4.3 Article

Racial and socioeconomic disparities in the efficacy of a family-based treatment programme for paediatric obesity

Journal

PEDIATRIC OBESITY
Volume 16, Issue 10, Pages -

Publisher

WILEY
DOI: 10.1111/ijpo.12792

Keywords

childhood obesity; family‐ based treatment; health disparities; income; race; weight loss

Categories

Funding

  1. National Center for Advancing Translational Sciences [UL1TR000423, UL1TR000448]
  2. National Center for Research Resources [KL2RR024994, UL1RR024992, UL1RR025014]
  3. National Heart, Lung, and Blood Institute [T32HL130357]
  4. National Institute of Child Health and Human Development [R01HD036904]
  5. National Institute of Diabetes and Digestive and Kidney Diseases [P30DK056341]
  6. National Institute of Mental Health [K24MH070446]
  7. Seattle Children's Research Institute
  8. St. Louis Children's Hospital Foundation
  9. Washington University in St. Louis School of Medicine

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The study found that family-based behavioural weight loss treatment is effective for children across different socioeconomic status and racial groups, but black children and children from low-income families experienced less weight loss at 4 months. However, no differences by race, social status, or income were detected from 4 to 12 months or from 0 to 12 months.
Background Family-based behavioural weight loss treatment (FBT) is an evidence-based intervention for paediatric overweight/obesity (OV/OB), but little research has examined the relative efficacy of FBT across socioeconomic status (SES), and racial groups. Method A total of 172 youth (7-11 years; 61.6% female; 70.1% White, 15.7% Black; child percent OV = 64.2 +/- 25.2; 14.5% low-income) completed 4 months of FBT and 8 months of additional intervention (either active social facilitation-based weight management or an education control condition). Parents reported family income, social status (Barratt simplified measure of social status) and child race at baseline. Household income was dichotomized into < or >50% of the area median family income. Race was classified into White, Black or other/multi-race. Treatment efficacy was assessed by change in child % OV (BMI % above median BMI for age and sex) and change in child BMI % of 95th percentile (BMI % of the 95th percentile of weight for age and sex). Latent change score models examined differences in weight change between 0 and 4 months, 4 and 12 months and 0 and 12 months by income, social status and race. Results Black children had, on average, less weight loss by 4 months compared to White children. Low-income was associated with less weight loss at 4 months when assessed independent of race. No differences by race, social status or income were detected from 4 to 12-months or from 0 to 12 months. Conclusions FBT is effective at producing child weight loss across different SES and racial groups, but more work is needed to understand observed differences in initial efficacy and optimize treatment across all groups.

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