A randomized, home-based, childhood obesity intervention delivered by patient navigators

BMC Public Health

Study Protocol

Shanna Knierim¹  Simon J. Hambidge²  Arthur J. Davidson³  Lourdes Yun³  Heather Mancinas³  L. Miriam Dickinson⁴  Matthew A. Haemer⁵  Richard E. Boles⁵ 

[1] Denver Health Ambulatory Care Services, Department of Pediatrics, 777 Bannock Street, 80204, Denver, USA;Denver Health, Division of Ambulatory Care, 666 Bannock Street, 80204, Denver, USA;Denver Public Health, 605 Bannock Street, 80204, Denver, CO, USA;Department of Family Medicine, University of Colorado Denver, 12631 E. 17th Avenue, 80045, Aurora, CO, USA;Department of Pediatrics, University of Colorado Denver School of Medicine, 12631 East 17th Avenue, 80045, Aurora, CO, USA;

关键词: Childhood obesity;    Low-income;    Latino;    Patient navigator;    Home-based obesity intervention;    Preschool;   

DOI  :  10.1186/s12889-015-1833-z

 received in 2015-04-28, accepted in 2015-05-13,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundAlthough Colorado is perceived as a healthy state, in 2010, 14.1 % of children aged 2–5 were overweight and 9.1 % were obese. Despite the high prevalence of obesity in this population, evidence to support particular strategies to treat obese preschoolers is lacking. The efficacy of home-based, childhood obesity interventions to reduce a child’s body mass index is inconclusive. However, this model uniquely provides an opportunity to observe and intervene with the home food and activity environment and engage the entire family in promoting changes that fit each family’s unique dynamics.Methods/designEligible participants are children aged 2–5 years who attended a well-child care visit at a Denver Health Community Health Service clinic within 12 months prior to recruitment and on that visit had a body mass index (BMI) >85th percentile-for-age. Participants are randomly recruited at study inception and allocated to the intervention in one of five defined 6-month stepped wedge engagements; the delayed intervention groups serves as control groups until the start of the intervention. The program is delivered by a patient navigator at the family’ home and consists of a 16-session curriculum focused on 1) parenting styles, 2) nutrition, and 3) physical activity. At each visit, a portion of curriculum is delivered to guide parents and children in selecting one goal for behavior change in each of three work areas to work on during the following week. The primary study outcome measure is change in BMI z-score from baseline to post-intervention period.DiscussionThis childhood obesity study, innovative for its home-based intervention venue, provides rich data characterizing barriers and facilitators to healthy behavior change within the home. The study population is innovative as it is focused on preschool-aged, Latino children from low-income families; this population has not typically been targeted in obesity management assessments. The home-based intervention is linked to clinical care through update letters and assessment of the program’s impact to the child’s medical providers. Informing primary care providers about a child’s accomplishments and challenges, allows the clinician to support the health weight effort when seeing families during subsequent clinical visits.Trial registrationClinicalTrials.gov NCT02024360 Registered December 21, 2013

【 授权许可】

CC BY   
© Yun et al.; licensee BioMed Central. 2015