246750 An obesity management intervention for Hispanic children in a pediatric clinic: Preliminary outcomes analysis

Monday, October 31, 2011

Dorothy Long Parma, MD , Institute for Health Promotion Research, University of Texas Health Science Center at San Antonio, University of Texas School of Public Health, San Antonio Regional Campus, San Antonio, TX
Deborah Parra-Medina, PhD, MPH , Institute for Health Promotion Research, University of Texas Health Science Center at San Antonio, San Antonio, TX
Cynthia Mojica, PhD, MPH , Institute for Health Promotion Research, University of Texas Health Science Center San Antonio, San Antonio, TX
Awilda Ramos, MD, FAAP , New Braunfels Pediatric Associates, P.A., New Braunfels, TX
One in three U.S. children is overweight or obese; minorities are disproportionately affected, and are at risk for type II diabetes, metabolic syndrome, and cardiovascular disease. Hispanic children aged 5-14 years (goal N=200) who were overweight (body mass index [BMI] 85th-94th percentile for age and gender) or obese (BMI &ge95th percentile) and a parent (goal N=200) were recruited from a pediatric clinic, and randomized to standard care (SC) or an educational intervention (EI). All participants received baseline and follow-up assessments focusing on diet/physical activity and parenting strategies. Outcomes included excess weight gain, sweetened beverage consumption, sedentary/physical activity and clinical parameters (fasting serum insulin and glucose levels, and blood pressure [BP], lipid profile, and liver function tests [LFTs]). To date we have enrolled 88 child-parent pairs, with 51% in the EI group. Most parents (90%) were mothers; 61% of children were female, mean age 9 years, 86% Medicaid/CHIP. There were no significant differences between groups in clinical parameters at baseline. Preliminary analyses of 35 participants that have completed the study revealed a significant difference between groups in excess weight gain. Approximately 11% of children in EI experienced excess weight gain (&ge3% increase in BMI) compared to 60% in SC (&Chi2=0.002; p<0.01). Mean systolic BP change was -8.2mmHg for EI compared to -1.5mmHg SC (t=1.91, df 33); this approached significance (p=0.06). There were no differences in sweetened beverage consumption; sedentary/physical activity; parenting strategies; or laboratory parameters. This may be due to the small number of completed post-study surveys to date. Overweight and obese Hispanic children in this population are at significantly increased risk of early morbidity and mortality due to chronic illness. Challenges to offering an obesity management intervention in a pediatric clinic setting include implementing standard protocols.

Learning Areas:
Administer health education strategies, interventions and programs

Learning Objectives:
Describe the baseline clinical characteristics of the study population. Analyze the effect of the Nutriton and Exercise Start Today intervention on weight maintenance, fasting serum glucose and insulin levels, consumption of fruits, vegetables, and sugary drinks, and clinical/ laboratory markers of chronic disease risk.

Keywords: Children and Adolescents, Obesity

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an MPH student conducting this research as my thesis project for graduation, expected in 08/2011
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.