 children used for yearly BMI change analysis.

Main Results:

• The M-HWYC intervention was not found to be non-inferior to the HWC, with a mean difference in %BMIp95 of 0.75 (90% CI: 0.07 to 1.43).
• Children in the HWC showed a statistically significant decrease in BMI (-0.23 per year) and %BMIp95 (-1.03 per year) compared to the comparison sites.
• No significant BMI changes were observed in children participating in the M-HWYC intervention.

Conclusions:

• The modified Healthy Weight and Your Child (M-HWYC) intervention failed to demonstrate non-inferiority to the Healthy Weight Clinic (HWC).
• The HWC intervention proved effective in improving BMI among participating children, suggesting it is a viable treatment option.
• The findings highlight the HWC as an effective strategy for pediatric weight management, particularly for disproportionately affected populations.