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Outcome data from the LEAP (Live, Eat and Play) trial: a randomized controlled trial of a primary care intervention for childhood overweight/mild obesity
McCallum, Zoe Wake, Melissa Gerner, Bibi Baur, Louise Gibbons, Kay Gold, Lisa Gunn, Jane Harris, Claire Naughton, Geraldine Riess, Colin
McCallum, Zoe
Wake, Melissa
Gerner, Bibi
Baur, Louise
Gibbons, Kay
Gold, Lisa
Gunn, Jane
Harris, Claire
Naughton, Geraldine
Riess, Colin
Abstract
Objectives: To reduce gain in body mass index (BMI) in overweight/mildly obese children in the primary care setting.
Design: Randomized controlled trial (RCT) nested within a baseline cross-sectional BMI survey.
Setting: Twenty nine general practices, Melbourne, Australia.
Participants:(1) BMI survey: 2112 children visiting their general practitioner (GP) April–December 2002; (2) RCT: individually randomized overweight/mildly obese (BMI z-score
Intervention: Four standard GP consultations over 12 weeks, targeting change in nutrition, physical activity and sedentary behaviour, supported by purpose-designed family materials.
Main outcome measures: Primary: BMI at 9 and 15 months post-randomization. Secondary: Parent-reported child nutrition, physical activity and health status; child-reported health status, body satisfaction and appearance/self-worth.
Results: Attrition was 10%. The adjusted mean difference (intervention–control) in BMI was -0.2 kg/m2 (95% CI: -0.6 to 0.1; P=0.25) at 9 months and -0.0 kg/m2 (95% CI: -0.5 to 0.5; P=1.00) at 15 months. There was a relative improvement in nutrition scores in the intervention arm at both 9 and 15 months. There was weak evidence of an increase in daily physical activity in the intervention arm. Health status and body image were similar in the trial arms.
Conclusions: This intervention did not result in a sustained BMI reduction, despite the improvement in parent-reported nutrition. Brief individualized solution-focused approaches may not be an effective approach to childhood overweight. Alternatively, this intervention may not have been intensive enough or the GP training may have been insufficient; however, increasing either would have significant cost and resource implications at a population level.
Keywords
childhood obesity, primary care, randomized controlled trial, secondary prevention, overweight
Date
2007
Type
Journal article
Journal
International Journal of Obesity
Book
Volume
31
Issue
4
Page Range
630-636
Article Number
ACU Department
Collections
Relation URI
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Event URL
Open Access Status
License
File Access
Controlled