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Childhood obesity interventions most effective with mixed approach


 

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Interventions that included computerized clinical decision support (CDS) for pediatric clinicians in combination with individualized family coaching yielded greater reductions in children’s BMI scores than did CDS alone or usual care, investigators have reported.

In a cluster-randomized clinical trial published in JAMA Pediatrics, researchers examined data from 549 children aged 6-12 years with a BMI at the 95% percentile or higher from 14 primary care practices. A total of 194 children were enrolled in the CDS arm, 171 in the CDS plus parental coaching arm, and 184 in the usual care arm, with follow-up visits occurring 1 year later. Changes to BMI score were assessed with the Healthcare Effectiveness Data and Information Set (HEDIS) measures for obesity.

Compared with the usual care arm, BMI increased less in children in the CDS arm during 1 year (−0.51). The CDS plus parental coaching arm had a smaller magnitude of effect on BMI (−0.34), the authors wrote.

The greatest improvements in BMI were among those patients who received both interventions and had the highest fidelity to intervention protocol, noted lead author Dr. Elsie M. Taveras, a pediatrician at Massachusetts General Hospital for Children in Boston.

Read the full article in JAMA Pediatrics: (DOI:10.1001/jamapediatrics.2015.0182.)

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