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Implementing Prevention Plus with Underserved Families in an Integrated Primary Care Setting.

Hollie A Raynor1, Sara Propst2, Shannon Robson3

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This study shows that the Prevention Plus (PP) intervention, especially when including caregiver goals (PP+), effectively reduced child BMI in underserved populations. The PP+ approach met clinical targets for meaningful BMI change at nine months.

Keywords:
childhoodobesityprimary caretreatmentunderserved

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Area of Science:

  • Pediatric Obesity Prevention
  • Behavioral Health Interventions
  • Community Health Research

Background:

  • Childhood obesity is a significant public health issue, particularly in underserved communities.
  • Existing interventions often face challenges in engagement and effectiveness within diverse populations.
  • The Prevention Plus (PP) intervention is a novel approach targeting energy balance behaviors.

Purpose of the Study:

  • To evaluate the effectiveness of a 6-month PP intervention on child standardized BMI (ZBMI) in underserved children.
  • To explore the impact of caregiver involvement (PP+ vs. PP-) on intervention outcomes.
  • To examine the relationship between food security and intervention effectiveness.

Main Methods:

  • A proof-of-concept trial randomized 73 underserved children (4-10 years, BMI ≥85th percentile) to PP+ or PP-.
  • Interventions were delivered by behavioral health consultants (BHCs) in federally qualified health centers over 6 months with a 9-month follow-up.
  • Outcomes included child anthropometrics, implementation data, and caregiver/BHC evaluations.

Main Results:

  • Child ZBMI significantly decreased at 6 and 9 months.
  • The PP+ intervention reached the clinical effect threshold of -0.16 ZBMI at 9 months (mean change -0.20).
  • High caregiver attendance (64%) and BHC component delivery (78.5%) were observed; caregivers and BHCs reported satisfaction and usefulness.

Conclusions:

  • The PP+ intervention, delivered in primary care settings, shows promise for achieving clinically meaningful reductions in child ZBMI among underserved families.
  • Caregiver involvement appears crucial for maximizing the intervention's impact.
  • The PP intervention is perceived as a viable treatment option by both families and providers.