Although limited by small sample size, the study found that parents who left geographically diverse weight management clinics/programs reported similar reasons for attrition. Future efforts should include offering alternative visit times, more treatment options, and financial and transportation assistance and exploring family expectations.
Obese children and adolescents have unique needs for specialized medical equipment while hospitalized and might require special diets and physical activity options as part of their medical treatment. It is important that patients with a diagnosis of obesity be identified on admission so that appropriate equipment and resources can be provided. We examined what components a healthy hospital environment should include and sought to determine if children's hospitals provide a healthy hospital environment that offers these components. In addition, we sought to determine if children's hospitals have policies in place to identify children with obesity so that appropriate resources and services can be offered to treat that diagnosis. We surveyed National Association of Children's Hospitals and Related Institutions member hospitals via a Web-based questionnaire and found that the majority of them do not have policies in place to identify patients with obesity. We did find that the majority of hospitals reported innovative programs or services to provide a healthy hospital environment for their patients, visitors, and staff but acknowledged limitations in providing some services. Specifically, children's hospitals can and should improve on their identification and management of obese pediatric patients.
Objective: Pediatric weight management programs are plagued by insufficient changes in standardized body mass index (zBMI), disproportionately impacting racial minorities. Treatment outcomes of a pediatric weight management program with a large and diverse baseline sample were evaluated. Demographic and socioeconomic predictors of change in zBMI after 1 year were examined separately to identify characteristics contributing to treatment outcomes. It was hypothesized that socioeconomic disparities would account for lower zBMI outcomes above and beyond demographic factors. Method: Data were collected from 1,784 youth at baseline (n ϭ 271 at 12 months; age M ϭ 11.89 years, SD ϭ 3.15). Information on zBMI, demographics (sex, race, age, mother's body mass index [BMI]) and socioeconomic status (SES; health insurance, number parents in home) were collected at baseline and 12 months post intervention. Results: After 1 year, average change in zBMI was Ϫ0.12 (SD ϭ 0.21). Linear hierarchical regression analysis assessed if SES factors predicted change in zBMI after 12 months above and beyond demographic factors. Demographics were entered in Block 1, and SES factors in Block 2. The final model significantly accounted for 14.2% of variance in change in zBMI (p Ͻ .000). Examining blocks separately indicated SES variables did not significantly add to the model beyond demographic variables, contributing to less than 1.0% of the variance. Unique predictors included age, and mother's BMI. Conclusions: Participation in the program was associated with decreases in zBMI for youth who completed the year of treatment and follow-ups. Factors related to age and family had the largest association with weight loss. SES factors were not related to change in zBMI beyond demographic factors.
Implications for Impact StatementExamination of the differential impact of demographic and socioeconomic (SES) factors on 12-month weight loss outcomes of a diverse, and urban pediatric weight management program indicated SES was not associated with weight loss above and beyond demographic variables. Youth under the age of 8 had the best weight loss outcomes, whereas those with mothers who reported high BMI at baseline saw the This article was published Online First September 26, 2019.
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