TY - JOUR
KW - Body Mass Index
KW - Caregivers
KW - Child
KW - Exercise
KW - Female
KW - Humans
KW - Male
KW - Pediatric Obesity/prevention & control
KW - Primary Health Care
KW - Childhood
KW - Obesity
KW - primary care
KW - treatment
KW - underserved
AU - H. A. Raynor
AU - S. Propst
AU - S. Robson
AU - K. S. Berlin
AU - C. S. Barroso
AU - P. Khatri
A1 - 
AB - Background: This proof-of-concept trial examined a 6-month Prevention Plus (PP) intervention implemented in a federally qualified health center on child standardized BMI (ZBMI), using a planned clinical effect threshold of -0.16 ZBMI. The relationship between food security status and PP delivered with caregiver goals (PP+) and without caregiver goals (PP-) on energy balance behaviors (i.e., fruits and vegetables, physical activity) and child ZBMI was explored. Methods: Seventy-three, underserved children, 4-10 years of age with a BMI ≥85th percentile, were randomized to one of two interventions, PP+ and PP-, both providing 2.5 hours of contact time, implemented in five clinics by behavioral health consultants (BHCs). Outcomes were child anthropometrics (included 9-month follow-up), implementation data collected from electronic health records, and caregiver and BHC evaluations. Results: Children were 57.5% female and 78.1% Hispanic, with 32.9% from food-insecure households and 58.9% from households with an annual income of less than $20,000. Child ZBMI significantly (p < 0.05) decreased at 6 and 9 months (-0.08 ± 0.24 and -0.12 ± 0.43), with only PP+ reaching the clinical threshold at 9 months (PP+: -0.20 ± 0.42 vs. PP-: -0.05 ± 0.42). Sixty-four percent of families attended ≥50% of the sessions, and BHCs delivered 78.5% ± 23.5% of components at attended sessions. Caregivers were satisfied with the intervention and BHCs found the intervention helpful/useful. No relationship with food insecurity status and outcomes was found. Conclusions: PP+ when delivered by a primary care provider to underserved families showed promise for producing a clinically meaningful effect. Families and providers felt the intervention was a viable treatment option.
AD - Department of Nutrition, University of Tennessee Knoxville, Knoxville, TN, USA.; Cherokee Health Systems, Knoxville, TN, USA.; Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, USA.; Department of Psychology, The University of Memphis, Memphis, TN, USA.; Department of Public Health, University of Tennessee Knoxville, Knoxville, TN, USA.; Cherokee Health Systems, Knoxville, TN, USA.
BT - Childhood obesity (Print)
C5 - Education & Workforce; Healthcare Disparities
CP - 4
DO - 10.1089/chi.2021.0071
IS - 4
JF - Childhood obesity (Print)
LA - eng
M1 - Journal Article
N2 - Background: This proof-of-concept trial examined a 6-month Prevention Plus (PP) intervention implemented in a federally qualified health center on child standardized BMI (ZBMI), using a planned clinical effect threshold of -0.16 ZBMI. The relationship between food security status and PP delivered with caregiver goals (PP+) and without caregiver goals (PP-) on energy balance behaviors (i.e., fruits and vegetables, physical activity) and child ZBMI was explored. Methods: Seventy-three, underserved children, 4-10 years of age with a BMI ≥85th percentile, were randomized to one of two interventions, PP+ and PP-, both providing 2.5 hours of contact time, implemented in five clinics by behavioral health consultants (BHCs). Outcomes were child anthropometrics (included 9-month follow-up), implementation data collected from electronic health records, and caregiver and BHC evaluations. Results: Children were 57.5% female and 78.1% Hispanic, with 32.9% from food-insecure households and 58.9% from households with an annual income of less than $20,000. Child ZBMI significantly (p < 0.05) decreased at 6 and 9 months (-0.08 ± 0.24 and -0.12 ± 0.43), with only PP+ reaching the clinical threshold at 9 months (PP+: -0.20 ± 0.42 vs. PP-: -0.05 ± 0.42). Sixty-four percent of families attended ≥50% of the sessions, and BHCs delivered 78.5% ± 23.5% of components at attended sessions. Caregivers were satisfied with the intervention and BHCs found the intervention helpful/useful. No relationship with food insecurity status and outcomes was found. Conclusions: PP+ when delivered by a primary care provider to underserved families showed promise for producing a clinically meaningful effect. Families and providers felt the intervention was a viable treatment option.
PY - 2022
SN - 2153-2176; 2153-2168; 2153-2168
SP - 254
EP - 265
EP - 
T1 - Implementing Prevention Plus with Underserved Families in an Integrated Primary Care Setting
T2 - Childhood obesity (Print)
TI - Implementing Prevention Plus with Underserved Families in an Integrated Primary Care Setting
U1 - Education & Workforce; Healthcare Disparities
U2 - 34767729
U3 - 10.1089/chi.2021.0071
VL - 18
VO - 2153-2176; 2153-2168; 2153-2168
Y1 - 2022
Y2 - Jun
ER -