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Clinical effectiveness of the Massachusetts Childhood Obesity Research Demonstration initiative among low‐income children
Author(s) -
Taveras Elsie M.,
Perkins Meghan,
Anand Shikha,
Woo Baidal Jennifer A.,
Nelson Candace C.,
Kamdar Neil,
Kwass JoAnn,
Gortmaker Steven L.,
Barrett Jessica L.,
Davison Kirsten K.,
Land Thomas
Publication year - 2017
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1002/oby.21866
Subject(s) - medicine , intervention (counseling) , childhood obesity , psychological intervention , obesity , confidence interval , low income , body mass index , electronic health record , family medicine , gerontology , community health , physical therapy , public health , overweight , health care , nursing , pathology , sociology , economics , economic growth , socioeconomics
Objective To examine the extent to which a clinical intervention resulted in reduced BMI z scores among 2‐ to 12‐year‐old children compared to routine practice (treatment as usual [TAU]). Methods The Massachusetts Childhood Obesity Research Demonstration (MA‐CORD) project is a multifaceted initiative to prevent childhood obesity among low‐income children. At the federally qualified community health centers (FQHCs) of two communities (Intervention Site #1 and #2), the following were implemented: (1) pediatric weight management training, (2) electronic decision supports for clinicians, (3) on‐site Healthy Weight Clinics, (4) community health worker integration, and (5) healthful clinical environment changes. One FQHC in a demographically matched community served as the TAU site. Using electronic health records, we assessed BMI z scores and used linear mixed models to examine BMI z score change over 2 years in each intervention site compared to a TAU site. Results Compared to children in the TAU site ( n = 2,286), children in Intervention Site #2 ( n = 1,368) had a significant decline in BMI z scores following the start of the intervention ( − 0.16 units/y; 95% confidence interval: − 0.21 to − 0.12). No evidence of an effect was found in Intervention Site #1 ( n = 111). Conclusions The MA‐CORD clinical interventions were associated with modest improvement in BMI z scores in one of two intervention communities compared to a TAU community.