Clinical effectiveness of the massachusetts childhood obesity research demonstration initiative among low-income children.

Abstract

ObjectiveTo examine the extent to which a clinical intervention resulted in reduced body mass index (BMI) z-scores among 2–12 year old children compared to routine practice (treatment as usual, TAU).MethodsThe Massachusetts Childhood Obesity Research Demonstration project (MA-CORD) is a multifaceted initiative to prevent childhood obesity among low-income children. In the federally qualified community health centers (FQHC) of two communities (Intervention Site #1 and #2), we implemented (1) pediatric weight management training; (2) electronic decision supports for clinicians; (3) on-site Healthy Weight Clinics; (4) community health worker integration; and (5) healthful clinical environment changes. One FQHC in a demographically-matched community served as the TAU site. Using electronic health records, we assessed BMI z-scores and used linear mixed models to examine BMI z-score change over 2 years in each intervention site compared to a TAU site.ResultsCompared to children in the TAU site (n=2286), children in Intervention site #2 (n=1368) had a significant decline in BMI z-scores following the start of the intervention (−0.16 units/year; 95% CI: −0.21, −0.12). We found no evidence of an effect in Intervention site #1 (n=111).ConclusionsThe MA-CORD clinical interventions were associated with modest improvement in BMI z-scores in one of two intervention communities compared to a TAU community.