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Comparison of Parent-Only vs Family-Based Interventions for Overweight Children in Underserved Rural SettingsOutcomes From Project STORY
David M. Janicke, PhD;
Bethany J. Sallinen, PhD;
Michael G. Perri, PhD;
Lesley D. Lutes, PhD;
Milagros Huerta, MD;
Janet H. Silverstein, MD;
Babette Brumback, PhD
Arch Pediatr Adolesc Med. 2008;162(12):1119-1125.
Objective To assess the effectiveness of parent-only vs family-based interventions for pediatric weight management in underserved rural settings.
Design A 3-arm randomized controlled clinical trial.
Setting All sessions were conducted at Cooperative Extension Service offices in underserved rural counties.
Participants Ninety-three overweight or obese children (8-14 years old) and their parent(s).
Intervention Families were randomized to (1) a behavioral family-based intervention, (2) a behavioral parent-only intervention, or (3) a wait-list control group.
Outcome Measure The primary outcome measure was change in children's standardized body mass index (BMI).
Results Seventy-one children completed posttreatment (month 4) and follow-up (month 10) assessments. At the month 4 assessment, children in the parent-only intervention demonstrated a greater decrease in BMI z score (mean difference [MD], 0.127; 95% confidence interval [CI], 0.027 to 0.226) than children in the control condition. No significant difference was found between the family-based intervention and the control condition (MD, 0.065; 95% CI, –0.027 to 0.158). At month 10 follow-up, children in the parent-only and family-based intervention groups demonstrated greater decreases in BMI z score from before treatment compared with those in the control group (MD, 0.115; 95% CI, 0.003 to 0.220; and MD, 0.136; 95% CI, 0.018 to 0.254, respectively). No difference was found in weight status change between the parent-only and family-based interventions at either assessment.
Conclusions A parent-only intervention may be a viable and effective alternative to family-based treatment of childhood overweight. Cooperative Extension Service offices have the potential to serve as effective venues for the dissemination of obesity-related health promotion programs.
Author Affiliations: Departments of Clinical and Health Psychology (Drs Janicke and Perri), Pediatrics (Drs Huerta and Silverstein), and Epidemiology and Biostatistics (Dr Brumback), University of Florida, Gainesville; Division of Child Behavioral Health, University of Michigan, Ann Arbor (Dr Sallinen); and Department of Psychology, East Carolina University, Greenville, North Carolina (Dr Lutes).
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