Home-Delivered Pediatric Weight Management for Low-Income Families: A Randomized Controlled Trial.

Area of Science:

• Pediatric obesity intervention
• Public health
• Behavioral science

Background:

• Children from lower-income households experience greater challenges in weight management interventions.
• Barriers to treatment attendance and adherence contribute to reduced weight loss in these populations.
• The CHECK randomized controlled trial investigated home-based delivery to overcome these barriers.

Purpose of the Study:

• To compare the effectiveness of home-delivered versus clinic-delivered pediatric weight management interventions.
• To assess the impact of intervention location on weight loss outcomes, attendance, and adherence.
• To identify factors influencing the success of weight management programs for children in lower-income households.

Main Methods:

• A randomized controlled trial (CHECK study) involving 269 children (aged 6-12 years) with overweight/obesity from lower-income households.
• Intervention delivered over 12 months with planned in-person sessions and telephone contacts.
• Comparison between home-delivered and clinic-delivered in-person intervention sessions; intention-to-treat analyses used.

Main Results:

• No significant difference in 12-month BMI z-score (zBMI) change between home-delivered (-0.031) and clinic-delivered (-0.002) arms.
• Home-delivered intervention significantly increased session attendance (11 vs 6.5 sessions) and contact time (500 vs 315.5 minutes).
• Pre-pandemic, home delivery showed greater zBMI reductions; no difference was observed post-pandemic.

Conclusions:

• Home delivery of pediatric weight management interventions did not improve overall 12-month weight loss outcomes.
• Home delivery enhanced intervention engagement through increased session attendance and contact time.
• Potential weight loss benefits of home-delivered interventions may exist, particularly in the pre-pandemic era.