(Press-News.org) Children whose families and pediatricians were most faithful to an obesity intervention program that included computerized clinical decision support for physicians and health coaching for families experienced the greatest improvements in body mass index (BMI), according to an article published online by JAMA Pediatrics.
The prevalence of childhood obesity in the United States remains at historically high levels. Clinical approaches that are cost-effective and scalable for obesity reduction in children are a public health priority. However, interventions to improve BMI in children have not proven effective in the context of primary care, according to the study background.
Elsie M. Taveras, M.D., M.P.H., of Massachusetts General Hospital for Children, Boston, and coauthors conducted a three-arm clinical trial that enrolled 549 children (ages 6 to 12) with BMIs at the 95 percent percentile or higher from 14 primary care practices from October 2011 through June 2012.
Five practices (194 children) were assigned to receive clinical decision support (CDS) tools where the existing electronic health record was modified to alert pediatricians to a child with a high BMI and provide links to growth charts, obesity screening guidelines and referrals for weight management programs. To support behavior change in families, pediatricians also provided educational materials and follow-up visits focused on behaviors changes, including decreasing screen time, less consumption of sugar-sweetened beverages, more exercise and sleep.
In five additional practices (171 children), the intervention included CDS tools plus a health coach was assigned to work with the families via telephone, text message and email support. The remaining four practices (184 children) were assigned to usual care, which was the standard care offered by the current pediatric office with no CDS tool for obesity.
The study found that children who had the greatest improvement in BMI were those whose families and pediatricians participated in, and were most faithful to, the intervention that included CDS tools in pediatric practices and health coaching for the family.
Results indicate that compared with participants who received usual care, participants who were the most faithful to the CDS plus coaching intervention had the greatest improvements in BMI (reduction of 0.53). Participants less faithful to the intervention did not improve their BMI.
Overall, BMI increased less in children in the CDS intervention during one year (a reduction of 0.51) and the CDS plus health coaching intervention resulted in a smaller magnitude of BMI improvement (reduction of 0.34) compared with usual care. However, at one year, no differences were found among the study groups in follow-up visits for weight management, according to the study.
"We found that an intervention that leveraged efficient health information technology to provide CDS for pediatric clinicians and that provided an intervention for self-guided behavior change by families resulted in improvements in the children's BMI," the study concludes.
INFORMATION:
(JAMA Pediatr. Published online April 20, 2015. doi:10.1001/jamapediatrics.2015.0182. Available pre-embargo to the media at http://media.jamanetwork.com.)
Editor's Note: This study was supported by an award from the American Recovery and Reinvestment Act. Please see article for additional information, including other authors, author contributions and affiliations, etc.
Media Advisory: To contact corresponding author Elsie M. Taveras, M.D., M.P.H., call Cassandra Aviles at 617-724-6433 or email cmaviles@partners.org.
To place an electronic embedded link to this study in your story Links will be live at the embargo time: http://archpedi.jamanetwork.com/article.aspx?doi=10.1001/jamapediatrics.2015.0182
(Boston) - Results of a new study led by Boston Medical Center (BMC) researchers, in collaboration with Harvard Medical School (HMS), indicate that the introduction of abuse-deterrent OxyContin, coupled with the removal of propoxyphene from the US prescription marketplace, may have played a role in decreasing opioid prescribing and overdoses. The findings, published in JAMA Internal Medicine, showed that these two changes led to a 19 percent drop in prescription opioid supply that was mirrored by a 20 percent drop in prescription opioid overdose between August 2010 and ...
Poor quality medicines are a real and urgent threat that could undermine decades of successful efforts to combat HIV/AIDS, malaria and tuberculosis, according to the editors of a collection of journal articles published today. Scientists report up to 41 percent of specimens failed to meet quality standards in global studies of about 17,000 drug samples. Among the collection is an article describing the discovery of falsified and substandard malaria drugs that caused an estimated 122,350 deaths in African children in 2013. Other studies identified poor quality antibiotics, ...
Researchers from the University of Birmingham have identified an important new way in which our immune systems are regulated, and hope that understanding it will help tackle the debilitating effects of type 1 diabetes, rheumatoid arthritis and other serious diseases.
The team discovered a novel pathway that regulates the movement of pathogenic immune cells from the blood into tissue during an inflammatory response.
A healthy, efficient immune system ordinarily works to damp down inflammation and carefully regulate the magnitude of the response to infection and disease. ...
A University of Texas at Austin scientist, working with an international research team, has developed the most precise sequence map yet of U.S. cotton and will soon create an even more detailed map for navigating the complex cotton genome. The finding may help lead to an inexpensive version of American cotton that rivals the quality of luxurious Egyptian cotton and helps develop crops that use less water and fewer pesticides for a cotton that is easier on the skin and easier on the land.
Z. Jeffrey Chen and his collaborators, Tianzhen Zhang and Wangzhen Guo at Nanjing ...
Using the latest genome sequencing techniques, a research team led by scientists from UC San Francisco (UCSF), Baylor College of Medicine, and Texas Children's Hospital has identified a new autoimmune syndrome characterized by a combination of severe lung disease and arthritis that currently has no therapy.
The hereditary disorder, which appears in early childhood, had never been diagnosed as a single syndrome. The new research revealed that it is caused by mutations in a single gene that disrupt how proteins are shuttled around within cells. Patients with the newly ...
We often make quick strategic decisions to attack an opponent or defend our position, yet how we make them is not well understood. Now, researchers at the RIKEN Brain Science Institute in Japan have pinpointed specific brain regions related to this process by examining neural activity in people playing shogi, a Japanese form of chess. Published in Nature Neuroscience, the study shows that two different regions within the cingulate cortex--one toward the front of the brain and the other toward the back--separately encode the values of defensive and offensive strategies.
Like ...
Large amounts of methane - whether as free gas or as solid gas hydrates - can be found in the sea floor along the ocean shores. When the hydrates dissolve or when the gas finds pathways in the sea floor to ascend, the methane can be released into the water and rise to the surface. Once emitted into the atmosphere, it acts as a very potent greenhouse gas twenty times stronger than carbon dioxide. Fortunately, marine bacteria exist that consume part of the methane before it reaches the water surface. Geomicrobiologists and oceanographers from Switzerland, Germany, Great Britain ...
New apps developed for children come online every day and many of them are marketed or labeled as "educational" - but how can we tell which of these thousands of apps will actually help children learn? A comprehensive new report published in Psychological Science in the Public Interest, a journal of the Association for Psychological Science, integrates research from scientific disciplines like psychological science, linguistics, and neuroscience to provide an evidence-based guide that parents, educators, and app designers alike can use to evaluate the quality of so-called ...
HANOVER, N.H. - Although the media often portray the Arctic as a new "Great Game" ripe for conflict, a group of international Arctic experts co-chaired by Dartmouth College released recommendations today aimed at preserving the polar north as an area for political and military cooperation, sustainable development and scientific research.
The report, which addresses the priorities of the Arctic Council, an intergovernmental forum of the eight nations that border the polar region, resulted from meetings at the Carnegie Endowment for International Peace in Washington, ...
Only three wolves seem to remain in Isle Royale National Park. Researchers from Michigan Technological University observed the wolves during their annual Winter Study, and the lone group, at an unprecedented low, is a sharp decline from nine wolves observed last winter.
The study's report, released today, marks the project's 57th year of observing wolves and moose in Isle Royale. It is the longest running predator-prey study in the world. This year, along with the three resident wolves, scientists estimated 1,250 moose on the island and observed two visiting wolves, ...
