An Obesity Management Intervention for Hispanic Children in a Pediatric Clinic

Title: AN OBESITY MANAGEMENT INTERVENTION FOR HISPANIC CHILDREN IN A PEDIATRIC CLINIC: STUDY DESIGN AND BASELINE CHARACTERISTICS Authors: Laura A. Rubalcava, MA, Dorothy A. Long Parma, MD, Deborah Parra-Medina, MPH, PhD, Cynthia M. Mojica, PhD, MPH Affiliation: Institute for Health Promotion Research, Dept of Epidemiology and Biostatistics, University of Texas Health Science Center at San Antonio Purpose: This study describes a pediatric obesity management intervention trial in a rural Hispanic clinic. Methods: Hispanic children aged 5-14 (goal N=200) who are overweight (body mass index [BMI] 85th-94th percentile for age and gender) or obese (BMI ≥ 95th percentile) and a parent are being recruited and randomized to standard care (SC) or an educational intervention (EI). The SC consists of brief, behavioral physician counseling and goal-setting using a Healthy Lifestyle Prescription, and clinical follow-up visits at two, six, and 18 weeks after the initial visit. The EI is delivered in English or Spanish, and includes SC plus one face-to-face, family-centered counseling session and monthly telephone counseling calls with a health educator, and newsletters. All participants receive baseline and follow-up assessments focused on obesity, diet and physical activity. Results: To date we have enrolled 43 children; most are female (60.5%), mean age is 9.2 years (SD=2.32), and 88% are on Medicaid/CHIP. Preliminary analyses of baseline data indicate that 89% of children have an abnormal waist circumference and a mean BMI percentile of 97.9 + 1.9. Abnormal levels of fasting insulin, glucose, and cholesterol were found in 27%, 14%, and 29% of children, respectively. Process evaluation of intervention implementation reveals that fifty-four percent of behavioral goals prescribed by the pediatrician were appropriately tailored to the child’s behavioral profile at baseline. All intervention participants have completed the face-to-face session (mean session length = 30 minutes) and 50% have received at least two follow-up counseling calls (mean call length = 12 minutes). Conclusions: Offering an obesity management intervention in a pediatric clinic setting is a feasible approach. However, challenges include implementing a standard protocol in a clinic setting, reaching parents for follow-up counseling calls, and tailoring healthy lifestyle prescription to child’s behavioral profile