Pediatric Weight Management Interventions in Primary Care Settings: A Meta-Analysis

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Abstract

Objective: Although the primary care setting has been recommended as an acceptable environment for pediatric overweight/obesity treatment, a quantitative analysis has not been conducted to determine the effectiveness of pediatric weight management interventions delivered in these settings. Therefore, the purpose of the current study was to conduct a meta-analysis of weight management interventions for youth in primary care settings. Method: A literature search using PsycINFO and PubMed was conducted to identify articles published through October 2015. Eighteen studies (3,358 participants) met inclusion criteria; studies included a treatment and comparison group and targeted individuals or families for treatment. Study characteristics were coded, and study rigor of articles was assessed. Results: The overall effect size for change in body mass index (BMI) in primary care weight management interventions compared to control groups was small but statistically significant (d = 0.26, 95% CI [.14, .38]). The number of treatment contacts, treatment months, and visits with a pediatrician emerged as significant moderators of outcome, such that BMI reduction was positively related to greater contact. Conclusions: In comparison to control conditions, weight management programs in primary care settings can be effective for BMI reduction, suggesting that primary care is a suitable setting for treatment of pediatric overweight/obesity. Additionally, treatments that were longer in duration, included more contacts (in person or phone), and included more contacts by a pediatrician had greater impact on BMI reduction. Future studies should continue to examine other aspects of acceptability and accessibility as well as demonstrate the effectiveness of interventions on improving psychosocial outcomes.

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