The PAC Study: Parents as Agents of Change in Pediatric Weight Management
Condition: Obesity; Child
MeSH terms: Obesity
Study type: Interventional

Summary: 
      The Canadian pediatric obesity epidemic has led to great interest in evaluating weight
      management care for obese children and families. Investigation is warranted since obesity is
      linked to risk factors for chronic diseases including type 2 diabetes mellitus (T2DM) and
      cardiovascular disease (CVD). Over the past 25 years, many interventions have studied the
      role of healthy lifestyle behaviours to help obese children achieve and maintain a healthy
      weight. A contemporary view of pediatric weight management interventions includes parents as
      a fundamental recipient of treatment. These interventions recognize the influence parents
      have on the lifestyle behaviours of their children. While such parent-based interventions
      have helped establish the role of education and behavioural theory in facilitating lifestyle
      changes, we believe an equally important intervention element is a focus on the role of
      cognitions in helping to interpret behaviour change and change maintenance. Our study
      incorporates cognitive behaviour theory (CBT) into an intervention for parents of obese
      children and compares it to a more traditional modality based on psycho-education (PEP).

      Hypothesis: Obese 8 - 12 year old children (n=45) whose parents complete a 16-session,
      group-based, CBT intervention will achieve greater reductions in adiposity as well as
      improvements in physiological risk factors for T2D, lifestyle behaviours, and psychosocial
      outcomes at post-intervention as well as 6- and 12-months follow-up versus children (n=45)
      whose parents complete a 16-session, group-based, psycho-education intervention .

      Primary Objective: To compare the impact of two weight management interventions (CBT versus
      PEP) for parents of obese children on child BMI z-score.

      Secondary Objective: To measure a comprehensive set of physiological, behavioural and
      psychosocial outcomes in obese children and parents pre- and post-intervention.

      We expect obese children whose parents complete the CBT intervention will experience greater
      reductions in BMI z-score vs. children whose parents complete the PEP intervention. We
      anticipate that improvements in parenting style, family stress, and lifestyle behaviours will
      be important to improve adiposity, lifestyle behaviours, and risk factors for T2DM and CVD in
      obese children.
    


Intervention name(s): Cognitive Behavioural Therapy (CBT); Psycho-Education Program (PEP)
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Clinical research supports the use of CBT-based interventions in weight management for adults and children. However, the current study will advance the existing knowledge-base by combining CBT with the parents as agents of change approach for pediatric weight management. CBT is a theoretically-based therapy that focuses on the role that cognitive processes play in the maintenance of problem behaviours, mood states, and habits. CBT highlights the relationship between thoughts, feelings and actions, and utilizes techniques involving motivation, goal-setting, problem-solving, and knowledge/skill acquisition that can facilitate sustainable behaviour changes.; PEP is a knowledge-based intervention that is modelled after traditional nutrition and health education programs. Research has demonstrated that knowledge based programs can improve health behaviours and outcomes in overweight and obese populations. In relation to CBT, PEP is a more passive intervention and there is limited focus on active skill building. While PEP does not represent a true control group, its content and delivery are consistent with what many clinicians provide for weight management.
Other intervention name(s): CBT; PEP
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Pediatric Obesity; Treatment; Cognitive Behavioural Therapy; Psychoeducation; Canada