Change in health-related quality of life in the context of pediatric obesity interventions: A meta-analytic review.

Objective: To quantitatively characterize change in health-related quality of life (HRQoL) in the context of behavioral (n = 16), surgical (n = 5), and pharmacological (n = 1) interventions for pediatric overweight and obesity. A secondary goal was to examine the relationship between change in HRQoL and change in body mass index (ΔBMI) by treatment type. The amount of weight loss necessary to observe a minimally clinically important difference (MCID) in HRQoL was determined. Method: Data were gathered from studies reporting on weight change and ΔHRQoL over the course of obesity interventions (N = 22) in youths (N = 1,332) with average ages between 7.4 and 16.5 years (M = 12.2). An overall effect size was calculated for ΔHRQoL. Moderation analyses were conducted using analysis of variance and weighted regression. MCID analyses were conducted by converting HRQoL data to standard error of measurement units. Results: The overall effect size for ΔHRQoL in the context of pediatric obesity interventions was medium (g = 0.51). A significant linear relationship was detected between ΔBMI and ΔHRQoL (R2 = 0.87). This relationship was moderated by treatment type, with medical (i.e., surgical) interventions demonstrating a stronger relationship. Results indicated that it takes a change of 0.998 BMI units to detect true change in HRQoL. Conclusion: This study provides the first known quantitative examination of changes in HRQoL associated with weight loss in pediatric interventions. Medical interventions appear to offer a more substantial increase in HRQoL per unit of BMI change. These results offer a concrete weight loss goal for noticing positive effects in daily life activities. (PsycINFO Database Record (c) 2016 APA, all rights reserved

Handbook of Pediatric Psychology

xxiv, 808 hlm.; 25 x 19 c

Pediatric weight management interventions in primary care settings: A meta-analysis.

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. (PsycINFO Database Record (c) 2016 APA, all rights reserved

Change in Health-Related Quality of Life in the Context of Pediatric Obesity Interventions: A Meta-Analytic Review

Objective: To quantitatively characterize change in health-related quality of life (HRQoL) in the context of behavioral (n = 16), surgical (n = 5), and pharmacological (n = 1) interventions for pediatric overweight and obesity. A secondary goal was to examine the relationship between change in HRQoL and change in body mass index (ΔBMI) by treatment type. The amount of weight loss necessary to observe a minimally clinically important difference (MCID) in HRQoL was determined. Method: Data were gathered from studies reporting on weight change and ΔHRQoL over the course of obesity interventions (N = 22) in youths (N = 1,332) with average ages between 7.4 and 16.5 years (M = 12.2). An overall effect size was calculated for ΔHRQoL. Moderation analyses were conducted using analysis of variance and weighted regression. MCID analyses were conducted by converting HRQoL data to standard error of measurement units. Results: The overall effect size for ΔHRQoL in the context of pediatric obesity interventions was medium (g = 0.51). A significant linear relationship was detected between ΔBMI and ΔHRQoL (R2 = 0.87). This relationship was moderated by treatment type, with medical (i.e., surgical) interventions demonstrating a stronger relationship. Results indicated that it takes a change of 0.998 BMI units to detect true change in HRQoL. Conclusion: This study provides the first known quantitative examination of changes in HRQoL associated with weight loss in pediatric interventions. Medical interventions appear to offer a more substantial increase in HRQoL per unit of BMI change. These results offer a concrete weight loss goal for noticing positive effects in daily life activities