Clinical-Community Collaboration: A Strategy to Improve Retention and Outcomes in Low-Income Minority Youth in Family-Based Obesity Treatment

Child Obes. 2018 Apr;14(3):141-148. doi: 10.1089/chi.2017.0266. Epub 2018 Mar 27.

Abstract

Background: Clinical-community collaboration is a promising strategy for pediatric obesity treatment, but current research is limited. This study examined the effect of a family-based treatment program embedded in a primary care clinic on retention and changes in child weight status at 1 year.

Methods: Children (2-16 years, BMI ≥85th percentile, 87.0% Hispanic) and their parents were recruited from a single pediatric clinic for Healthy Hawks Primary Plus (HHP+). Children were referred by physicians and enrolled by a bilingual clinic-based recruitment coordinator. Participants received 12 weekly 2-hour sessions focused on lifestyle modification and health behavior change and then received bimonthly follow-up visits with their clinic-based physician through 1-year follow-up. Child body mass index (BMI) percentage of the 95th percentile (%BMIp95) was measured as the primary outcome at baseline, postintervention, and 1-year follow-up. Random effect multilevel models assessed changes in child weight status over time accounting for clustering by family. To further evaluate the impact, HHP+ retention and changes in child weight status were compared to a standard 12-week treatment program only.

Results: HHP+ participants had significantly better retention at 1 year (73.9%, p ≤ 0.001) compared to the standard treatment program (38.3%). In HHP+, physician visit attendance was significantly correlated with retention at 1 year (r = 0.69, p ≤ 0.001), and HHP+ completers had significant reductions in %BMIp95 between baseline and 1-year follow-up (p = 0.03).

Conclusion: Clinical-community partnerships might be a promising strategy to improve retention and reduce child weight status in populations currently underrepresented in obesity treatment.

Keywords: behavioral interventions; childhood obesity; health disparities; primary care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Behavior Therapy / methods
  • Body Mass Index
  • Body Weight
  • Child
  • Child, Preschool
  • Community Health Services*
  • Family
  • Female
  • Health Behavior
  • Health Promotion
  • Hispanic or Latino
  • Humans
  • Life Style
  • Male
  • Minority Groups*
  • Parents
  • Pediatric Obesity / therapy*
  • Pediatricians
  • Poverty*
  • Public-Private Sector Partnerships
  • Retention in Care / statistics & numerical data*
  • Treatment Outcome*