Behavior Change Family Counseling to Reduce Rate of Weight Gain in At-Risk Children

NCT ID: NCT00241891

Last Updated: 2015-04-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

158 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-07-31

Study Completion Date

2015-02-28

Brief Summary

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This study will train primary care providers to counsel families on behavior change that is aimed at reducing the rate of weight gain in at-risk children.

Detailed Description

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BACKGROUND:

In addition to family, school, and community, primary care is a promising setting for childhood obesity prevention. However, most pediatric primary care providers are not trained to deliver behavior modification interventions and, according to preliminary data, are less likely to address obesity prevention when they perceive insufficient time during well-care visits.

DESIGN NARRATIVE:

This is a controlled study of obesity prevention, with group randomization of two standardized 12-month intervention strategies at the practice level. The intervention strategies are based on the behavioral economics theory and will be delivered by primary care providers after training in behavior modification. The first strategy will target change in multiple behaviors, while the second strategy will target only one behavior (beverage consumption). These two interventions will be compared to an active control intervention that is unrelated to weight (bullying prevention). Six to seven primary care practices will be randomized to each arm with 21 patients per practice, for a total of 17 practices and 350 patients. The primary aim is to demonstrate that either obesity prevention intervention will result in less body mass index (BMI) increase (adjusted using z-score) in children age 8 to 12 years who are at risk for overweight (BMI 50th-95th percentile), as compared to a control intervention. The study also hypothesizes that the multiple-behavior intervention, the single-behavior intervention, or both will result in less adjusted BMI increase than the control intervention at 24 months post-randomization, with no a priori assumption in differences between the two obesity prevention strategies. Blood pressure, insulin resistance, dyslipidemia, and oral health status will be secondary outcomes. Intermediate behavioral outcomes and process data will be collected.

Conditions

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Cardiovascular Diseases Heart Diseases Obesity

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Healthy Lifestyle (Active Intervention)

Parents and children in this program which will participate in a series of consultations and activities focused on multiple healthy interventions including healthy eating, drinking, and physical activity. The children will participate in a variety of age-appropriate games, activities and exercises that are focused on healthy eating, drinking, and physical activity. In addition, your child will receive information on developing healthy interpersonal and social skills.

Group Type OTHER

Multiple behavior interventions

Intervention Type BEHAVIORAL

Focused on multiple behaviors (nutrition, beverages, physical activity, and sedentary lifestyle) which may have a significant impact on weight.

Healthy Drinks (Active Intervention)

Parents and children in this program will participate in a series of consultations and activities focused on a single intervention, the effects of beverage choices on diet, general health and teeth health. The children will participate in a variety of age-appropriate games, activities and exercises that are focused on beverages and health. In addition, your child will receive information on healthy nutrition, physical activity, and interpersonal and social skills.

Group Type OTHER

Single behavior intervention

Intervention Type BEHAVIORAL

Focused on changing beverage choices which may have a significant impact on weight.

Social and Leadership Skills (Control Intervention)

Parents and children in this program will participate in a series of consultations that are designed to help your child learn strategies to make and keep friends, to express feelings appropriately, and to successfully decrease conflicts that often occur at school among children. The children will participate in a variety of age-appropriate games, activities and exercises that are focused on these friendship making strategies. In addition, your child will receive information on healthy nutrition and physical activity. There is o intervention with regards to healthy weight.

Group Type OTHER

Control Intervention unrelated to weight

Intervention Type BEHAVIORAL

Focused on standard intervention strategies unrelated to weight including bullying prevention.

Interventions

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Single behavior intervention

Focused on changing beverage choices which may have a significant impact on weight.

Intervention Type BEHAVIORAL

Multiple behavior interventions

Focused on multiple behaviors (nutrition, beverages, physical activity, and sedentary lifestyle) which may have a significant impact on weight.

Intervention Type BEHAVIORAL

Control Intervention unrelated to weight

Focused on standard intervention strategies unrelated to weight including bullying prevention.

Intervention Type BEHAVIORAL

Other Intervention Names

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Focused on changing beverage choices with the goal

Eligibility Criteria

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Inclusion Criteria

* Sought care at the participating practices at least once in the 3 years prior to study entry
* Children "at risk for overweight" at their last clinical visit (according to the Center for Disease Control and Prevention \[CDC\] definition of a BMI at or above the 50th percentile, but less than the 95th percentile)
* Children who consume at least 28 oz of sweetened beverages per week (i.e., an average of 4 oz per day) as assessed during the telephone screening by selected components of a validated food frequency questionnaire
* The following conditions will be acceptable if they have been well controlled in the 3 months prior to study entry: hypertension, dyslipidemia, sleep apnea, asthma, and insulin resistance without diabetes

Exclusion Criteria

* Developmental delay requiring special education
* Depression
* Psychosis
* Eating disorder
* Significant orthopedic problems interfering with physical activity
* Diabetes
* Any significant chronic condition potentially interfering with nutrition or physical activity
* Treated with a drug known to affect weight gain
* Measured BMI z-score at first visit higher than +2.0 Standard Deviations (97.7th percentile)
* Families who are uninterested or unable to participate
* Home-schooled
Minimum Eligible Age

8 Years

Maximum Eligible Age

12 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Heart, Lung, and Blood Institute (NHLBI)

NIH

Sponsor Role collaborator

Children's Hospital of Philadelphia

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Stephen Leff, PhD

Role: PRINCIPAL_INVESTIGATOR

Children's Hospital of Philadelphia

Locations

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The Children's Hospital of Philadelphia

Philadelphia, Pennsylvania, United States

Site Status

Countries

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United States

References

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Stettler N, Wrotniak BH, Hill DL, Kumanyika SK, Xanthopoulos MS, Nihtianova S, Shults J, Leff SS, Pinto A, Berkowitz RI, Faith MS. Prevention of excess weight gain in paediatric primary care: beverages only or multiple lifestyle factors. The Smart Step Study, a cluster-randomized clinical trial. Pediatr Obes. 2015 Aug;10(4):267-74. doi: 10.1111/ijpo.260. Epub 2014 Sep 24.

Reference Type DERIVED
PMID: 25251166 (View on PubMed)

Other Identifiers

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R01HL084056

Identifier Type: NIH

Identifier Source: secondary_id

View Link

2005-7-4442

Identifier Type: -

Identifier Source: org_study_id

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