The CANadian Pediatric Weight Management Registry (CANPWR): Study protocol

Abstract

BackgroundOver recent decades, the prevalence of pediatric obesity has increased markedly in developed and developing countries, and the impact of obesity on health throughout the lifespan has led to urgent calls for action. Family-based weight management interventions that emphasize healthy lifestyle changes can lead to modest improvements in weight status of children with obesity. However, these interventions are generally short in duration, reported in the context of randomized controlled trials and there are few reports of outcomes of these treatment approaches in the clinical setting. Answering these questions is critical for improving the care of children with obesity accessing outpatient health services for weight management. In response, the CANadian Pediatric Weight management Registry (CANPWR) was designed with the following three primary aims:1. Document changes in anthropometric, lifestyle, behavioural, and obesity-related co-morbidities in children enrolled in Canadian pediatric weight management programs over a three-year period;2. Characterize the individual-, family-, and program-level determinants of change in anthropometric and obesity-related co-morbidities;3. Examine the individual-, family-, and program-level determinants of program attrition.Methods/DesignThis prospective cohort, multi-centre study will include children (2–17 years old; body mass index ≥85th percentile) enrolled in one of eight Canadian pediatric weight management centres. We will recruit 1,600 study participants over a three-year period. Data collection will occur at presentation and 6-, 12-, 24-, and 36-months follow-up. The primary study outcomes are BMI z-score and change in BMI z-score over time. Secondary outcomes include anthropometric (e.g., height, waist circumference,), cardiometabolic (e.g., blood pressure, lipid profile, glycemia), lifestyle (e.g., dietary intake, physical activity, sedentary activity), and psychosocial (e.g., health-related quality of life) variables. Potential determinants of change and program attrition will include individual-, family-, and program-level variables.DiscussionThis study will enable our interdisciplinary team of clinicians, researchers, and trainees to address foundational issues regarding the management of pediatric obesity in Canada. It will also serve as a harmonized, evidence-based registry and platform for conducting future intervention research, which will ultimately enhance the weight management care provided to children with obesity and their families.

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

“…7 With regard to pediatric obesity, registries have been established in Europe 8 and Canada. 9 The Working Group of Obesity in Childhood and Adolescence was founded in Germany in 1998 in cooperation with the European Childhood Obesity Group, German Society of Pediatrics, German Society of Obesity, and the Childhood Obesity Task Force of the International Obesity Taskforce/World Health Organization. 8 The Canadian Pediatric Weight Management Registry published baseline data in 2015.…”

The readiness and motivation interview for families (RMI-Family) managing pediatric obesity: study protocol

“…Once contacted, families’ study participation will be confirmed based on inclusion and exclusion criteria, and if included, research staff will complete informed consent and assent procedures. These steps are purposeful, designed to minimize perceptions of coercion on behalf of the research team, distinguish families’ clinical care from research, and mirror the recruitment process for our other ongoing multi-centre studies [20, 21]. …”

Canadian Pediatric Weight Management Registry (CANPWR): baseline descriptive statistics and comparison to Canadian norms

“…This study included participants enrolled in the CANPWR pilot study. Research Ethics Board approval was obtained for the CANPWR study from all participating sites [ 2 ]. Written informed consent was provided for all participants by their parents or guardian and written participant assent was also obtained.…”

“…The current prevalence of childhood obesity in Canada is 11.7% [ 1 ]. A number of tertiary care centres in Canada offer pediatric weight management programs, although programs are not linked or harmonized and their efficacy and effectiveness is largely unknown [ 2 , 3 ]. To address these limitations, the CANadian Pediatric Weight management Registry (CANPWR) [ 2 ] was created to: Document changes in anthropometric, lifestyle, behavioral, and obesity-related co-morbidities in children enrolled in Canadian pediatric weight management programs over a three-year period; Characterize the individual-, family-, and program-level determinants of change in anthropometric and obesity-related co-morbidities; Examine the individual-level, family-level, and program-level determinants of program attrition.…”

“…The study outcomes of interest include BMI z-score, change in BMI z-score over time, anthropometric, cardiometabolic, lifestyle, and psychosocial variables as well as potential determinants of change and program attrition at the individual-, family-, and program-level. Further details on the CANPWR study and protocol are available elsewhere [ 2 ].…”