(EA01-15-25) Applying a Community-Based Integrated Model to Manage Childhood Obesity With Lifestyle Intervention

Scientific conference where the work was recently presented: ObesityWeek 2024

Date on which the work was previously presented at the scientific conference listed: November 3, 2024

Objectives: Lifestyle intervention for childhood obesity requires integration of services across a multidisciplinary care team. To facilitate integration, we designed a Community-Based Integrated Model (CBIM) for Weight Management – with the child and family at the center and wraparound services coordinated across healthcare (primary care, nutrition, behavioral health), community organizations (food assistance, physical activity), and family home.

Methods: We operationalized CBIM. During routine visits, primary care providers identified and referred children (aged 8-15 years, BMI ≥85^th percentile) to a lifestyle intervention program and tracked weight and height. Dietitians provided specialty care via virtual visits using the Boston Children’s fit kit for evidence-based counseling on lifestyle behaviors. Care coordinators helped implement plans of care – connecting families with clinical and community resources – and distributed quarterly progress reports to members of the care team. Parents were engaged in shared decision-making as the primary agents for creating a healthful family home.

Results: We enrolled 236 children (36.9% Female, 47.5% Hispanic, 46.2% with household income < $1,000/week) and obtained follow-up (10.7 ± 3.0 months) weight and height data to calculate BMI for 219 children. We expressed BMI as percentage above the 95^th percentile (%BMI_p95). Before enrollment, %BMI_p95 increased by β=0.30 (95% CI: 0.28, 0.32) per month. After enrollment, %BMI_p95 decreased by β=−0.12 (−0.23, −0.02) per month, yielding a change in trajectory of β=−0.42 (−0.54, −0.30) per month (p < 0.001). Health-related quality of life (PedsQL^TM Generic Core Scale, total score) improved by 7.3 (5.1, 9.5) points (p < 0.001). Family-reported experience of integrated care was favorable, with 78.7% of respondents perceiving members of the care team to be working in a coordinated fashion (always, almost always, usually). 

Conclusions: Application of CBIM holds promise as a flexible and scalable approach for managing childhood obesity.

Funding Sources: New Balance Foundation