Clinical/Behavioral Approach to Overweight in Latino Youth
Condition: Overweight; Pediatric Obesity
MeSH terms: Overweight; Pediatric Obesity
Study type: Interventional

Summary: 
      This randomized controlled trial tests the efficacy of a culturally and linguistically
      appropriate, evidence-based intervention to slow weight gain or promote weight loss among
      overweight 6-9 year old Mexican-American children.
    

Detailed description: 
      Overweight and obesity is a serious problem for Mexican-American children, due in part to
      poverty, acculturation, genetic predisposition or other factors. Clinic-based weight control
      studies have shown promise, but often include convenience samples with few or no Latino
      children. This randomized controlled trial tests the efficacy of a culturally and
      linguistically appropriate, evidence-based intervention to lower Body Mass Index (BMI) or
      slow weight gain among overweight 6-9 year old Mexican-American children randomly sampled
      from a large (36,192 pediatric patients) community clinic providing services to low and
      medium income families in a US-Mexico border community (San Ysidro, CA). Intervention and
      measurement design and selection are based on a "Socioecological Model for Latino Health
      Promotion". Children and their parents will be randomly assigned to either a Special
      Intervention (SI) or Usual Care (UC) group. The SI group will participate in the following
      behavior change activities based on Prevention Plus and Structured Weight Management
      approaches:

        1. classes providing culturally-sensitive health education regarding healthy eating,
           increasing physical activity, decreasing sedentary behaviors, and effective parenting
           behaviors to model and reinforce children's health behaviors, instruction on how to
           modify both social and structural aspects of the home environment, and skills-building
           to navigate community resources;

        2. clinical visits with a Health Educator and Mid-Level Provider (MLP);

        3. family visits with primary care providers (PCP); and

        4. phone calls to reinforce goal setting.

      The UC group will receive standard health education for childhood obesity already provided by
      the community clinic. The primary outcome for the study is child BMI, which along with other
      changes in physical outcomes, child health behaviors and parenting behaviors will be
      evaluated at four time-points (baseline, 6-, 12-, and 18-months). The primary hypothesis is
      that the SI group will demonstrate lower mean BMI than the UC group at the end of a 6 month
      intervention with a maximum difference occurring at 12 months, and will sustain this
      difference for an additional six months (18 months after baseline). Secondary aims include
      examining intervention effects on children's energy balance, physical activity levels,
      sedentary behavior and parenting strategies related to their children's health behaviors.
    

Intervention name(s): "Lights of Change"; Usual Care
Intervention type(s): Behavioral; Behavioral
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: Childhood; Obesity