ABSTRACT
PURPOSE: To conduct a meta-analysis of randomized controlled trials examining the efficacy of comprehensive behavioral family lifestyle interventions (CBFLI) for pediatric obesity. METHOD: Common research databases were searched for articles through April 1, 2013. 20 different studies (42 effect sizes and 1,671 participants) met inclusion criteria. Risk of bias assessment and rating of quality of the evidence were conducted. RESULTS: The overall effect size for CBFLIs as compared with passive control groups over all time points was statistically significant (Hedge's g = 0.473, 95% confidence interval [.362, .584]) and suggestive of a small effect size. Duration of treatment, number of treatment sessions, the amount of time in treatment, child age, format of therapy (individual vs. group), form of contact, and study use of intent to treat analysis were all statistically significant moderators of effect size. CONCLUSION: CBFLIs demonstrated efficacy for improving weight outcomes in youths who are overweight or obese.
Subject(s)
Behavior Therapy/methods , Family Therapy/methods , Life Style , Pediatric Obesity/therapy , Adolescent , Adult , Body Weight , Child , Humans , Pediatric Obesity/psychologyABSTRACT
BACKGROUND: The current study examined parental factors related to risk of adolescent obesity within the context of a family systems framework. METHODS: Seventy predominantly African American, low-income caregiver-adolescent dyads participated in the study. Validated measures of parental perceived child risk for development of type 2 diabetes mellitus, parental limit setting for sedentary behavior, and parental nurturance were evaluated as predictors of adolescent body mass index. RESULTS: In this cross-sectional study, multiple linear regression demonstrated that parents of adolescents with higher zBMI reported worrying more about their child's risk of developing type 2 diabetes mellitus. Parent limit setting was also a significant predictor of adolescent zBMI. Contrary to expectations, higher levels of nurturance were associated with higher adolescent zBMI. Post hoc analyses revealed a trend towards a significant interaction between nurturance and limit setting, such that high levels of both parental nurturance and limit setting were associated with lower adolescent zBMI. CONCLUSIONS: Current findings suggest the importance of authoritative parenting and monitoring of adolescent health behaviors in the treatment of obesity.
Subject(s)
Black or African American/statistics & numerical data , Body Mass Index , Diabetes Mellitus, Type 2/ethnology , Medically Underserved Area , Parenting/ethnology , Pediatric Obesity/ethnology , Adolescent , Adolescent Behavior/ethnology , Black or African American/psychology , Age Factors , Child , Cross-Sectional Studies , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/psychology , Female , Health Behavior/ethnology , Health Knowledge, Attitudes, Practice/ethnology , Humans , Linear Models , Male , Parent-Child Relations/ethnology , Parenting/psychology , Pediatric Obesity/diagnosis , Pediatric Obesity/psychology , Perception , Poverty/ethnology , Risk Assessment , Risk Factors , Sedentary Behavior/ethnology , Socioeconomic Factors , South Carolina/epidemiologyABSTRACT
OBJECTIVE: This study examined parenting variables (communication, monitoring) as moderators of a family-based intervention for reducing sedentary behavior (SB) in African American adolescents. As a secondary aim, a similar model was tested using adolescent weight status as the outcome. METHODS: African American adolescents (n = 73; 12.45 ± 1.45 years; 60% girls; 63% overweight/obese) and caregivers were randomized to a 6-week interactive, parent-based intervention or general health condition. Parent-adolescent communication and monitoring of health behaviors were self-reported by parents. Adolescent SB was self-reported by youth. RESULTS: There was a significant intervention by communication interaction, such that intervention families with more positive communication showed lower adolescent SB than those with less positive communication or those in the comparison condition. No effects were found for monitoring on SB or for the model with weight status as the outcome. CONCLUSIONS: Parent-adolescent communication may be an effective component to integrate into health promotion programs for African American adolescents.
