Steps to Growing Up Healthy: a pediatric primary care based obesity prevention program for young children

BMC Public Health

Michelle M Cloutier¹  Autherene Grant²  Dominica Hernandez³  Christine McCauley Ohannessian¹  James Wiley²  Amy A Gorin³ 

[1] Children’s Center for Community Research, Connecticut Children’s Medical Center, University of Connecticut Health Center, 282 Washington Street, Hartford, CT 06106, USA;Children’s Center for Community Research, Connecticut Children’s Medical Center, 282 Washington Street, Hartford, CT 06106, USA;Department of Psychology, Center for Health, Intervention and Prevention, University of Connecticut, 2006 Hillside Road, Unit 1248, Storrs, CT 06269-1248, USA

关键词: Motivational interviewing;    Low-income;    Latino;    Weight management;   

Others  :  1161311
DOI  :  10.1186/1471-2458-14-72

 received in 2013-10-22, accepted in 2013-12-05,  发布年份 2014

【 摘 要 】

Background

Leading medical organizations have called on primary care pediatricians to take a central role in the prevention of childhood obesity. Weight counseling typically has not been incorporated into routine pediatric practice due to time and training constraints. Brief interventions with simple behavior change messages are needed to reach high-risk children, particularly Latino and Black children who are disproportionately affected by obesity and related comorbidities. Steps to Growing Up Healthy (Added Value) is a randomized controlled trial testing the efficacy of brief motivational counseling (BMC) delivered by primary care clinicians and the added value of supplementing BMC with monthly contact by community health workers (CHW) in the prevention/reversal of obesity in Latino and Black children ages 2-4 years old.

Methods/Design

Mother-child dyads (targeted n = 150) are recruited for this 12-month randomized trial at an inner-city pediatric primary care clinic and randomized to: 1) BMC delivered by clinicians and nurses at well, sick, and WIC visits with the goal of reducing obesogenic behaviors (BMC); 2) BMC plus monthly phone calls by a CHW (BMC + Phone); or 3) BMC plus monthly home visits by a CHW (BMC + Home). During BMC, the medical team facilitates the selection of a specific goal (i.e., reduce sugar sweetened beverage consumption) that is meaningful to the mother and teaches the mother simple behavioral strategies. Monthly contacts with CHWs are designed to identify and overcome barriers to goal progress. Dyads are assessed at baseline and 12 months and the primary outcome is change in the child’s BMI percentile. We hypothesize that BMC + Phone and BMC + Home will produce greater reductions in BMI percentiles than BMC alone and that BMC + Home will produce greater reductions in BMI percentiles than BMC + Phone.

Discussion

Steps to Growing Up Healthy will provide important information about whether a brief primary care-based intervention that utilizes a motivational interviewing and goal setting approach can be incorporated into routine care and is sufficient to prevent/reverse obesity in young children. The study will also explore whether monthly contact with a community health worker bridges the gap between the clinic and the community and is an effective strategy for promoting obesity prevention in high-risk families.

Trial registration

ClinicalTrials.gov NCT01973153

【 授权许可】

   
2014 Gorin et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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