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A child‐centered health dialogue for the prevention of obesity in child health services in Sweden – A randomized controlled trial including an economic evaluation

Derwig, Mariette LU ; Tiberg, Irén LU ; Björk, Jonas LU ; Welander Tärneberg, Anna LU and Kristensson Hallström, Inger LU (2022) In Obesity Science Practice 8(1). p.77-90
Abstract
Background
Prevention of child obesity is an international public health priority and believed to be effective when started in early childhood. Caregivers often ask for an early and structured response from health professionals when their child is identified with overweight, yet cost-effective interventions for children aged 2–6 years and their caregivers in Child Health Services are lacking.

Objectives
To evaluate the effects and cost-effectiveness of a child-centered health dialogue in the Child Health Services in Sweden on 4-year-old children with normal weight and overweight.

Methods
Thirty-seven Child Health Centers were randomly assigned to deliver intervention or usual care. The primary outcome was... (More)
Background
Prevention of child obesity is an international public health priority and believed to be effective when started in early childhood. Caregivers often ask for an early and structured response from health professionals when their child is identified with overweight, yet cost-effective interventions for children aged 2–6 years and their caregivers in Child Health Services are lacking.

Objectives
To evaluate the effects and cost-effectiveness of a child-centered health dialogue in the Child Health Services in Sweden on 4-year-old children with normal weight and overweight.

Methods
Thirty-seven Child Health Centers were randomly assigned to deliver intervention or usual care. The primary outcome was zBMI-change.

Results
A total of 4598 children with normal weight (zBMI: 0.1 [SD = 0.6] and 490 children with overweight (zBMI: 1.6 [SD = 0.3]) (mean age: 4.1 years [SD = 0.1]; 49% females) were included. At follow-up, at a mean age of 5.1 years [SD = 0.1], there was no intervention effect on zBMI-change for children with normal weight. Children with overweight in the control group increased zBMI by 0.01 ± 0.50, while children in the intervention group decreased zBMI by 0.08 ± 0.52. The intervention effect on zBMI-change for children with overweight was –0.11, with a 95% confidence interval of –0.24 to 0.01 (p = 0.07). The estimated additional costs of the Child-Centered Health Dialogue for children with overweight were 167 euros per child with overweight and the incremental cost-effectiveness ratio was 183 euros per 0.1 zBMI unit prevented.

Conclusions
This low-intensive multicomponent child-centered intervention for the primary prevention of child obesity did not show statistical significant effects on zBMI, but is suggested to be cost-effective with the potential to be implemented universally in the Child Health Services. Future studies should investigate the impact of socio-economic factors in universally implemented obesity prevention programs. (Less)
Please use this url to cite or link to this publication:
author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
child‐centered, child obesity, cost‐effectiveness, family therapy, prevention, primary care
in
Obesity Science Practice
volume
8
issue
1
pages
77 - 90
publisher
Wiley-Blackwell
external identifiers
  • scopus:85112295788
  • pmid:35127124
ISSN
2055-2238
DOI
10.1002/osp4.547
project
LUC3 - Lund University Child Centered Care
Child Centred Health Dialogue- a model to promote a healthy lifestyle in families and prevent overweight and obesity in preschool children.
language
English
LU publication?
yes
id
8c43ab8c-377f-4017-b398-d253f4a12a45
date added to LUP
2021-08-16 15:27:54
date last changed
2023-04-24 14:57:09
@article{8c43ab8c-377f-4017-b398-d253f4a12a45,
  abstract     = {{Background<br/>Prevention of child obesity is an international public health priority and believed to be effective when started in early childhood. Caregivers often ask for an early and structured response from health professionals when their child is identified with overweight, yet cost-effective interventions for children aged 2–6 years and their caregivers in Child Health Services are lacking.<br/><br/>Objectives<br/>To evaluate the effects and cost-effectiveness of a child-centered health dialogue in the Child Health Services in Sweden on 4-year-old children with normal weight and overweight.<br/><br/>Methods<br/>Thirty-seven Child Health Centers were randomly assigned to deliver intervention or usual care. The primary outcome was zBMI-change.<br/><br/>Results<br/>A total of 4598 children with normal weight (zBMI: 0.1 [SD = 0.6] and 490 children with overweight (zBMI: 1.6 [SD = 0.3]) (mean age: 4.1 years [SD = 0.1]; 49% females) were included. At follow-up, at a mean age of 5.1 years [SD = 0.1], there was no intervention effect on zBMI-change for children with normal weight. Children with overweight in the control group increased zBMI by 0.01 ± 0.50, while children in the intervention group decreased zBMI by 0.08 ± 0.52. The intervention effect on zBMI-change for children with overweight was –0.11, with a 95% confidence interval of –0.24 to 0.01 (p = 0.07). The estimated additional costs of the Child-Centered Health Dialogue for children with overweight were 167 euros per child with overweight and the incremental cost-effectiveness ratio was 183 euros per 0.1 zBMI unit prevented.<br/><br/>Conclusions<br/>This low-intensive multicomponent child-centered intervention for the primary prevention of child obesity did not show statistical significant effects on zBMI, but is suggested to be cost-effective with the potential to be implemented universally in the Child Health Services. Future studies should investigate the impact of socio-economic factors in universally implemented obesity prevention programs.}},
  author       = {{Derwig, Mariette and Tiberg, Irén and Björk, Jonas and Welander Tärneberg, Anna and Kristensson Hallström, Inger}},
  issn         = {{2055-2238}},
  keywords     = {{child‐centered, child obesity, cost‐effectiveness, family therapy, prevention, primary care}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{77--90}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Obesity Science Practice}},
  title        = {{A child‐centered health dialogue for the prevention of obesity in child health services in Sweden – A randomized controlled trial including an economic evaluation}},
  url          = {{http://dx.doi.org/10.1002/osp4.547}},
  doi          = {{10.1002/osp4.547}},
  volume       = {{8}},
  year         = {{2022}},
}