Obesity Clinical Trial
Official title:
Effect of a Weight Management Program for Overweight and Obese Children: a Randomized Controlled Trial
The purpose of this study, and its original contribution to research, is to determine the impact of a physical activity skill development and parent centered family weight management program on the weight, cardiovascular health, physical activity, dietary intake and sedentary behaviors of overweight and obese children.
AIMS
The aim of this randomized controlled trial (RCT) is to evaluate and compare in overweight
children the effectiveness of the following interventions:
1. a parent-centered dietary modification program; 2. a physical activity skill development
program; and 3. a parent-centered dietary modification + physical activity skill development
program.
BACKGROUND
We have successfully piloted two community-based conventional weight management programs,
SHARK (a physical activity-based program) and PRAISE (a dietary modification program),
suitable for use with overweight, pre-adolescent children, and propose that the combination
of these two programs into a multi-component intervention has the potential to effectively
treat child obesity. We hypothesize that at 6-, 12-, and 24-month follow-ups, compared to
overweight children allocated to the physical activity only and dietary modification only
groups, overweight children in the physical activity + dietary modification group will
display a greater reduction in their adiposity and display improved metabolic profiles.
Secondary analyses will determine if the combined intervention improves physical activity,
sedentariness, energy intake, movement skills, self-esteem, and an activity of daily living.
RESEARCH PLAN
Study design: An assessor-blinded randomized controlled trial.
Participants and their recruitment: 216 overweight children in Wollongong and Newcastle aged
6-9 years will be recruited. Each site will recruit 108 participants, 36 in each treatment
arm. Recruitment will occur through the Media Units at both universities, through local GPs
(general practitioners) and pediatricians.
Inclusion criteria: BMI (Body Mass Index) above international cut-off points for age and
gender, one parent able to attend all required sessions, pre-pubertal, and no sibling
enrolled.
Exclusion criteria: Extreme obesity (BMI SD [mean] score > 3.5), known syndromal causes of
obesity, long term oral steroids, medications associated with weight gain, chronic illness,
dietary restriction.
Allocation to groups: Computer-based random number-producing algorithm schedule.
Interventions: SHARK Physical activity skill development program. The “SHARK” program
focuses on increasing the children's actual competence (or fundamental movement skills),
perceived competence, and social support for physical activity. PRAISE parent-centered
family weight management program. The PRAISE Program is a non-diet approach to healthy
eating that aims to decrease overly restrictive eating and encourage eating in response to
“true hunger”.
Assessment of outcome variables: assessed at baseline, 6-, 12-, and 24-month follow-ups.
Adiposity: BMI SD score, height, weight, and waist circumference. Metabolic profile
measures: blood pressure; cholesterol, triglycerides; glucose and insulin.
Physical activity energy expenditure and sedentary activities: total kilocalories expended
and time spent in sedentary activities.
Dietary energy intake: 4-day weighed food record (2 week days and the week-end), parent
selection of lower fat items in the household grocery shopping and behavior changes related
to a healthy lifestyle.
Actual and perceived competence: Test of Gross Motor Development and the Self-Perception
Profile for Children.
Activity of daily living: Sit-to-stand transfer.
Statistical analyses: intention-to-treat analysis using the 12-month follow-up as the
initial endpoint and 24-month follow-up as final data point.
Quality-assurance. Site bias, standardized and clearly defined protocols and retention
strategies have been fully addressed.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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