NEW ORLEANS — A parent-only based treatment intervention may be equally effective as and cost less than a family-based treatment intervention, according to a presenter here.
“One of the challenges with providing family-based therapy is that it’s relatively intensive. It involves weekly meetings for 1 hour, and they’re typically group-based, and it also involves behavioral coaching,” Kerri N. Boutelle, PhD, of the Center for Healthy Eating and Activity Research at the University of California San Diego, said during her presentation. “These programs are typically only offered in medical centers. If we provided these for cost, we would be broke, so we wondered if we could make these programs more cost-effective and/or easier to disseminate.”
Boutelle and colleagues evaluated 150 children (mean age, 10.4 years; mean BMI z score, 2; 66.4% girls) and a parent (mean age, 43 years; mean BMI z score, 31.9; 87.1% women) randomly assigned to parent-based treatment (parent only) or family based treatment (parent plus child). Child weight change (BMI z score), parent weight change (BMI z score), changes in diet and physical activity, and cost-effectiveness were assessed at baseline, after treatment, and at 6- and 18-month follow-up.
“Not surprisingly the parent-based treatment had greater attrition during treatment — at 27% compared with family-based treatment at 8%,” Boutelle said.
At the 18-month follow-up assessment, BMI z score in children was reduced by -0.2 in the family-based treatment and -0.17 in the parent-only based treatment.
“We found noninferiority in terms of the child weight loss, and we also see noninferiority statistically in terms of the parent weight loss,” Boutelle said.
No significant differences were found between the two groups for any of the secondary outcomes, including parenting style and parent feeding behavior.
Parent-based treatment was more cost-effective compared with family-based treatment.
“In parent-based treatment, a caring adult provides the information to the child as opposed to interventionists who don’t necessarily know them,” Boutelle said. “The caring adult can, in fact, adapt it more to the intricacies of the child than maybe a health care professional. We also believe that there’s something to be said about having to have 100% responsibility for providing program to your child. We think that parents become more effective that way.” – by Amber Cox
Boutelle K, et al. Oral T-OR-2036. Presented at: ObesityWeek 2016; Oct. 31-Nov. 4, 2016; New Orleans.
Disclosure: Boutelle reports no relevant financial disclosures.