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      Technology Components as Adjuncts to Family-Based Pediatric Obesity Treatment in Low-Income Minority Youth

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          Abstract

          <p id="d1157601e370"> <b> <i>Background:</i> </b> Strategies to treat pediatric obesity are needed, especially among high-need populations. Technology is an innovative approach; however, data on technology as adjuncts to in-person treatment programs are limited. </p><p id="d1157601e378"> <b> <i>Methods:</i> </b> A total of 64 children [body mass index (BMI) ≥85th percentile, mean age = 9.6 ± 3.1 years, 32.8% female, 84.4% Hispanic] were recruited to participate in one of three cohorts of a family-based behavioral group (FBBG) treatment program: FBBG only, TECH1, and TECH2. Rolling, nonrandomized recruitment was used to enroll participants into three cohorts from May 2014 to February 2015. FBBG began in May 2014 and received the standard, in-person 12-week treatment only ( <i>n</i> = 21); TECH1 began in September 2014 and received FBBG plus a digital tablet equipped with a fitness app (FITNET) ( <i>n</i> = 20); TECH2 began in February 2015 and received FBBG and FITNET, plus five individually tailored TeleMed health-coaching sessions delivered via Skype ( <i>n</i> = 23). Child BMI z-score (BMI-z) was assessed at baseline and postintervention. Secondary aims examined weekly FBBG attendance, feasibility/acceptability of FITNET and Skype, and the effect of technology engagement on BMI-z. </p><p id="d1157601e395"> <b> <i>Results:</i> </b> FBBG and TECH1 participants did not show significant reductions in BMI-z postintervention [FBBG: β = −0.05(0.04), <i>p</i> = 0.25; TECH1: β = −0.006(0.06), <i>p</i> = 0.92], but TECH2 participants did [β = −0.09(0.02), <i>p</i> &lt; 0.001] and TeleMed session participation was significantly associated with BMI-z reduction [β = −0.04(0.01), <i>p</i> = 0.01]. FITNET use and FBBG attendance were not associated with BMI-z in any cohort. Overall, participants rated the technology as highly acceptable. </p><p id="d1157601e415"> <b> <i>Conclusions:</i> </b> Technology adjuncts are feasible, used by hard-to-reach participants, and show promise for improving child weight status in obesity treatment programs. </p>

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          Most cited references17

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            The efficacy of treatments for pediatric obesity remains unclear. We performed a systematic review of randomized trials to estimate the efficacy of nonsurgical interventions for pediatric obesity. Librarian-designed search strategies of nine electronic databases from inception until February 2006, review of reference lists from published reviews, and content expert advice provided potentially eligible studies. Eligible studies were randomized trials of overweight children and adolescents assessing the effect of nonsurgical interventions on obesity outcomes. Independently and in duplicate, reviewers assessed the quality of each trial and collected data on interventions and outcomes. Of 76 eligible trials, 61 had complete data for meta-analysis. Short-term medications were effective, including sibutramine [random-effects pooled estimate of body mass index (BMI) loss of 2.4 kg/m(2) with a 95% confidence interval (CI) of 1.8-3.1; proportion of between-study inconsistency not due to chance (I(2)) = 30%] and orlistat (BMI loss = 0.7 kg/m(2); CI = 0.3-1.2; I(2) = 0%). Trials that measured the effect of physical activity on adiposity (i.e. percent body fat and fat-free mass) found a moderate treatment effect (effect size = -0.52; CI = -0.73 to -0.30; I(2) = 0%), whereas trials measuring the effect on BMI found no significant effect (effect size = -0.02; CI = -0.21 to 0.18; I(2) = 0%), but reporting bias may explain this finding. Combined lifestyle interventions (24 trials) led to small changes in BMI. Limited evidence supports the short-term efficacy of medications and lifestyle interventions. The long-term efficacy and safety of pediatric obesity treatments remain unclear.
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                Author and article information

                Journal
                Childhood Obesity
                Childhood Obesity
                Mary Ann Liebert Inc
                2153-2168
                2153-2176
                December 2017
                December 2017
                : 13
                : 6
                : 433-442
                Affiliations
                [1 ]Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
                [2 ]Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC.
                [3 ]Department of Counseling, School, and Educational Psychology, University at Buffalo-SUNY, Buffalo, NY.
                [4 ]Center for Children's Healthy Lifestyles &amp; Nutrition, Kansas City, MD.
                [5 ]Children's Mercy Hospital, Kansas City, MD.
                [6 ]Preventive Medicine &amp; Public Health, University of Kansas Medical Center, Kansas City, KS.
                [7 ]Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS.
                Article
                10.1089/chi.2017.0021
                6913110
                28727927
                7d08c124-899e-49ac-a9c5-50716bd5f8f7
                © 2017

                http://www.liebertpub.com/nv/resources-tools/text-and-data-mining-policy/121/

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