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

Lauren Fiechtner1,2, Meghan Perkins3, Vincent Biggs4

  • 1Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, Massachusetts lfiechtner@mgh.harvard.edu.

Pediatrics
|September 2, 2021
PubMed

Insights

The Healthy Weight Clinic (HWC) effectively reduced BMI in Hispanic children, while the modified Healthy Weight and Your Child (M-HWYC) intervention did not show significant results. HWC offers a promising pediatric weight management solution.

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.
Abstract

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