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      Caregiver’s readiness for change as a predictor of outcome and attendance in an intervention programme for children and adolescents with obesity: a secondary data analysis

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          Abstract

          Objective/design

          It remains unclear as to the efficacy of readiness for change measurements in child and adolescent obesity intervention programmes. This observational study aimed to determine whether the caregiver’s stage of change could predict outcome and adherence to treatment in an intensive intervention programme for children and adolescents with obesity.

          Setting

          Participants were from the Whānau Pakari randomised clinical trial, a community based multi-disciplinary intervention programme for obesity in Taranaki, New Zealand.

          Participants

          Eligible participants (recruited January 2012 to August 2014) were aged 5–16 years and had a body mass index (BMI) ≥98th centile or BMI >91st centile with weight-related comorbidities.

          Interventions

          This study only assessed participants randomised to the high-intensity intervention programme (6-month assessments with weekly group sessions for 12 months) given attendance data were required (n=96).

          Primary and secondary outcome measures

          Primary trial outcome was BMI SD score (SDS). Secondary outcome measures included indices such as fruit and vegetable intake, 550-m run/walk time and quality of life scores. At baseline assessment, participants (if >11 years old) and their accompanying adult were assessed for readiness to make healthy lifestyle change.

          Results

          A quantitative measure of stage of change in caregivers was not a predictor of primary or secondary outcomes (change in BMI SDS pre-contemplation/contemplation −0.08, 95% CI −0.18 to 0.03, action −0.16, 95% CI −0.27 to –0.05, p=0.27), or overall attendance in the weekly activity sessions (40.0% vs 37.1%, respectively, p=0.54) in the child or adolescent.

          Conclusions

          Caregiver’s stage of change was not a predictor of success in this multi-disciplinary assessment and intervention programme for children and adolescents with obesity. Future research needs to determine participants’ factors for success.

          Trial registration number

          ANZCTR12611000862943; Post-results.

          Related collections

          Most cited references22

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          The PedsQL 4.0 as a pediatric population health measure: feasibility, reliability, and validity.

          The application of health-related quality of life (HRQOL) as a pediatric population health measure may facilitate risk assessment and resource allocation, the tracking of community health, the identification of health disparities, and the determination of health outcomes from interventions and policy decisions. To determine the feasibility, reliability, and validity of the 23-item PedsQL 4.0 (Pediatric Quality of Life Inventory) Generic Core Scales as a measure of pediatric population health for children and adolescents. Mail survey in February and March 2001 to 20 031 families with children ages 2-16 years throughout the State of California encompassing all new enrollees in the State's Children's Health Insurance Program (SCHIP) for those months and targeted language groups. The PedsQL 4.0 Generic Core Scales (Physical, Emotional, Social, School Functioning) were completed by 10 241 families through a statewide mail survey to evaluate the HRQOL of new enrollees in SCHIP. The PedsQL 4.0 evidenced minimal missing responses, achieved excellent reliability for the Total Scale Score (alpha =.89 child;.92 parent report), and distinguished between healthy children and children with chronic health conditions. The PedsQL 4.0 was also related to indicators of health care access, days missed from school, days sick in bed or too ill to play, and days needing care. The results demonstrate the feasibility, reliability, and validity of the PedsQL 4.0 as a pediatric population health outcome. Measuring pediatric HRQOL may be a way to evaluate the health outcomes of SCHIP.
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            The Child Behavior Checklist and Related Forms for Assessing Behavioral/Emotional Problems and Competencies

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              Development of a short 'readiness to change' questionnaire for use in brief, opportunistic interventions among excessive drinkers

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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2019
                27 March 2019
                : 9
                : 3
                : e023195
                Affiliations
                [1 ] Department of Paediatrics, Taranaki District Health Board , New Plymouth, New Zealand
                [2 ] Liggins Institute, The University of Auckland , Auckland, New Zealand
                [3 ] Taranaki District Health Board , New Plymouth, New Zealand
                [4 ] Faculty of Medical and Health Sciences, The University of Auckland , Auckland, New Zealand
                [5 ] Department of Paediatrics, The University of Auckland , Auckland, New Zealand
                Author notes
                [Correspondence to ] Dr Yvonne C Anderson; yvonne.anderson@ 123456tdhb.org.nz
                Article
                bmjopen-2018-023195
                10.1136/bmjopen-2018-023195
                6475337
                30918030
                7320f56a-e828-4c35-a846-3ebb04b1157a
                © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 26 March 2018
                : 04 October 2018
                : 09 January 2019
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001505, Health Research Council of New Zealand;
                Funded by: Taranaki Medical Foundation;
                Funded by: FundRef http://dx.doi.org/10.13039/501100001232, Royal Australasian College of Physicians;
                Funded by: Lotteries Health Research;
                Funded by: FundRef http://dx.doi.org/10.13039/501100001518, Maurice and Phyllis Paykel Trust;
                Categories
                Paediatrics
                Research
                1506
                1593
                Custom metadata
                unlocked

                Medicine
                general paediatrics,paediatric obesity,program evaluation,health behaviour,childhood obesity intervention,readiness for change

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