Obesity Clinical Trial
Official title:
Primary Care Obesity Prevention: One or Multiple Targets
This study will train primary care providers to counsel families on behavior change that is aimed at reducing the rate of weight gain in at-risk children.
BACKGROUND:
In addition to family, school, and community, primary care is a promising setting for
childhood obesity prevention. However, most pediatric primary care providers are not trained
to deliver behavior modification interventions and, according to preliminary data, are less
likely to address obesity prevention when they perceive insufficient time during well-care
visits.
DESIGN NARRATIVE:
This is a controlled study of obesity prevention, with group randomization of two
standardized 12-month intervention strategies at the practice level. The intervention
strategies are based on the behavioral economics theory and will be delivered by primary
care providers after training in behavior modification. The first strategy will target
change in multiple behaviors, while the second strategy will target only one behavior
(beverage consumption). These two interventions will be compared to an active control
intervention that is unrelated to weight (bullying prevention). Six to seven primary care
practices will be randomized to each arm with 21 patients per practice, for a total of 17
practices and 350 patients. The primary aim is to demonstrate that either obesity prevention
intervention will result in less body mass index (BMI) increase (adjusted using z-score) in
children age 8 to 12 years who are at risk for overweight (BMI 50th-95th percentile), as
compared to a control intervention. The study also hypothesizes that the multiple-behavior
intervention, the single-behavior intervention, or both will result in less adjusted BMI
increase than the control intervention at 24 months post-randomization, with no a priori
assumption in differences between the two obesity prevention strategies. Blood pressure,
insulin resistance, dyslipidemia, and oral health status will be secondary outcomes.
Intermediate behavioral outcomes and process data will be collected.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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