Comparison of Parent-Only vs Family-Based Interventions for Overweight Children in Underserved Rural Settings

Abstract

OBJECTIVE: To assess the effectiveness of parent-only vs family-based interventions for pediatric weight management in underserved rural settings. DESIGN: A 3-arm randomized controlled clinical trial. SETTING: All sessions were conducted at Cooperative Extension Service offices in underserved rural counties. PARTICIPANTS: Ninety-three overweight or obese children (8-14 years old) and their parent(s). INTERVENTION: Families were randomized to (1) a behavioral family-based intervention, (2) a behavioral parent-only intervention, or (3) a wait-list control group. OUTCOME MEASURE: The primary outcome measure was change in children's standardized body mass index (BMI). RESULTS: Seventy-one children completed posttreatment (month 4) and follow-up (month 10) assessments. At the month 4 assessment, children in the parent-only intervention demonstrated a greater decrease in BMI z score (mean difference [MD], 0.127; 95% confidence interval [CI], 0.027 to 0.226) than children in the control condition. No significant difference was found between the family-based intervention and the control condition (MD, 0.065; 95% CI, -0.027 to 0.158). At month 10 follow-up, children in the parent-only and family-based intervention groups demonstrated greater decreases in BMI z score from before treatment compared with those in the control group (MD, 0.115; 95% CI, 0.003 to 0.220; and MD, 0.136; 95% CI, 0.018 to 0.254, respectively). No difference was found in weight status change between the parent-only and family-based interventions at either assessment. CONCLUSIONS: A parent-only intervention may be a viable and effective alternative to family-based treatment of childhood overweight. Cooperative Extension Service offices have the potential to serve as effective venues for the dissemination of obesity-related health promotion programs.