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British Journal of Medicine and Medical Research, ISSN: 2231-0614,Vol.: 20, Issue.: 2


Staged Treatment for Childhood Obesity in a Medical Home: A Feasibility Study


Linessa Zuniga1,2, Stephanie A. Marton1,3,4, Heidi Schwarzwald1,3,4, Angelo P. Giardino1,2* and Sarah E. Barlow1,2

1Texas Children's Hospital, Houston, TX, USA.

2Academic General Pediatrics, Baylor College of Medicine, Houston, TX, USA.

3Community Pediatrics, Baylor College of Medicine, Houston, TX, USA.

4Texas Children’s Health Plan, Centers for Children and Women, Houston, TX, USA.

Article Information


(1) Toru Watanabe, Department of Pediatrics, Niigata City General Hospital, Japan.


(1) Cihad Dundar, Ondokuz Mayıs University, Turkey.

(2) Olatunbosun Titilope Helen, University of Uyo, Nigeria.

(3) Masaru Kubota, Ryukoku University, Japan.

Complete Peer review History: http://www.sciencedomain.org/review-history/18121


Introduction: In 2007, a committee of experts made evidence-informed recommendations for the treatment of childhood obesity that proposed a stepwise approach to treatment of overweight and obese children. The aim of this study is to assess the feasibility and efficacy of a staged intervention for obese and overweight children in a large medical home.

Methods: A staged intervention approach to treating childhood obesity was implemented for patients enrolled in a large Medicaid managed care organization in Houston, Texas. Patients were eligible if they were between the ages of 7 and 13 years and had a BMI greater than the 85th percentile. After one year, patients EMR was reviewed to compare final & initial BMI as well as patient participation.

Results: 51 children were enrolled over a period of 3 months. Participation was low with only 18% of all completed problem-oriented visits focusing on healthy weight counseling (stage 1). Despite a high acceptance rate for enrollment into the Keep Fit classes (stage 2), patients did not continue to attend classes over the course of the year, on average attending only 21% of scheduled classes. The stage 3 group program was not offered. There was no improvement in BMI status and no relationship between the frequency of documented weight counseling and BMI change.

Discussion: Exposure to the planned program was low and thus we were unable to ascertain the efficacy of a staged intervention for childhood obesity. In assessing feasibility, there are several reasons that could explain the high rate of attrition, including scheduling conflicts, lack of transportation, and poor motivation.

Keywords :

Obesity; childhood; medical home; staged obesity treatment, feasibility.

Full Article - PDF    Page 1-8

DOI : 10.9734/BJMMR/2017/31527

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