The Long-Term Benefits of an Integrated Model to Treat Childhood Obesity

Objective: To understand short- and long-term outcomes of diverse, low-income participants in a childhood obesity intervention, and to examine participant expectations, motivators, facilitators, and barriers to program attendance and engagement.

Methods: A sequential mixed-methods study design was employed: first, a retrospective analysis of an integrated clinic-community intervention cohort to identify predictors of success at the end of a six-month intervention. Then, the most and least successful participants and their parents were recruited to participate in in-depth semi-structured audio-recorded interviews. Transcripts were analyzed with a thematic analysis approach. Themes were grouped into categories including: (1) barriers and (2) facilitators and motivators of program attendance and engagement, (3) program expectations, (4) lifestyle effects, and (5) parent perceptions of effects on child health. Body mass index z-scores (BMIz) two years after intervention completion were obtained to assess long-term effects of the program.

Results: Only Hispanic race was found to be a significant predictor of BMIz reduction at intervention completion. Two years after program completion, intervention participants reduced their BMIz by 0.07. Prominent barriers to program engagement included travel to intervention site and parent work schedules. Motivators included social support from family members and enjoyment of program sessions. All participants cited at least one lifestyle change, including improved diet choices and increased physical activity levels. All parents expressed satisfaction with some aspect of the program, even if their child did not lose weight.

Conclusion: Results suggest a number of positive long-term outcomes associated with an integrated clinic-community treatment model, which include BMIz reduction, increased health education, positive eating changes, and increased physical activity levels.