Randomized Controlled Trial of the MEND Program: A Family‐based Community Intervention for Childhood Obesity

Sacher, Paul; Kolotourou, Maria; Chadwick, Paul; Cole, Tim J.; Lawson, Margaret; Lucas, Alan; Singhal, Atul

doi:10.1038/oby.2009.433

Cited by 272 publications

(455 citation statements)

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“…35 The MEND ('Mind Exercise, Nutrition, Do it!') intervention 33 currently commissioned by many health-care payers in England involves B36 h of contact time with children and parents conducted by health, social, education and exercise professionals and is estimated to cost Bd385 per child. 36 In contrast, interventions delivered to individual families all had o10 h of planned contact time with participants and were delivered by General Practitioners, pediatricians or dietitians over periods ranging from 12 weeks to 24 months.…”

Section: Resultsmentioning

confidence: 99%

“…The interventions to treat obesity could broadly be categorized into three groups: interventions aimed at modifying behaviour, diet and/or physical activity delivered to groups of children and/or parents 24,26,29,31,33 or delivered to individual families; 25,27,30 and technology-based interventions used in the home or community aimed at promoting physical activity or reducing sedentary activities. 28,32 For the group-based interventions, planned contact time with professionals ranged from 10 (ref.…”

Section: Resultsmentioning

confidence: 99%

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Economic evaluation of lifestyle interventions to treat overweight or obesity in children

et al. 2012

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OBJECTIVE:To estimate lifetime cost effectiveness of lifestyle interventions to treat overweight and obese children, from the UK National Health Service perspective. DESIGN: An adaptation of the National Heart Forum economic model to predict lifetime health service costs and outcomes of lifestyle interventions on obesity-related diseases. SETTING: Hospital or community-based weight-management programmes. POPULATION: Hypothetical cohorts of overweight or obese children based on body mass data from the National Child Measurement Programme. INTERVENTIONS: Lifestyle interventions that have been compared with no or minimal intervention in randomized controlled trials (RCTs). MAIN OUTCOME MEASURES: Reduction in body mass index (BMI) standard deviation score (SDS), intervention resources/costs, lifetime treatment costs, obesity-related diseases and cost per life year gained. RESULTS: Ten RCTs were identified by our search strategy. The median effect of interventions versus control from these 10 RCTs was a difference in BMI SDS of À0.13 at 12 months, but the range in effects among interventions was broad (0.04 to À0.60). Indicative costs per child of these interventions ranged from d108 to d662. For obese children aged 10 --11 years, an intervention that resulted in a median reduction in BMI SDS at 12 months at a moderate cost of d400 increased life expectancy by 0.19 years and intervention costs were offset by subsequent undiscounted savings in treatment costs (net saving of d110 per child), though this saving did not emerge until the sixth or seventh decade of life. The discounted cost per life year gained was d13 589. Results were broadly similar for interventions aimed at children aged 4 --5 years and which targeted both obese and overweight children. For more costly interventions, savings were less likely. CONCLUSION: Interventions to treat childhood obesity are potentially cost effective although cost savings and health benefits may not appear until the sixth or seventh decade of life.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Economic evaluation of lifestyle interventions to treat overweight or obesity in children

et al. 2012

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“…4 Typically, obesity interventions in children include treatment-seeking families or recruit via advertisement or referrals. [11][12][13][14][15] The widespread inability of both parents 16 and health professionals 17 to correctly identify children as overweight limits intervention to the very overweight. This seems sensible given that obese children have greater health risks and are more likely to be obese adults than mildly overweight children.…”

Section: What This Study Addsmentioning

confidence: 99%

A Tailored Family-Based Obesity Intervention: A Randomized Trial

Taylor¹,

et al. 2015

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OBJECTIVE: To determine whether a 2-year family-based intervention using frequent contact and limited expert involvement was effective in reducing excessive weight compared with usual care.METHODS: Two hundred and six overweight and obese (BMI $85th percentile) children aged 4 to 8 years were randomized to usual care (UC) or tailored package (TP) sessions at university research rooms. UC families received personalized feedback and generalized advice regarding healthy lifestyles at baseline and 6 months. TP families attended a single multidisciplinary session to develop specific goals suitable for each family, then met with a mentor each month for 12 months, and every third month for another 12 months to discuss progress and provide support. Outcome measurements (anthropometry, questionnaires, dietary intake, accelerometry) were obtained at 0, 12, and 24 months.RESULTS: BMI at 24 months was significantly lower in TP compared with UC children (difference, 95% confidence interval: -0.34, -0.65 to -0.02), as was BMI z score (-0.12, -0.20 to -0.04) and waist circumference (-1.5, -2.5 to -0.5 cm). TP children consumed more fruit and vegetables (P = .038) and fewer noncore foods (P = .020) than UC children, and fewer noncore foods were available in the home (P = .002). TP children were also more physically active (P = .035). No differences in parental feeding practices, parenting, quality of life, child sleep, or behavior were observed.CONCLUSIONS: Frequent, low-dose support was effective for reducing excessive weight in predominantly mild to moderately overweight children over a 2-year period. Such initiatives could feasibly be incorporated into primary care.

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“…on a wide range of outcomes at 3, 6 and 12 months from baseline. 2,3 In the current study we report outcomes at 2.4-years from baseline in a random subsample of children who attended MEND 7-13 programs delivered in London (UK) community settings under service level conditions (i.e. not for research, but following the provision of the MEND 7-13 program as a child weight management public health service).…”

Section: Introductionmentioning

confidence: 99%