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Choices: Family Physicians Treat Overweight Children [NICHD]

Cheryl Ritenbaugh, PhD, MPH

Physicians and clinics have not provided adequate care for obese children; this problem is even more acute for clinics serving lower income and minority populations.  The group office visit model is an approach to managing chronic conditions which fits within the clinic fee-for-service model and is being used increasingly to deliver care to groups of patients with needs in common.  We are testing the use of the 12 session group office visit model to provide an obesity treatment intervention for children 9-11 years of age in gender-specific groups and their parents in a clinic setting that serves a high proportion of Mexican American lower income patients.  The targets of the intervention for the children are less TV viewing, less sweetened beverages, and net lower portion sizes, improved fast food choices (or less fast food), and more general physical activity.  Each session includes self-monitoring, physical activity, and a cognitive/learning component.  Parents participate along with their children. The cognitive basis for the intervention is enhancing resiliency, shown to be effective for both adults and children in this age group across a variety of settings.  The design is a randomized lagged intervention for 36 children and their parents.  All children will are measured at baseline, 4, 8, 12,and 16 months.