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A family-based behavioral group obesity randomized control feasibility trial across a clinical trials network: a
Ann M Davis1, Paul Darden2, Brittany Lancaster1,3
1Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, United States.
Insights
Tele-behavioral health interventions for rural children did not show a link between treatment dose and body mass index (BMI) outcomes. Further research is needed to understand how intervention delivery impacts health results in these populations.
Area of Science:
- Pediatric health
- Telemedicine
- Behavioral health
Background:
- Rural communities face unique challenges in accessing healthcare.
- Tele-behavioral health programs offer a potential solution for delivering interventions to underserved populations.
- Understanding the relationship between intervention dose and outcomes is crucial for optimizing treatment efficacy.
Purpose of the Study:
- To examine the association between the dose of a tele-behavioral health intervention and body mass index (BMI) outcomes in children and families from rural areas.
- To investigate how different components of the intervention (group, individual, total contact hours) relate to BMI changes.
- To identify factors that may influence the dose of intervention received by participants.
Main Methods:
- A tele-behavioral health program was delivered to child/caregiver dyads (n=52) in rural communities.
- Intervention dose was measured as contact hours, including nutrition, physical activity, and behavioral caregiver training.
- Generalized linear mixed models were used to analyze the impact of dose received on BMI outcomes.
Main Results:
- The majority of participants (64.4%) received at least 80% of the total intervention dose.
- Older children, males, Black children, and those from a specific site received significantly less intervention dose than targeted.
- No significant relationship was found between the dose of intervention received and BMI outcomes in children or caregivers.
Conclusions:
- Contact hours in this tele-behavioral health program did not predict health outcomes for rural families.
- The study was underpowered, and results were affected by the early stages of the COVID-19 pandemic, warranting cautious interpretation.
- Further research is needed to explore effective strategies for improving health outcomes in rural pediatric populations via tele-behavioral health.
Objective:
This ancillary study's purpose is to describe the relationship between dose of treatment and body mass index (BMI) outcomes in a tele-behavioral health program delivered in the IDeA States Pediatric Clinical Trials Network to children and their families living in rural communities.
Methods:
Participants randomized to the intervention were able to receive 26 contact hours (15 hr of group sessions and 11 hr of individual sessions) of material focused on nutrition, physical activity, and behavioral caregiver training delivered via interactive televideo. Dose of the intervention received by child/caregiver dyads (n = 52) from rural areas was measured as contact hours. The total doses of group, individual, and total contact hours were analyzed, and generalized linear mixed models were utilized to determine how dose received impacted BMI outcomes.
Results:
The majority (64.4%) of participants received the target of at least 80% (20.8 hr) of the total intervention dose. Older children (9-11 years) achieved significantly less intervention dose than targeted (M = 19.7; p = .031); as did males (M = 17.2; p < .001), children who identified as Black (M = 17.8; p < .001), and children from Site 3 (M = 18.0; p < .001). Dose was not significantly related to BMI outcomes in children or caregivers.
Conclusions:
As this study is underpowered and took place during the early stages of the COVID-19 pandemic, results should be interpreted with caution, but contact hours did not predict health outcomes for families living in rural communities.
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