The Effect of the HealthyKids Program on Childhood Obesity and Long- term BMI Maintenance

Transcription

1 The Effect of the HealthyKids Program on Childhood Obesity and Long- term BMI Maintenance Jamie Jeffrey, MD, FAAP Adele P. Schweller, DO Stephanie Thompson, PhD

2 Background Overweight and obesity becoming BIGGER issues; affeccng 1:6 US kids resulcng in chronic disease such as hypertension, dyslipidemia, pre- diabetes and diabetes in children. USPSTF 2007 Expert CommiLee meecng: Increase in obesity cannot be solely a:ributed to gene=c risk West Virginia: #1 Adult Obesity Stateofobesity

3 HealthyKids Wellness & Weight Management Family based Medically supervised MulCdisciplinary 8 weekly visits Group Exercise NutriCon Class & AcCvity Monthly follow- ups Die=cian Exercise Physiologist Pediatrician Child + Family

4 ObjecDves of the Study 1) Evaluate if the HealthyKids program resulted in a decrease in BMI z- score during program enrollment 2) Evaluate if the HealthyKids program resulted in a successful long- term BMI maintenance 3) Determine which factors contribute to long term weight loss success 4) InvesCgate associacon between number of sessions alended and weight loss success

5 Methods SAMPLE: Children (n=67) who parccipated in >1 HealthyKids Group Program sessions between RETROSPECTIVE: EvaluaCon of each pacent s percent change in BMI from the start to the end of the HealthyKids Program with data obtained from QI database PROSPECTIVE: EvaluaCon of each pacent s percent change in BMI from their Cme of enrollment to their current BMI status in 2016 collected either in person or mail/phone survey

6 EvaluaDng Pediatric Growth hlp://kidshealth.org

7 Methods- data analysis BMI z- score: Allows for quancficacon of values that are beyond the standardized growth curves, as in the case of severe obesity (to account for discrete BMI percencles > 95th) Paired t- tests: Used to determine if BMI z- scores changed over Cme Mixed- design ANOVA models: Used to determine which pacent factors are associated with BMI z- score change

8 Results RetrospecDve From start to end of HealthyKids Group Program enrollment in PaCents age range was 5-18 years at the Cme of parccipacon 75% of parccipants completed 7-8 sessions > 50% of parccipants had a family history of: Obesity Hypertension Hyperlipidemia Type 2 Diabetes >50% of parccipants had a diagnosis of: Acanthosis nigricans BMI z- score stacsccally decreased (p <0.001) 91% (61/67 pacents) had a decrease in BMI z- scores Race, gender, insurance type did NOT correlate with BMI z- score change

9 Results ProspecDve PROSPECTIVE From the end of program enrollment to present day survey 39% of parccipants (26/67) returned surveys PaCents age range was years at the Cme of survey response Mean Cme from enrollment to survey= 8.0 ± 1.1 years 69.2 % had a concnued decrease in BMI z- score between end of program enrollment and survey (p = 0.04)

10 Discussion No long- term data indicacng a standard for successful intervencon in pediatric populacon Studies show that with improving the BMI in children, there is a direct effect on comorbidices: blood pressure lipid levels insulin sensicvity overall cardiovascular risk

11 2010 SystemaCc review, Pediatrics IdenCfied 11 behavioral studies published aner 2005 with 6-12 month follow ups for short- term outcomes Most evaluated pacents 4-18 years old Only 3 had > 40 parccipants All 11 had beneficial effect on BMI at follow up (but not all stacsccally significant)

12 Discussion ParCcipaCon in the HealthyKids program resulted in stacsccally significant decrease in BMI z- score which concnued an average of 8 years post- parccipacon This study did show that the younger age group (5-10 years) had a greater decrease in BMI z- score indicacng a benefit to earlier referral This could impact severe obesity Timing could be related to the adiposity rebound

13 LimitaDons of the Study Small sample size (n = 67) may not be generalizable to a naconal scale Post- parccipacon surveys were completed via self- report with a low response rate Effects on weight loss are mulcfactorial and are not comprehensively represented in this study

14 Conclusion This study demonstrates the poten/al of a mulc- disciplinary program to have long- term weight maintenance success within the pediatric populacon impaccng future obesity and chronic disease especially with preven/on and early referral.