A Novel Home‐Based Intervention for Child and Adolescent Obesity: The Results of the Whānau Pakari Randomized Controlled Trial

Abstract

Objective: To report 12-month outcomes from a multidisciplinary child obesity intervention program, targeting high-risk groups. Methods: In this unblinded randomized controlled trial, participants (recruited January 2012-August 2014) were aged 5 to 16 years, resided in Taranaki, Aotearoa/New Zealand, and had BMI 98th percentile or BMI > 91st percentile with weight-related comorbidities. Randomization was by minimization (age and ethnicity), with participants assigned to an intense intervention group (home-based assessments at 6-month intervals and a 12-month multidisciplinary program with weekly group sessions) or to a minimalintensity control group with home-based assessments and advice at each 6-month follow-up. The primary outcome was the change in BMI standard deviation score (SDS) at 12 months from baseline. A mixed model analysis was undertaken, incorporating all 6-and 12-month data. Results: Two hundred and three children were randomly assigned (47% Maori, 43% New Zealand European, 53% female, 28% from the most deprived quintile, mean age 10.7 years, mean BMI SDS 3.12). Both groups displayed a change in BMI SDS at 12 months from baseline (20.12 control, 20.10 intervention), improvements in cardiovascular fitness (P < 0.0001), and improvements in quality of life (P < 0.001). Achieving 70% attendance in the intense intervention group resulted in a change in BMI SDS of 20.22. Conclusions: This program achieved a high recruitment of target groups and a high rate of BMI SDS reduction, irrespective of intervention intensity. If retention is optimized, the intensive program doubles its effect.

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“…Engagement with Wh anau Pakari was associated with a significant decrease in BMI SDS in the low intensity group (-0.12, 95% CI -0.2 to -0.03) and high intensity intervention (-0.10, 95% CI -0.19 to -0.02) at 12 months. 3 Attendance ≥70% in the high intensity intervention doubled the effect (-0.22, 95% CI -0.36 to -0.09, p = 0.04). Improvements occurred in quality of life (p<0.001) and cardiovascular fitness (p<0.0001) in both groups.…”

“…New Plymouth, New Zealand; 2 Liggins Institute, University of Auckland, New Zealand; 3 Department of Paediatrics, Child and Youth Health, University of Auckland, Auckland, New Zealand…”