Randomized Controlled Trial

. 2022 Sep;18(6):409-421.

doi: 10.1089/chi.2021.0221. Epub 2022 Jan 26.

Managing Obesity in Young Children: A Multiple Methods Study Assessing Feasibility, Acceptability, and Implementation of a Multicomponent, Family-Based Intervention

Laura M Kinlin^{1

2

3}, Stephan M Oreskovich³, Raluca Dubrowski³, Geoff D C Ball⁴, Melanie Barwick^{3

5

6}, Elizabeth Dettmer^{2

7}, Jess Haines⁸, Jill Hamilton^{2

9

10}, Theresa H M Kim³, Marie Klaassen¹¹, Paola Luca¹², Jonathon L Maguire^{2

6

10

13

14}, Myla E Moretti^{6

15}, Elaine Stasiulis^{3

16}, Alene Toulany^{2

3

17}, Catherine S Birken^{1

2

3

6

10}

Affiliations

¹ Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.
² Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
³ Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada.
⁴ Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
⁵ Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
⁶ Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
⁷ Department of Psychology, The Hospital for Sick Children, Toronto, Ontario, Canada.
⁸ Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada.
⁹ Division of Endocrinology, The Hospital for Sick Children, Toronto, Ontario, Canada.
¹⁰ Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
¹¹ Toronto Public Health, Toronto, Ontario, Canada.
¹² Section of Pediatric Endocrinology, Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada.
¹³ Department of Pediatrics, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
¹⁴ Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
¹⁵ Clinical Trials Unit, Ontario Child Health Support Unit, The Hospital for Sick Children, Toronto, Ontario, Canada.
¹⁶ Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
¹⁷ Division of Adolescent Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.

PMID: 35085455
PMCID: PMC9492792
DOI: 10.1089/chi.2021.0221

Randomized Controlled Trial

Managing Obesity in Young Children: A Multiple Methods Study Assessing Feasibility, Acceptability, and Implementation of a Multicomponent, Family-Based Intervention

Laura M Kinlin et al. Child Obes. 2022 Sep.

. 2022 Sep;18(6):409-421.

doi: 10.1089/chi.2021.0221. Epub 2022 Jan 26.

Authors

Affiliations

¹ Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.
² Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
³ Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada.
⁴ Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
⁵ Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
⁶ Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
⁷ Department of Psychology, The Hospital for Sick Children, Toronto, Ontario, Canada.
⁸ Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada.
⁹ Division of Endocrinology, The Hospital for Sick Children, Toronto, Ontario, Canada.
¹⁰ Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
¹¹ Toronto Public Health, Toronto, Ontario, Canada.
¹² Section of Pediatric Endocrinology, Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada.
¹³ Department of Pediatrics, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
¹⁴ Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
¹⁵ Clinical Trials Unit, Ontario Child Health Support Unit, The Hospital for Sick Children, Toronto, Ontario, Canada.
¹⁶ Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
¹⁷ Division of Adolescent Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.

PMID: 35085455
PMCID: PMC9492792
DOI: 10.1089/chi.2021.0221

Abstract

Background: We developed a multicomponent, family-based intervention for young children with obesity consisting of parent group sessions, home nursing visits, and multidisciplinary clinical encounters. Our objective was to assess intervention feasibility, acceptability, and implementation. Methods: From 2017 to 2020, we conducted a multiple methods study in the obesity management clinic at a tertiary children's hospital (Toronto, Canada). We included 1-6 year olds with a body mass index ≥97th percentile and their parents; we also included health care providers (HCPs) who delivered the intervention. To assess feasibility, we performed a pilot randomized controlled trial (RCT) comparing the intervention to usual care. To explore acceptability, we conducted parent focus groups. To explore implementation, we examined contextual factors with HCPs using the Consolidated Framework for Implementation Research. Results: There was a high level of ineligibility (n = 34/61) for the pilot RCT. Over 21 months, 11 parent-child dyads were recruited; of 6 randomized to the intervention, 3 did not participate in group sessions or home visits. In focus groups, themes identified by parents (n = 8) related to information provided at referral; fit between the intervention and patient needs; parental gains from participating in the intervention; and feasibility of group sessions. HCPs (n = 10) identified contextual factors that were positively and negatively associated with intervention implementation. Conclusions: We encountered challenges related to intervention feasibility, acceptability, and implementation. Lessons learned from this study will inform the next iteration of our intervention and are relevant to intervention development and implementation for young children with obesity. Clinical Trial Registration number: NCT03219658.

Keywords: acceptability; feasibility; implementation; pediatric obesity; pilot RCT.

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Conflict of interest statement

G.D.C.B has served as a consultant for Novo Nordisk. None of the other authors has a financial relationship or potential conflict of interest to disclose.

Figures

**Figure 1.**
Core components of the STOMP-EY intervention. STOMP-EY, SickKids Team Obesity Management Program-Early Years.

**Figure 2.**
CONSORT flow diagram for the pilot randomized controlled trial of the STOMP-EY intervention. CONSORT, Consolidated Standards of Reporting Trials.

See this image and copyright information in PMC

References

1. Kelly AS, Barlow SE, Rao G, et al. . Severe obesity in children and adolescents: Identification, associated health risks, and treatment approaches: A scientific statement from the American Heart Association. Circulation 2013;128:1689–1712. - PubMed
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Managing Obesity in Young Children: A Multiple Methods Study Assessing Feasibility, Acceptability, and Implementation of a Multicomponent, Family-Based Intervention

Affiliations

Managing Obesity in Young Children: A Multiple Methods Study Assessing Feasibility, Acceptability, and Implementation of a Multicomponent, Family-Based Intervention

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Associated data

Grants and funding

LinkOut - more resources

Full Text Sources

Medical