Design of the GOT Doc study: A randomized controlled trial comparing a Guided Self-Help obesity treatment program for childhood obesity in the primary care setting to traditional family-based behavioral weight loss

Kyung E Rhee,Lourdes Herrera,David Strong,Anthony M Debenedetto,Yuyan Shi,Kerri N Boutelle

doi:10.1016/j.conctc.2021.100771

Abstract

Currently one-third of children in the United States have overweight or obesity (OW/OB). The goal of Healthy People 2020 is to reduce the proportion of children with OW/OB and increase the proportion of primary care visits that include nutrition and weight-related counseling. Unfortunately, many health care providers find it difficult to offer effective weight-related counseling and treatment in the primary care setting. Therefore, new models of care are needed that allow a greater proportion of children with OW/OB and their parents to access care and receive quality weight management treatment. The current paper describes the GOT Doc study which is designed to test the effectiveness of a Guided Self-Help (GSH) model of obesity treatment that can be delivered in the primary care setting compared to a traditional Family-Based Behavioral weight loss treatment (FBT) delivered at an academic center. We will assess the impact of this program on attendance (access to care) and changes in child BMI percentile/z-score. We will also examine the impact of this treatment model on change in child lifestyle behaviors, parent support behaviors, and parent self-efficacy and empowerment to make behavior change. Finally, we will assess the cost-effectiveness of this model on changes in child BMI percentile/z-score. We believe the GSH intervention will be a cost-effective model of obesity management that can be implemented in community practices around the country, thereby increasing access to treatment for a broader proportion of our population and decreasing rates of childhood obesity.

Highlights

One in three children in the United States aged 6–19 years have overweight or obesity, with higher rates among Hispanic and African-American children [1]
We developed a Guided Self-Help (GSH) model of obesity manage ment which is shorter in duration, could be delivered in the primary care setting, and has been shown to be effective as family-based behavioral therapy (FBT) [19]
The GOT Doc study will test the effectiveness of a Guided Self-Help model of pediatric obesity management that is delivered in the pri mary care setting

Summary

Introduction

One in three children in the United States aged 6–19 years have overweight or obesity, with higher rates among Hispanic and African-American children [1]. – Shopping on a Budget and Meal Planning – Lifestyle & Sedentary Behaviors – Body Image & Teasing – Social Support – Relapse Prevention “On a scale of 1–5 with 1 being ‘not important’ and 5 being ‘very important’, how important is it for you to make changes to help your child lose weight at this time?”; “On a scale of 1–5 with 1 being ‘not confident’ and 5 being ‘very confident’, how confident are you that you can help your child lose weight at this time?”; and “On a scale of 1–5 with 1 being ‘not motivated at all’ and 5 being ‘very motivated’, how motivated are you to help your child lose weight at this time?” These questions are based on the transtheoretical model of behavior change [45], and patients who report higher scores on these questions have reported greater success in weight loss activities [21,46,47]. Due to the clear differences in treat ment groups, participants will not be blinded to the treatment arms

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