There remains a compelling need for evidenced-based intervention models to assist primary care practitioners to treat their overweight pediatric patients. This project is an efficacy trial to test two potentially generalizable interventions that address many of the key barriers to obesity counseling in pediatric primary care.
Aim 1. Cost Effectiveness: We examine cost effectiveness of the interventions using cost per BMI percentile change as the primary metric as well as the number of outpatient and emergency department visits.
Aim 2. Moderator effects: We hypothesize that children in Group 3 from the upper end of the BMI distribution, i.e., > 95th percentile will show greater change in BMI percentile than their counterparts in Group 2, i.e., baseline weight will interact with Group membership. We also explore whether parent baseline BMI predicts child response to the intervention.
Aim 3. Mediation effects: We explore whether changes in child BMI (if observed) are explained by changes in diet and physical activity behaviors assessed by accelerometer (50% subsample), 24hr diet and activity recalls (50% subsample), and the brief behavior screener completed by all parents.
This Project is conducted with children ages 2-8 and their caregiver recruited from primary care pediatric practices in 4 regions of the PROS (Pediatric Research in Office Settings) Network of the American Academy of Pediatrics (AAP). The counseling occurs with the parent. Children are generally absent from the room at the time of the counseling. We work with a total of 30 PROS practices (20 children per practice).