Objective/design It remains unclear as to the efficacy of readiness for change measurements in child and adolescent obesity intervention programmes. This observational study aimed to determine whether the caregiver’s stage of change could predict outcome and adherence to treatment in an intensive intervention programme for children and adolescents with obesity.
Setting Participants were from the Whānau Pakari randomised clinical trial, a community based multi-disciplinary intervention programme for obesity in Taranaki, New Zealand.
Participants Eligible participants (recruited January 2012 to August 2014) were aged 5–16 years and had a body mass index (BMI) ≥98th centile or BMI >91st centile with weight-related comorbidities.
Interventions This study only assessed participants randomised to the high-intensity intervention programme (6-month assessments with weekly group sessions for 12 months) given attendance data were required (n=96).
Primary and secondary outcome measures Primary trial outcome was BMI SD score (SDS). Secondary outcome measures included indices such as fruit and vegetable intake, 550-m run/walk time and quality of life scores. At baseline assessment, participants (if >11 years old) and their accompanying adult were assessed for readiness to make healthy lifestyle change.
Results A quantitative measure of stage of change in caregivers was not a predictor of primary or secondary outcomes (change in BMI SDS pre-contemplation/contemplation −0.08, 95% CI −0.18 to 0.03, action −0.16, 95% CI −0.27 to –0.05, p=0.27), or overall attendance in the weekly activity sessions (40.0% vs 37.1%, respectively, p=0.54) in the child or adolescent.
Conclusions Caregiver’s stage of change was not a predictor of success in this multi-disciplinary assessment and intervention programme for children and adolescents with obesity. Future research needs to determine participants’ factors for success.
Trial registration number ANZCTR12611000862943; Post-results.
- general paediatrics
- paediatric obesity
- program evaluation
- health behaviour
- childhood obesity intervention
- readiness for change
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Contributors YCA designed the study, co-ordinated the trial, provided paediatrician oversight, drafted the initial manuscript and approved the final manuscript as submitted. GMSD created the trial-designed readiness for change quantitative assessment tool. LEW recruited participants and undertook assessments and data entry. KFT provided psychologist oversight and analysis of patient data. TW assisted with study design and reliability/validity of the questionnaires. CG is secondary supervisor for the research team and assisted with study design. TLC supervised data entry and cleaning. AS assisted with data entry and attendance data. JGBD undertook data analysis. WC contributed to study design. PH contributed to study design and supervised the research team. All authors contributed to discussions and critically appraised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
Funding This work was supported by grants from the Health Research Council of NZ, Royal Australasian College of Physicians, Maurice and Phyllis Paykel Trust, Taranaki Medical Foundation, and Lotteries Health Research.
Competing interests YCA reports grants from Health Research Council of NZ, grants from Royal Australasian College of Physicians, grants from Maurice and Phyllis Paykel Trust, grants from Taranaki Medical Foundation during the conduct of the study; TLC and AS report grants from Taranaki Medical Foundation, grants from Maurice and Phyllis Paykel Trust, grants from Lotteries Health Research during the conduct of the study; PH reports grants from Lotteries Health Research during the conduct of the study.
Ethics approval Ethics approval for the trial was granted by the Central Health and Disability Ethics Committee (NZ) (CEN/11/09/054).
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Anonymised and de-identified data will be made available to other investigators upon request. Interested readers should contact the senior author PH (firstname.lastname@example.org) to obtain the data.
Patient consent for publication Not required.
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