Clinical-Community Interventions for Improving Quality of Life in Childhood Obesity

Two clinical-community interventions—enhanced primary care and enhanced primary care with coaching—are capable of improving parent-reported outcomes and a child’s quality of life for childhood obesity.

A study published in JAMA Pediatrics investigated the effectiveness of clinical-community interventions through a randomized trial with 721 children between the ages of 2 and 12 years with a body mass index (BMI) in the 85th or greater percentile.

The children were divided into 2 intervention groups:

1. An enhanced primary care group, which included clinical support for pediatric weight management, educational materials for parents, a Neighborhood Resource Guide, and monthly text messages
2. An enhanced primary care group plus individual health coaching, consisting of twice-weekly text messages and telephone or video calls every 2 months in order to promote behavior change and connects them with family and neighborhood resources

The researchers followed up with the participants after 1 year through the assessment of parent-reported outcomes, the child’s BMI, and the overall quality of life. For the enhanced primary care group, at 1 year, there was a BMI z score improvement of ­—0.07, while the enhanced primary care plus coaching group had a BMI z score improvement of —0.09.

“We found that parent-reported child health-related quality of life improved by 1.53 units among the enhanced primary care plus coaching group and appeared to be driven by large improvements in the psychosocial score of the Pediatric Quality of Life, comparably higher than previous pediatric obesity trials,” the researchers reported.

Despite the lack of significant difference between the 2 intervention groups, both demonstrated an improvement of parental resource empowerment. Furthermore, parents in the enhanced primary care plus coaching group reported improvements in their child’s health-related quality of life.

“These findings suggest that the educational content delivered in both intervention arms related to social and emotional wellness, including content on stress reduction, positive thinking, and bullying, may have driven the observed improvements in child quality of life,” the authors concluded.

The researchers acknowledged the improvements involved with health coaching, but that the effects were not significant enough when involving the child’s BMI compared with enhanced primary care alone.