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Obesity (Silver Spring). 2017 Jul 13. doi: 10.1002/oby.21929. [Epub ahead of print]

Efficacy of a community- versus primary care-centered program for childhood obesity: TX CORD RCT.

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USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center-School of Public Health, Austin Regional Campus, Austin, Texas, USA.
Children's Health, GI Practice, The University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Texas Center for the Prevention and Treatment of Childhood Obesity, Dell Children's Medical Center, University of Texas at Austin Dell Medical School, Austin, Texas, USA.
Center for Systems and Community Design; Department of Community Health and Social Sciences; Graduate School of Public Health and Health Policy, City University of New York, New York, New York, USA.
Duke University Global Health Institute, Durham, North Carolina, USA, and Duke-NUS Medical School, Singapore.
Childhood Nutrition Research Centre, University College-London, London, UK.



This randomized controlled trial was conducted to determine comparative efficacy of a 12-month community-centered weight management program (MEND2-5 for ages 2-5 or MEND/CATCH6-12 for ages 6-12) against a primary care-centered program (Next Steps) in low-income children.


Five hundred forty-nine Hispanic and black children (BMI ≥ 85th percentile), stratified by age groups (2-5, 6-8, and 9-12 years), were randomly assigned to MEND2-5 (27 contact hours)/MEND/CATCH6-12 (121.5 contact hours) or Next Steps (8 contact hours). Primary (BMI value at the 95th percentile [%BMIp95 ]) and secondary outcomes were measured at baseline, 3 months (Intensive Phase), and 12 months (Transition Phase).


For age group 6-8, MEND/CATCH6-12 resulted in greater improvement in %BMIp95 than Next Steps during the Intensive Phase. Effect size (95% CI) was -1.94 (-3.88, -0.01) percentage points (P = 0.05). For age group 9-12, effect size was -1.38 (-2.87, 0.16) percentage points for %BMIp95 (P = 0.07). MEND2-5 did not differentially affect %BMIp95 . Attendance averaged 52% and 22% during the Intensive and Transition Phases. Intervention compliance was inversely correlated to change in %BMIp95 during the Intensive Phase (P < 0.05). In the Transition Phase, %BMIp95 was maintained or rebounded in both programs (P < 0.05).


MEND/CATCH6-12 was more efficacious for BMI reduction at 3 months but not 12 months compared to Next Steps in underserved children. Intervention compliance influenced outcomes, emphasizing the need for research in sustaining family engagement in low-income populations.

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