Long-Term Outcomes of a Multidisciplinary Weight Management Intervention for Youth with Disabilities

Pona, Ashleigh A.; Gillette, Meredith L. Dreyer; Stough, Cathleen Odar; Gerling, Janelle K; Sweeney, Brooke

doi:10.1089/chi.2016.0334

Cited by 22 publications

(33 citation statements)

References 30 publications

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“…Because the primary TX‐CORD outcome study demonstrated minimal intervention effects within the 2 to 5 year‐old‐stratum compared with the older groups, the association of age with Latent Class 1 appears to be driven by weight status rather than intervention effect. Findings from other studies examining the relationship of age with intervention outcome are mixed, showing better effect with younger participants, older participants, or no relation with age . The studies varied in program structure, age range of participants, duration of program and follow‐up, the country where the study was done, and the developmental trajectory of the participants, hindering comparison.…”

Section: Discussionmentioning

confidence: 99%

“…The studies varied in program structure, age range of participants, duration of program and follow‐up, the country where the study was done, and the developmental trajectory of the participants, hindering comparison. Of note, only a few studies of the association of age on intervention effect included children below age 5 years …”

Section: Discussionmentioning

confidence: 99%

“…Of note, only a few studies of the association of age on intervention effect included children below age 5 years. 37,39,43 Strengths of this study include its large sample size, its focus on low-income and ethnically diverse populations that need effective weight management programs, robust measures, and the 12-month intervention duration. A limitation of these findings is that GMM is a largely data-driven secondary analysis, and findings require confirmation in a prospective study.…”

Section: Baseline Characteristics Associated With Membership In Latentmentioning

confidence: 99%

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Who benefits from the intervention? Correlates of successful BMI reduction in the Texas Childhood Obesity Demonstration Project (TX‐CORD)

et al. 2020

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Background Many childhood obesity intervention studies report mean outcomes but do not explore the variation in responses and the characteristics of those who respond well. Objective To identify child and family characteristics associated with improvement in the primary outcome, %BMIp95, of the Texas Childhood Obesity Research Demonstration project (TX‐CORD). Methods The 12‐month TX‐CORD secondary prevention study randomized 549 children, ages 2 to 12 years, with BMI ≥85th percentile to the intensive intervention vs. the comparison program, with measurements at baseline, 3‐, and 12‐months. A growth mixture model was used to identify mutually exclusive latent %BMIp95 trajectories. Latent class regression tested associations between baseline characteristics and latent class membership. Results A 2‐class solution emerged after accounting for the effect of intervention randomization. Latent Class 1 participants (86% of sample) were characterized by mild‐to‐moderate obesity and demonstrated a significantly greater response to the intensive intervention between 0 and 3 months (slope‐on‐group = −0.931, p = 0.03). A rebound between 3 and 12 months was not significantly different between arms. Latent Class 2 participants (14%), who had severe obesity, demonstrated no difference in response between intervention groups. Characteristics associated with Class 1 membership included younger age (2–5 years vs. 6–12 years: OR 3.70, p = .035) and lower maternal BMI category (< 35 kg/m2 vs. ≥ 35 kg/m2: OR 7.14, p < .0001). Conclusions The optimal target population for the intensive intervention are children who have milder obesity, are younger, and do not have a mother with severe obesity. Children with severe obesity may require different approaches.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Baseline Characteristics Associated With Membership In Latentmentioning

confidence: 99%

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Who benefits from the intervention? Correlates of successful BMI reduction in the Texas Childhood Obesity Demonstration Project (TX‐CORD)

et al. 2020

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“…This suggests that an early intervention program to control weight would benefit these children. Pona et al [28] reported that after a program to control weight a significant interaction between child age and time of intervention revealed that younger children exhibited greater decreases in z-score body mass index over the treatment compared to older children.…”

Section: Resultsmentioning

confidence: 99%

Comparative analysis of gross motor coordination between overweight/obese and eutrophic children

2020

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Introduction: Overweight and obese children may have lower motor coordination score than normal-weight children. Objective: To compare gross motor coordination between overweight/obese and normal-weight children and investigate the associated factors with the motor coordination scores. Method: This cross-sectional study involved 169 children of both genders, aged 6-9 years. Children with malformations, bone, muscle, and joint or neurological disorders, and BMI z < -2 were excluded. Gross motor coordination was assessed by the “Körperkoordinationstest für Kinder” (KTK). The associated factors with the motor coordination scores were analyzed by linear regression. Results: The mean scores for balancing backwards (84.2 ± 13.2 vs. 91.0 ± 15.0), hopping over on one foot (127.9 ± 10.1 vs. 132.3 ± 12.1), shifting platforms sidewise (123.5 ± 23.4 vs. 129.8 ± 14.9), as well as the overall motor scores (112.5 ± 14.8 vs. 118.8 ± 11.6) were significantly lower (p < 0.05) in overweight/obese children when compared to normal-weight children. The percentage of poor motor scores (< 85) in balancing backwards was higher in overweight/obese children (60.4% vs. 36.4%, p = 0.004) and was similar for jumping sideways (18.8% vs. 9.9%, p = 0.116), as well as for shifting platforms sidewise (6.3% vs. 0.8%, p = 0.070). By multiple linear regression analysis, the variables overweight/obesity and sports practice for less than 2 times/week decreased significantly (p < 0.05) the motor coordination score by -18.7 and -15.6 points, respectively. Conclusion: The overweight/obese children scored lower in the motor coordination tests compared to the normal-weight children. Overweight/obesity and low frequency of physical activity were associated with lower scores of gross motor coordination.

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“…This begins with counseling in the primary care setting for stage 1 and progresses to multidisciplinary services, medications, and bariatric surgery for those in stage 4 treatment 6 . Multidisciplinary weight management programs (MWMPs) have demonstrated success in weight reduction across a range of clinical settings and are frequently used to combat obesity at the patient level 7–9 . Assessment of readiness to change behaviors contributing to obesity is recommended at initiation of MWMP and is often informally performed as part of an overall motivational interviewing approach by the clinician during office visits 10 …”

mentioning

confidence: 99%

Readiness to Change and Prospective Effects of Weight Management Programs in Pediatric Nonalcoholic Fatty Liver Disease

Slowik

Wasserkrug

Fischer

et al. 2020

Clinical Translational Sci

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Non-alcoholic fatty liver disease (NAFLD) is an increasing problem in pediatrics with limited treatment options. We prospectively assessed outcomes in patients managed in a hepatology clinic (HC) alone vs. those managed in combination with a multidisciplinary weight management program (MWMP). We describe each group's readiness to change at the time of NAFLD diagnosis. Patients diagnosed with NAFLD were given a modified Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) at enrollment (T1) to assess readiness to change. They were then followed at 3-9 months (T2) and at 10-15 months (T3). Linear mixed models were used to evaluate changes in body mass index (BMI), BMI z-score, and transaminases over time and between the two groups. There were no significant treatment group main effects or treatment × time interactions for our primary end points for HC alone (n = 75) or with MWMP (n = 18). There was a significant main effect for time for BMI z-score, with BMI z-scores declining on average by 0.0568 (P = 0.004) from visit to visit. Low SOCRATES subscales scores in HC alone (n = 33) or with MWMP (n = 4) suggested a patient population with low recognition of disease and likelihood of taking steps for change. Patients with obesity and NAFLD had low scores on all three SOCRATES subscales. Despite this, both groups had improvement in BMI z-score without significant difference between the two treatment groups in other primary end points. Further study is needed to identify the most effective patient selection and treatment strategies for pediatric patients with NAFLD, including pharmacotherapy and surgery. Despite ongoing efforts to improve the public awareness and care of children in the United States, rates of obesity are increasing with 18.5% of US children and adolescents ages 2-19 years classified as obese in 2015-2016. 1,2 Decades of study have demonstrated interactions among genetics, nutrition, physical activity, culture, and public health policy in addition to emerging theories of infectobesity, the microbiome, circadian rhythm, and other potential contributors. 3,4 As a result, children are at increasing risk of developing metabolic syndrome, nonalcoholic fatty liver disease (NAFLD), and premature mortality, and complication rates increase as they become adolescents. 5 Treatment options vary, but a staged approach is recommended for children and adolescents with obesity. This

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Long-Term Outcomes of a Multidisciplinary Weight Management Intervention for Youth with Disabilities

Cited by 22 publications

References 30 publications

Who benefits from the intervention? Correlates of successful BMI reduction in the Texas Childhood Obesity Demonstration Project (TX‐CORD)

Who benefits from the intervention? Correlates of successful BMI reduction in the Texas Childhood Obesity Demonstration Project (TX‐CORD)

Comparative analysis of gross motor coordination between overweight/obese and eutrophic children

Readiness to Change and Prospective Effects of Weight Management Programs in Pediatric Nonalcoholic Fatty Liver Disease

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