Pediatric Practice-based Obesity Intervention to Support Families: FITLINE
Condition: Pediatric Obesity
MeSH terms: Obesity; Pediatric Obesity
Study type: Interventional
Phase: Phase 1

Summary: 
      The American Academy of Pediatrics (AAP) recommends a staged approach for pediatric practices
      to manage the growing problem of pediatric overweight and obesity, starting with Stage 1,
      Prevention Plus, which encourages families to improve basic lifestyle choices related to
      eating and activity in order to improve BMI status. This study will test the effectiveness of
      an innovative FITLINE telephone counseling program for overweight and obese 8-12 year olds
      seen in pediatric practices where nutritionists coach parents in improving their child's diet
      and physical activity, to reduce BMI. If found to be effective, the FITLINE program will
      provide a model for widespread implementation of Stage 1, Prevention Plus of the AAP expert
      committee recommendations through pediatric practices nationwide.
    

Detailed description: 
      The American Academy of Pediatrics (AAP) recommends a staged approach to the management of
      pediatric overweight and obesity, starting with Stage 1, Prevention Plus, which encourages
      families to improve lifestyle choices related to eating and activity in order to improve BMI
      status. Most pediatric practices, however, have difficulty implementing these guidelines due
      to limited time and access to weight loss experts to whom they can refer their patients and
      families, and burden to families in accessing in-person weight loss services. In response,
      The investigators team developed the FITLINE pediatric practice-based referral program that
      provides practices an easily accessible resource to help families make AAP-recommended Stage
      1 lifestyle changes. The program includes two components. The first, a pediatric
      practice-based component, consists of systems to identify overweight and obese children ages
      8-12, a brief pediatric provider-delivered intervention, referral to the FITLINE counseling
      program, and feedback from the FITLINE nutritionist. The second, a parent support component,
      consists of six weekly FITLINE counseling telephone calls delivered by centrally located
      nutritionists who provide tailored, personalized coaching, along with a parent booklet to
      guide parents in setting goals and working with their child to make Stage 1 lifestyle
      changes. Providers receive a summary from the nutritionist of the progress made by families
      so they may support maintenance of an improved lifestyle, or refer for additional
      intervention. A nonrandomized intervention study with contemporaneous control was used.
      Parents and their children ages 8-12 with BMI ≥85th percentile (N=40) were recruited from two
      pediatric practices. Practices implemented systems to identify overweight/obese children,
      prompt brief provider intervention, and refer parents to 6-weekly FITLINE telephone
      counseling sessions with a nutritionist who guided parents in setting goals and helping their
      child make American Academy of Pediatrics (AAP)-recommended lifestyle changes. Child BMI and
      parent survey of child diet and physical activity were completed at baseline and 3 months.
      Medical record data from 44 children matched for age and BMI was collected.
    

Intervention name(s): FITLINE practice-based referral program
Intervention type(s): Behavioral
Intervention description(s): The FITLINE practice-based referral program provides pediatric practices an easily accessible resource to help families make AAP-recommended Stage 1 lifestyle changes. The program includes a pediatric practice-based component (systems to identify overweight and obese children ages 8-12, a brief pediatric provider-delivered intervention, referral to the FITLINE counseling program, and feedback from the FITLINE nutritionist) and a parent support component(eight weekly FITLINE counseling telephone calls delivered by centrally located nutritionists). Providers receive a summary from the nutritionist of the progress made by families so they may support maintenance of an improved lifestyle, or refer for additional intervention.
Allocation: Non-Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment