Dataset Information

The Effectiveness of a Family-Centered Childhood Obesity Intervention at the YMCA: A Pilot Study.

ABSTRACT: Objective:Community-based, family-centered obesity prevention/treatment initiatives have been shown to be effective in reducing body mass index (BMI) and improving healthy habits in children if implemented with high intensity and sufficient duration. Let's Go! 5-2-1-0 Program (5-2-1-0) was incorporated into family-centered, monthly physical activity classes and cooking classes over six months delivered by Young Men's Christian Association (YMCA) staff. We hypothesized that implementation of this intervention would improve 5-2-1-0 knowledge attainment, increase healthy behavior (based on 5- 2-1-0 curriculum), and improve BMI and waist circumference measurements in children. Methods:Children attending YMCA summer camps in Rochester, MN, during 2016 were recruited via study packets mailed to their families. Height, weight, and waist circumference measurements as well as the results of the Modified Healthy Habits Survey and the 5-2-1-0 Knowledge Acquisition Survey were recorded for each participating child at baseline and 6-month follow-up. The intervention group received monthly healthy habit reminder emails, and was invited to monthly evening cooking and physical activity classes for 7 sessions over a 6-month period. Results:Fifteen families in the intervention group attended classes. Of those, 13 families regularly participated in (attended at least 5 out of 7) both the monthly physical activity and cooking classes. The children in the intervention group had a significant improvement in the number of Knowledge Acquisition Survey questions answered correctly (p<0.001), while there was no improvement in the control group. As compared to children in the control group, there was no significant change in BMI or waist circumference or healthy habits in the intervention group. Conclusion:Our study findings indicate that our intervention resulted in improved knowledge about healthy habits, but did not significantly impact healthy habits or BMI. Potential reasons for this were the small sample size and the attenuated length and/or intensity of the intervention.

SUBMITTER: Gentile N

PROVIDER: S-EPMC5931388 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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The Effectiveness of a Family-Centered Childhood Obesity Intervention at the YMCA: A Pilot Study.

Gentile N N Kaufman T K TK Maxson J J Klein D M DM Merten S S Price M M Swenson L L Weaver A L AL Brewer J J Rajjo T T Narr C C Ziebarth S S Lynch B A BA

Journal of community medicine & health education 20180223 1

<h4>Objective</h4>Community-based, family-centered obesity prevention/treatment initiatives have been shown to be effective in reducing body mass index (BMI) and improving healthy habits in children if implemented with high intensity and sufficient duration. Let's Go! 5-2-1-0 Program (5-2-1-0) was incorporated into family-centered, monthly physical activity classes and cooking classes over six months delivered by Young Men's Christian Association (YMCA) staff. We hypothesized that implementation ...[more]

PMID: 29732240

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Project description:BackgroundIncorporating family-centered care principles into childhood obesity interventions is integral for improved clinical decision making, better follow-through, and more effective communication that leads to better outcomes and greater satisfaction with services. The purpose of this study is to evaluate the psychometric properties of a modified version of the Family Centered-Care Assessment (mFCCA) tool and to assess the family-centeredness of two clinical-community childhood obesity interventions.MethodsConnect for Health was a randomized trial testing the comparative effectiveness of two interventions that enrolled 721 children, ages 2-12 years, with a body mass index (BMI) ≥ 85th percentile. The two arms were (1) enhanced primary care; and (2) enhanced primary care plus contextually-tailored, health coaching. At the end of the one-year intervention, the mFCCA was administered. We used Rasch analyses to assess the tool's psychometrics and examined differences between the groups using multiple linear regression.Results629 parents completed the mFCCA resulting in an 87% response rate. The mean (SD) age of children was 8.0 (3.0) years. The exploratory factor analysis with 24 items all loaded onto a single factor. The Rasch modeling demonstrated good reliability as evidenced by the person separation reliability coefficient (0.99), and strong validity as evidenced by the range of item difficulty and overall model fit. The mean (SD, range) mFCCA score was 4.14 (0.85, 1-5). Compared to parents of children in the enhanced primary care arm, those whose children were in the enhanced primary care plus health coaching arm had higher mFCCA scores indicating greater perception of family-centeredness (β = 0.61 units [95% CI: 0.49, 0.73]).ConclusionsUsing the mFCCA which demonstrated good psychometric properties for the assessment of family-centered care among parents of children with obesity, we found that individualized health coaching is a family-centered approach to pediatric weight management.Trial registrationClinicaltrials.gov NCT02124460.

Project description:BACKGROUND:Pediatric obesity is a multi-faceted public health concern that can lead to cardiovascular diseases, cancers, and early mortality. Small changes in diet, physical activity, or BMI can significantly reduce the possibility of developing cardiometabolic risk factors. Family-based behavioral interventions are an underutilized, evidence-based approach that have been found to significantly prevent excess weight gain and obesity in children and adolescents. Poor program availability, low participation rates, and non-adherence are noted barriers to positive outcomes. Effective interventions for pediatric obesity in primary care are hampered by low family functioning, motivation, and adherence to recommendations. METHODS:This (type II) hybrid effectiveness-implementation randomized trial tests the Family Check-Up 4 Health (FCU4Health) program, which was designed to target health behavior change in children by improving family management practices and parenting skills, with the goal of preventing obesity and excess weight gain. The FCU4Health is assessment driven to tailor services and increase parent motivation. A sample of 350 families with children aged 6 to 12 years who are identified as overweight or obese (BMI???85th percentile for age and gender) will be enrolled at three primary care clinics [two Federally Qualified Healthcare Centers (FQHCs) and a children's hospital]. All clinics serve predominantly Medicaid patients and a large ethnic minority population, including Latinos, African Americans, and American Indians who face disparities in obesity, cardiometabolic risk, and access to care. The FCU4Health will be coordinated with usual care, using two different delivery strategies: an embedded approach for the two FQHCs and a referral model for the hospital-based clinic. To assess program effectiveness (BMI, body composition, child health behaviors, parenting, and utilization of support services) and implementation outcomes (such outcomes as acceptability, adoption, feasibility, appropriateness, fidelity, and cost), we use a multi-method and multi-informant assessment strategy including electronic health record data, behavioral observation, questionnaires, interviews, and cost capture methods. DISCUSSION:This study has the potential to prevent excess weight gain, obesity, and health disparities in children by establishing the effectiveness of the FCU4Health and collecting information critical for healthcare decision makers to support sustainable implementation of family-based programs in primary care. TRIAL REGISTRATION:NCT03013309 ClinicalTrials.gov.

Project description:Background:Home-based lifestyle behaviour interventions show promise for treating and preventing childhood obesity. According to family theories, engaging the entire family unit, including parents, to change their family behaviour and dynamics may be necessary to prevent the development of childhood obesity. However, little is known about how these interventions, which may change the family dynamics and weight-related behaviours of parents, affect weight outcomes in parents. Our objective was to examine the effect of a pilot home-based childhood obesity prevention intervention on measures of anthropometrics and body composition in Canadian parents. Methods:Forty-four families with children aged 1.5-5?years were randomized to one of three groups: 4 home visits with a health educator, emails, and mailed incentives (4?HV); 2 home visits, emails, and mailed incentives (2?HV); or general health emails (control). Both the 2?HV and 4?HV intervention were conducted over a period of 6?months. Body composition and anthropometric outcomes were measured at baseline and at 6?months and 18?months from baseline. Results:In parents with baseline body mass index (BMI)???25?kg/m2, the 2?HV group had significantly lower body mass and waist circumference at 6-month (CI = -5.85,-0.14 kg;-5.82,-0.30 respectively) and 18-month follow-up (CI?=?-7.57,-1.21?kg;-9.30,-2.50?cm respectively) when compared to control, and significantly lower BMI at 18-month follow-up when compared to control (CI?=?-2.59,-0.29?kg/m2). In parents with baseline BMI?<?25?kg/m2, the 4?HV group had significantly lower percentage fat mass (CI?=?-3.94,-0.12%), while the 2?HV group had significantly lower body mass (CI?=?-2.56,-0.42?kg) and BMI (CI?=?-0.77,-0.08?kg/m2) at 6-month follow-up, both compared to control; these effects were not maintained at 18-month follow-up. Conclusions:This study provides support that a home-based childhood obesity prevention intervention may improve weight outcomes among parents. Future research should explore how home-based interventions influence family behaviour and dynamics to impact weight outcomes in children and their parents. Trial registration:Prospectively registered August 2014, clinical trial identifier NCT02223234.

Project description:BackgroundGo-Golborne was a three-year pilot programme to test an innovative, community-based 'whole system' approach to preventing overweight in children in Golborne ward, London. Whilst there is a growing interest in local whole systems approaches to obesity, understandings of what they look like in practice are newly emerging. Go-Golborne was designed, implemented and evaluated within this context.MethodsThe evaluation used a case-study design and theory of change approach to assess the effectiveness of the intervention. Height/weight measurements of children in the six participating primary schools were recorded annually for 4 years. For behavioural outcomes, children aged six-11 completed four annual on-line surveys (total 4331 responses). Parents were surveyed in year one and year four (177 responses). Three focus group discussions were held with children aged 10-11 (N = 21); interviews were conducted with parents (N = 11), and school representatives (N = 4). Stakeholders were surveyed twice (37 responses), and interviews were conducted with key stakeholders (N = 11). An extensive range of programme documents were reviewed and additional process data was collected from the programme team. The RE-AIM framework was used to synthesise findings and examine public health impact.ResultsGo-Golborne reached a diverse range of partners across Golborne. Events were attended by over 3360 local children and families and all six primary schools in the ward actively engaged in activities. The proportion of children in the above healthy weight categories remained stable over time. A number of changes in home, school and neighbourhood environments to support healthy behaviour change were evidenced. There was some qualitative evidence of positive changes in children's behaviours, though significant or sustained changes were not evidenced by the quantitative data.ConclusionsGo-Golborne helped stakeholders and parents to develop a shared commitment to improving healthy weight in children, to identify barriers to a healthy lifestyle, and to start to make changes in their services/behaviours. The campaigns and changes made at micro-level appeared to be insufficient, in the face of counteracting forces and personal factors, to achieve significant behaviour change within 3 years. This highlights the need for local initiatives to be reinforced by supporting action at regional, national and global levels.

Dataset Information

The Effectiveness of a Family-Centered Childhood Obesity Intervention at the YMCA: A Pilot Study.

Publications

The Effectiveness of a Family-Centered Childhood Obesity Intervention at the YMCA: A Pilot Study.

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