Pediatric Weight Management Program Outcomes in a Largely Minority, Low Socioeconomic Status Population

Demeule-Hayes, Michelle; Winters, Matthew W.; Getzoff, Elizabeth A.; Schwimmer, Bradley A.; Rogers, Vicky S.; Scheimann, Ann O.

doi:10.4137/cmped.s38457

Cited by 8 publications

(5 citation statements)

References 29 publications

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“…The original study examining Weigh Smart Program outcomes, conducted by Demeule-Hayes and colleagues (2016) included 1,051 children, and examined overall treatment outcomes, and outcomes by program track after 1 year. In addition to zBMI, this article included information on laboratory and anthropometric outcomes, examining change in each item through a series of t tests.…”

Section: Methodsmentioning

confidence: 99%

“…Details on this programs methodology as well as its initial effectiveness results were previously published (Demeule-Hayes et al, 2016). Demeule-Hayes and colleagues (2016) examined outcomes by program track and focused on examining changes in laboratory and anthropometric measurements after 1 year, noting overall improvements regardless of track. Specifically, in a baseline sample of 1,051 youth, authors found significant 1-year improvement in zBMI, as well as metabolic blood markers.…”

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confidence: 99%

“…Washington Pediatric Hospital, a nonprofit children’s hospital servicing a large metropolitan population in Baltimore, Maryland. Details on this programs methodology as well as its initial effectiveness results were previously published (Demeule-Hayes et al, 2016). Demeule-Hayes and colleagues (2016) examined outcomes by program track and focused on examining changes in laboratory and anthropometric measurements after 1 year, noting overall improvements regardless of track.…”

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confidence: 99%

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Sociodemographic Outcomes From an Urban Pediatric Obesity Program

Andorko

Getzoff

Gelfand

et al. 2020

Clinical Practice in Pediatric Psychology

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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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Section: Methodsmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Sociodemographic Outcomes From an Urban Pediatric Obesity Program

Andorko

Getzoff

Gelfand

et al. 2020

Clinical Practice in Pediatric Psychology

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“…In particular, lifestyle modification programs that incorporate parental involvement and behavioral therapy techniques into structured dietary and physical activity treatment guidelines [5][6][7] can produce significant and clinically meaningful weight reduction [8] where positive outcomes are sustained in youth with overweight/obesity for at least a year [5,9]. Randomized controlled trials (RCTs) have demonstrated the effectiveness of family-based pediatric lifestyle modification interventions [5] and evaluations of these interventions in routine practice settings have also demonstrated a modest reduction in BMI or z-BMI [10][11][12][13][14][15][16][17][18][19][20]. However, given that clinical trials are typically equipped with more research personnel to encourage attendance (e.g., personally calling participants to attend treatment and complete assessments; more flexibility to cater to patients' schedules for appointments) and external funding to compensate participants for participation (e.g., financially incentivizing assessment completion and/or not charging for treatment), more research on weight management programs as an element of routine practice at hospital-based clinics is warranted, especially when more patients are and will be treated in these and similar practice settings.…”

Section: Introductionmentioning

confidence: 99%

Behavioral and Psychological Predictors of BMI Reduction in Children Seeking Treatment at a Hospital Clinics Family Based Pediatric Weight Management Program

Kk¹,

Griffin²,

El³

et al. 2018

J Child Obes

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The rate and occurrence of childhood obesity is concerning and sets young people on a trajectory of lifetime physical health and psychological problems. Although randomized controlled trials have demonstrated the effectiveness of family-based pediatric lifestyle modification interventions, there is still a dearth of research evaluating behavioral and psychological predictors of treatment outcome under realworld practice settings.Objective: To address this gap, we explored demographic, behavioral, and psychological predictors of treatment success in a family-based pediatric weight management program in a hospital-based clinic.Methods: For 662 consecutively-treated children with overweight/obesity, we conducted four linear regressions examining demographic, psychological and behavioral predictors of post BMI z-scores (z-BMI), controlling for pretreatment BMI z-scores.Results: Overall there was a significant decrease in z-BMI from pre to post-treatment. Linear regressions revealed that participants who began treatment at a younger age, lower BMI (<99 th percentile), and who, at pre-treatment, were more likely to have externalizing problems (CBCL) had a lower z-BMI at post treatment, after controlling for pretreatment z-BMI. Results also indicated that those who attended more visits, specifically more visits with an exercise specialist, and who achieved more behavioral goals in treatment had a lower z-BMI at post treatment, after controlling for pre-treatment z-BMI. Conclusion:Our findings provide modest support for the effectiveness of family-based pediatric lifestyle modification interventions in hospital-based clinics. We suggest the need for health care providers to identify and prepare children and their families to enter treatment at a younger age and lower BMI, to emphasize sessions with exercise specialists, and treatment engagement/goal achievement at home.

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“…22 Another study at a pediatric specialty hospital recruited participants through physician referral and tested a 12-month weight management program in low-income children (7-18 years, BMI ‡85th percentile, 59.7% Medicaid, 67.3% black). 23 While BMIz significantly improved, the study suffered from very high attrition (81% loss to follow-up). An additional study recruited low-income Latino children (9-12 years, BMI ‡85th percentile) to participate in a 6-month family-centered, primary care based program.…”

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confidence: 97%