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Randomized Controlled Trial
. 2011 Aug;165(8):714-22.
doi: 10.1001/archpediatrics.2011.44. Epub 2011 Apr 4.

Randomized controlled trial to improve primary care to prevent and manage childhood obesity: the High Five for Kids study

Elsie M Taveras  1 , Steven L Gortmaker, Katherine H Hohman, Christine M Horan, Ken P Kleinman, Kathleen Mitchell, Sarah Price, Lisa A Prosser, Sheryl L Rifas-Shiman, Matthew W Gillman
Affiliations
Randomized Controlled Trial

Randomized controlled trial to improve primary care to prevent and manage childhood obesity: the High Five for Kids study

Elsie M Taveras et al. Arch Pediatr Adolesc Med. 2011 Aug.

Abstract

Objective: To examine the effectiveness of a primary care-based obesity intervention over the first year (6 intervention contacts) of a planned 2-year study.

Design: Cluster randomized controlled trial.

Setting: Ten pediatric practices, 5 intervention and 5 usual care.

Participants: Four hundred seventy-five children aged 2 to 6 years with body mass index (BMI) in the 95th percentile or higher or 85th to less than 95th percentile if at least 1 parent was overweight; 445 (93%) had 1-year outcomes.

Intervention: Intervention practices received primary care restructuring, and families received motivational interviewing by clinicians and educational modules targeting television viewing and fast food and sugar-sweetened beverage intake.

Outcome measures: Change in BMI and obesity-related behaviors from baseline to 1 year.

Results: Compared with usual care, intervention participants had a smaller, nonsignificant change in BMI (-0.21; 95% confidence interval [CI], -0.50 to 0.07; P = .15), greater decreases in television viewing (-0.36 h/d; 95% CI, -0.64 to -0.09; P = .01), and slightly greater decreases in fast food (-0.16 serving/wk; 95% CI, -0.33 to 0.01; P = .07) and sugar-sweetened beverage (-0.22 serving/d; 95% CI, -0.52 to 0.08; P = .15) intake. In post hoc analyses, we observed significant effects on BMI among girls (-0.38; 95% CI, -0.73 to -0.03; P = .03) but not boys (0.04; 95% CI, -0.55 to 0.63; P = .89) and among participants in households with annual incomes of $50 000 or less (-0.93; 95% CI, -1.60 to -0.25; P = .01) but not in higher-income households (0.02; 95% CI, -0.30 to 0.33; P = .92).

Conclusion: After 1 year, the High Five for Kids intervention was effective in reducing television viewing but did not significantly reduce BMI.

Trial registration: ClinicalTrials.gov NCT00377767.

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Figures

Figure 1
Figure 1
Conceptual framework, based on the Chronic Care Model, of the High Five for Kids Study
Figure 2
Figure 2
Participant flow for the High Five for Kids Study
Figure 3
Figure 3
High Five for Kids poster for pediatric primary care waiting rooms
Figure 4
Figure 4
Change in health behaviors from baseline to 1-year according to whether the family chose to work on the behavior
See this image and copyright information in PMC

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