Sociodemographic Outcomes From an Urban Pediatric Obesity Program

• Published in: Clinical practice in pediatric psychology 2020-12, Vol.8 (4), p.369-381
• Main Authors: Andorko, Nicole D., Getzoff, Elizabeth A., Gelfand, Kenneth, Demeule, Michelle, Scheimann, Ann O.
• Format: Article
• Language: English
• Subjects: Body Mass Index; Body Weight; Demographic Characteristics; Female; Human; Male; Minority Groups; Obesity; Pediatrics; Socioeconomic Status; Treatment Outcomes; Urban Environments; Weight Control
• ISSN: 2169-4826; 2169-4834
• DOI: 10.1037/cpp0000308

Objective: Pediatric weight management programs are plagued by insufficient changes in standardized body mass index (zBMI), disproportionately impacting racial minorities. Treatment outcomes of a pediatric weight management program with a large and diverse baseline sample were evaluated. Demographic and socioeconomic predictors of change in zBMI after 1 year were examined separately to identify characteristics contributing to treatment outcomes. It was hypothesized that socioeconomic disparities would account for lower zBMI outcomes above and beyond demographic factors. Method: Data were collected from 1,784 youth at baseline (n = 271 at 12 months; age M = 11.89 years, SD = 3.15). Information on zBMI, demographics (sex, race, age, mother's body mass index [BMI]) and socioeconomic status (SES; health insurance, number parents in home) were collected at baseline and 12 months post intervention. Results: After 1 year, average change in zBMI was −0.12 (SD = 0.21). Linear hierarchical regression analysis assessed if SES factors predicted change in zBMI after 12 months above and beyond demographic factors. Demographics were entered in Block 1, and SES factors in Block 2. The final model significantly accounted for 14.2% of variance in change in zBMI (p < .000). Examining blocks separately indicated SES variables did not significantly add to the model beyond demographic variables, contributing to less than 1.0% of the variance. Unique predictors included age, and mother's BMI. Conclusions: Participation in the program was associated with decreases in zBMI for youth who completed the year of treatment and follow-ups. Factors related to age and family had the largest association with weight loss. SES factors were not related to change in zBMI beyond demographic factors. Implications for Impact Statement Examination of the differential impact of demographic and socioeconomic (SES) factors on 12-month weight loss outcomes of a diverse, and urban pediatric weight management program indicated SES was not associated with weight loss above and beyond demographic variables. Youth under the age of 8 had the best weight loss outcomes, whereas those with mothers who reported high BMI at baseline saw the least improvement. Findings highlighted the importance of creating flexible programs that tailor pediatric weight loss interventions to be age-appropriate and inclusive to all members of the family.