Implementing Prevention Plus with Underserved Families in an Integrated Primary Care Setting

Authors

Hollie A. Raynor, Department of Nutrition, University of Tennessee Knoxville, Knoxville, TN, USA.
Sara Propst, Cherokee Health Systems, Knoxville, TN, USA.
Shannon Robson, Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, USA.
Kristoffer S. Berlin, Department of Psychology, The University of Memphis, Memphis, TN, USA.Follow
Cristina S. Barroso, Department of Public Health, University of Tennessee Knoxville, Knoxville, TN, USA.Follow
Parinda Khatri, Cherokee Health Systems, Knoxville, TN, USA.Follow

Abstract

This proof-of-concept trial examined a 6-month Prevention Plus (PP) intervention implemented in a federally qualified health center on child standardized BMI (ZBMI), using a planned clinical effect threshold of -0.16 ZBMI. The relationship between food security status and PP delivered with caregiver goals (PP+) and without caregiver goals (PP-) on energy balance behaviors (, fruits and vegetables, physical activity) and child ZBMI was explored. Seventy-three, underserved children, 4-10 years of age with a BMI ≥85th percentile, were randomized to one of two interventions, PP+ and PP-, both providing 2.5 hours of contact time, implemented in five clinics by behavioral health consultants (BHCs). Outcomes were child anthropometrics (included 9-month follow-up), implementation data collected from electronic health records, and caregiver and BHC evaluations. Children were 57.5% female and 78.1% Hispanic, with 32.9% from food-insecure households and 58.9% from households with an annual income of less than $20,000. Child ZBMI significantly ( < 0.05) decreased at 6 and 9 months (-0.08 ± 0.24 and -0.12 ± 0.43), with only PP+ reaching the clinical threshold at 9 months (PP+: -0.20 ± 0.42 vs. PP-: -0.05 ± 0.42). Sixty-four percent of families attended ≥50% of the sessions, and BHCs delivered 78.5% ± 23.5% of components at attended sessions. Caregivers were satisfied with the intervention and BHCs found the intervention helpful/useful. No relationship with food insecurity status and outcomes was found. PP+ when delivered by a primary care provider to underserved families showed promise for producing a clinically meaningful effect. Families and providers felt the intervention was a viable treatment option.

Publication Title

Childhood obesity (Print)

Recommended Citation

Raynor, H. A., Propst, S., Robson, S., Berlin, K. S., Barroso, C. S., & Khatri, P. (2022). Implementing Prevention Plus with Underserved Families in an Integrated Primary Care Setting. Childhood obesity (Print), 18 (4), 254-265. https://doi.org/10.1089/chi.2021.0071