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What was the research about?

Children with obesity may develop health problems that usually affect adults, such as heart disease or high blood pressure. In Virginia’s Dan River Region, childhood obesity is about three times higher than in the rest of the state. This region has limited resources and a shortage of doctors and nurses.

In this study, the research team wanted to improve body mass index, or BMI, in children with obesity or overweight who live in this region. BMI is a measure of body fat. For children, BMI is based on age, height, weight, and sex. The team compared two programs shown to improve BMI:

• iChoose was for parents and children. Families took 12 classes about healthy eating and 48 exercise classes. Parents received 24 automated phone calls for support, and children received newsletters twice a month.
• Family Connections was for parents only. It included two classes and 10 phone calls.

The research team looked at BMI and other health outcomes for children and their parents.

What were the results?

After six months, the two programs didn’t improve children’s or parents’:

• BMI
• Blood pressure
• Quality of life
• Intake of fruit, vegetables, water, or sugary drinks
• Exercise level

Who was in the study?

The study included 139 children and 128 parents. Of the children, 48 percent were White, 45 percent were Black, and 8 percent were another race. Also, 9 percent were Hispanic. The average age was 10, and 58 percent were girls. Based on BMI, 73 percent had obesity, and 27 percent had overweight.

Of the parents, 49 percent were White, 49 percent were Black, and 2 percent were another race. Also, 5 percent were Hispanic. The average age was 49, and 97 percent were women. Based on BMI, 76 percent had obesity, 17 percent had overweight, and 7 percent were in the healthy weight range.

What did the research team do?

The research team assigned families by chance to take part in one of the two programs. At the start of the study and six months later, the team measured the children’s BMI. They also collected information about parents’ weight, parents’ and children’s blood pressure, and families’ eating and exercise habits.

The research team worked with parents of children with obesity, community groups, and doctors to design and conduct the study.

What were the limits of the study?

Only 18 percent of eligible families enrolled in the study. Also, only 63 percent of iChoose families and 84 percent of Family Connections families completed the study. Results might have differed if more families joined or completed the study.

Future research could look at ways to get families to sign up for and complete programs for children with obesity or overweight.

How can people use the results?

Health professionals that serve families in areas with limited resources can use these results when considering ways to help children with obesity or overweight.

Objective

To compare the effectiveness of two family-based programs in reducing body mass index (BMI) among children with obesity or overweight

Study Design

This randomized controlled trial compared the effectiveness of two family-based childhood obesity treatment programs in reducing BMI among families living in Virginia’s Dan River Region. This region is a medically underserved area with a high prevalence of childhood obesity, food insecurity, and physical inactivity.

Researchers randomly assigned families to one of two programs:

• iChoose is a high-intensity intervention for parents and children. The program included 12 two-hour family classes on healthy eating and physical activity, biweekly automated support calls to parents, biweekly children’s newsletters, and 48 one-hour family exercise sessions over six months. This program also included a six-month maintenance period with biweekly support calls and children’s newsletters.
• Family Connections is a low-intensity intervention for parents only. The program included two 90-minute classes and 10 support calls over six months.

The study included 139 children and 128 parents. Among children, 48% were White, 45% were Black, and 8% were another race; 9% were Hispanic. The average age of children was 10, and 58% were female. Based on BMI z-scores, 73% had obesity and 27% had overweight.

Among parents, 49% were White, 49% were Black, and 2% were another race; 5% were Hispanic. The average age was 39, and 97% were female. Based on BMI, 76% had obesity, 17% had overweight, and 7% were in the healthy weight range.

At baseline and six months later, researchers used height, weight, age, and gender to calculate children’s BMI z-scores. Researchers calculated parents’ BMI and measured parents’ and children’s blood pressure. For other secondary outcomes, parents and children completed surveys.

Using a community-based participatory research approach, the researchers worked with a group of community organizations and health professionals and a group of parents of children who had participated in a previous obesity program to design and conduct the study.

Results

At six months, the two programs did not differ significantly in changes in BMI or any secondary outcomes.

Compared with baseline, neither program had statistically significant changes in children’s BMI or secondary outcomes at six months.

Limitations

Only 18% of eligible families enrolled in the study. Also, only 63% of iChoose families and 84% of Family Connections families completed the 6-month follow-up. Problems with recruitment and completing follow-up assessments limited researchers’ ability to detect differences between the interventions.

Conclusions and Relevance

In this study, neither family-based obesity program significantly improved children’s BMI or other health outcomes among parents and children at six months.

Future Research Needs

Future research could examine how to improve recruitment and retention of families in childhood obesity programs, especially in medically underserved areas with a high prevalence of obesity.