Establishment of the Pediatric Obesity Weight Evaluation Registry: A National Research Collaborative for Identifying the Optimal Assessment and Treatment of Pediatric Obesity

Kirk, Shelley; Armstrong, Sarah; King, Eileen; Trapp, Christine M.; Grow, Mollie; Tucker, Jared M.; Joseph, Madeline; Liu, Lenna; Weedn, Ashley; Sweeney, Brooke; Fox, Claudia K.; Fathima, Samreen; Williams, Ronald J.; Kim, Roy; Stratbucker, William

doi:10.1089/chi.2016.0060

Cited by 44 publications

(51 citation statements)

References 24 publications

(24 reference statements)

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“…This project was based on data from the Pediatric Obesity Weight Evaluation Registry (POWER) (ClinicalTrials.gov NCT02121132), a prospective study collecting longitudinal data from a network of 31 multicomponent PWM programs across the United States. The purpose of POWER is to identify participant and program characteristics associated with favorable outcomes . For inclusion in POWER, programs must provide multicomponent PWM treatment for youth with obesity and collect the required data elements.…”

Section: Methodsmentioning

confidence: 99%

Long and Short of It: Early Response Predicts Longer‐Term Outcomes in Pediatric Weight Management

Gross

Kaizer

Kelly

et al. 2019

Obesity

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Objective: This study aimed to examine whether 1-month BMI improvement is predictive of superior 6-and 12-month BMI changes in a national sample of youth in pediatric weight management treatment. Methods: Participants were 4-to 18-year-olds from the Pediatric Obesity Weight Evaluation Registry, a prospective study collecting data from 31 pediatric weight management programs across the United States. Response at 1 month was defined as ≥ 3% BMI reduction; success at 6 and 12 months was defined as ≥ 5% BMI reduction from baseline. Analyses used linear and logistic regression with robust variance estimation. Results: Primary analyses were completed with 687 participants (mean age 12.2 years). One-month responders demonstrated significant improvements in BMI compared with nonresponders at 6 months (BMI, −2.05 vs. 0.05; %BMI, −5.81 vs. 0.23; P < 0.001 for all) and 12 months (BMI, −1.87 vs. 0.30; %BMI, −5.04 vs. 1.06; P < 0.001 for all). The odds of success for 1-month responders were 9.64 (95% CI: 5.85-15.87; P < 0.001) times that of nonresponders at 6 months and 5.24 (95% CI: 2.49-11.02; P < 0.001) times that of nonresponders at 12 months. Conclusions: In treatment-seeking youth with obesity, early BMI reduction was significantly associated with greater long-term BMI reduction. Nonresponders may benefit from early treatment redirection or intensification.

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Section: Methodsmentioning

confidence: 99%

Long and Short of It: Early Response Predicts Longer‐Term Outcomes in Pediatric Weight Management

Gross

Kaizer

Kelly

et al. 2019

Obesity

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“…Many HCMS and some clinicians highlighted the need to embed research into clinical practice in order to inform best-practice models of care and to enable the development of a business case for new and/or expansion of services. Clinical groups in Europe [46], Canada [47] and the USA [48] have developed central registries to record and analyse standard clinical outcome data from multiple sites in each country. These central registries are a way to produce high-quality and meaningful outcome data, which can be used to identify best practices for pediatric weight management and as a way of undertaking multi-site research [48].…”

Section: Discussionmentioning

confidence: 99%

“…Clinical groups in Europe [46], Canada [47] and the USA [48] have developed central registries to record and analyse standard clinical outcome data from multiple sites in each country. These central registries are a way to produce high-quality and meaningful outcome data, which can be used to identify best practices for pediatric weight management and as a way of undertaking multi-site research [48]. These collaborations are thought to be an essential component of weight management and should be a focus for all pediatric weight management services in the future.…”

Section: Discussionmentioning

confidence: 99%

Clinician perspectives on models of care for pediatric weight management services in Australia: A mixed-methods study

Cohen¹,

Alexander²,

Signorelli³

et al. 2019

Preprint

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Introduction For children with moderate to severe obesity, secondary and tertiary level services provide a platform for a more intensive approach toward weight management. Clinician and health care managers’ (HCM) views are imperative for informing the nature of future services to treat such children. Methods This concurrent mixed-methods study utilized questionnaires and semi-structured focus groups with clinicians, and one-on-one semi-structured interviews with HCMs, who worked in six secondary or tertiary pediatric weight management clinics across five public hospitals in New South Wales, Australia. The Theoretical Domains Framework was employed to underpin the development of the interview guides. The recorded interviews were transcribed verbatim and coded line-by-line, noting the key emerging themes. The results from the questionnaire were analyzed using descriptive statistics. Results Clinicians (n=27) provided multiple approaches to weight management, tailored to families and patients. Clinicians more often provided general healthy eating advice over a specific diet approach. Four-fifths used body mass index percentile change as a measure of success, as well as behavioral outcomes such as improvements in physical activity levels, screen time and sleep quality. Use of a combination of group and individual sessions were thought to improve engagement and reduce attrition rates. Clinicians and HCMs recommended integrating clinics into community centres and providing specific programs for sub-groups such as children from culturally and linguistically diverse communities or children with development delay. Many clinicians and HCMs stressed the importance of pediatric weight clinics using a holistic approach to treatment. Research into clinical outcomes for services was recommended to enable the development of a business case for further funding of pediatric weight management services. Conclusion Addressing common barriers to current pediatric weight management services, and designing future models of care based on key stakeholders’ preferences, are critical to achieving optimal care provision for this high risk population.

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“…Seventy‐two percent of those seeking care from pediatric weight management programs have severe obesity 9 ; however, their response to lifestyle/behavioral management is modest, 10 with even lower responses associated with severity of obesity and adolescent age 10 , 11 . Few studies report the effectiveness of intensive lifestyle interventions for children with severe obesity, which range from 5% to 20% excessive body weight loss or a BMI reduction of 1.9–3 kg/m 2 10 , 12 , 13 .…”

Section: Rationale For Treatment Of Childhood Obesitymentioning

confidence: 99%

Weight Loss Surgery in Adolescents

Christison

Gupta

2017

Nut in Clin Prac

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Childhood obesity continues to be a national health problem, with growing numbers of adolescents (8.7%) affected by severe obesity and its associated cardiometabolic risks. Since current nonsurgical methods for treating these adolescents have only modest effects, weight loss surgery (WLS) is an alternative treatment. An overview of the literature was conducted describing the selection, management, and outcomes of adolescents undergoing WLS. Adolescent guidelines require physical and emotional maturity as well as serious comorbidities associated with body mass index cutoffs higher than those used for adults. Medium-term to long-term outcomes are similar to those of adults undergoing WLS. Such outcomes depend on management by a multidisciplinary team with expertise in caring for adolescents who are still developing psychosocially and who are relatively more dependent on family supports for continued care. Future exploration is needed to elucidate optimal surgical indications for adolescents, improved adherence to postoperative care, and the impact of WLS on life expectancy. Resulting evidence can better inform the direction for healthcare delivery and policy directed toward this at-risk population.

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Establishment of the Pediatric Obesity Weight Evaluation Registry: A National Research Collaborative for Identifying the Optimal Assessment and Treatment of Pediatric Obesity

Cited by 44 publications

References 24 publications

Long and Short of It: Early Response Predicts Longer‐Term Outcomes in Pediatric Weight Management

Long and Short of It: Early Response Predicts Longer‐Term Outcomes in Pediatric Weight Management

Clinician perspectives on models of care for pediatric weight management services in Australia: A mixed-methods study

Weight Loss Surgery in Adolescents

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