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Building a response criterion for pediatric multidisciplinary obesity intervention success based on combined benefits

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Abstract

To propose a response criterion for analyzing the intervention success by verifying patient outcomes after a multidisciplinary obesity treatment program in Brazilian children and adolescents. Obese children and adolescents (n = 103) completed a 16-week multidisciplinary intervention (IG) and were compared to the control group (CG) (n = 66). A cluster of parameters (e.g. total domain of HRQoL; BMI z-score; cardiorespiratory fitness; body mass; waist circumference; fat mass; lean mass) were measured pre and post-intervention, and the sum of the median percentage variation and the percentile 25 and 75 were used from IG and CG to determine the responsiveness to the program. We are proposing four ranges in which children and adolescents may be classified after the intervention: (1) CG percentile 50 values or lower are considered non-responsive to the intervention, (2) values greater than CG percentile 50 but lower than IG percentile 50 are considered slightly responsive, (3) values greater than IG percentile 50 but lower than IG percentile 75 were considered as moderately responsive, and (4) values greater than IG percentile 75 were considered very responsive.

Conclusions: This criterion may serve as a complementary tool that can be employed to monitor the response to this model of multidisciplinary intervention.

What is Known:

• The effectiveness of multidisciplinary obesity interventions is usually determined by comparing changes in selected outcomes in the intervention versus versus control group.

• There is no consensus about what should be assessed before and after the intervention program, which makes difficult to compare different programs and to determine their rate of responsiveness.

What is New:

• This study proposes a response criteria to pediatric obesity interventions following a similar model compared to ours based on key variables that presents low cost and high applicability in different settings.

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Abbreviations

BMI:

Body mass index

CG:

Control group

IG:

Intervention group

HRQoL:

Health-related quality of life

MRI:

Moderately responsive to the intervention

NRI:

Non-responsive to the intervention

P:

Percentile

PedsQL™:

Pediatric Quality of Life Inventory™

PMTO:

Multidisciplinary obesity treatment program

SRI:

Slightly responsive to the intervention

VRI:

Very responsive to the intervention

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Acknowledgements

The authors thank the members of the Multiprofessional Nucleus of Obesity Treatment program for their contribution to data collection and intervention development; they also thank the Araucaria Foundation (Agreement 179/10, protocol 19213) and Capes (501100002322) for financial support.

Funding

Araucaria Foundation (Agreement 179/10, protocol 19213).

Author information

Authors and Affiliations

Authors

Contributions

Nelson Nardo Junior: Dr. Nardo Junior conceptualized and designed the study, contributed to data collection, carried out the initial analyses, drafted the initial manuscript, critically reviewed the manuscript, and approved the final manuscript as submitted.

Josiane A. A. Bianchini: Mrs. Bianchini conceptualized and designed the study, contributed to data collection, carried out the initial analyses, drafted the initial manuscript, critically reviewed the manuscript, and approved the final manuscript as submitted.

Danilo F. da Silva: Mr. da Silva conceptualized and designed the study, contributed to data collection, carried out the initial analyses, drafted the initial manuscript, critically reviewed the manuscript, and approved the final manuscript as submitted.

Zachary M. Ferraro analyzed and interpreted data, critically reviewed the manuscript, and approved the final manuscript as submitted.

Carlos A. Lopera: Mr. Lopera contributed to data collection, drafted the initial manuscript, critically reviewed the manuscript, and approved the final manuscript as submitted.

Vanessa D. S. Antonini: Mrs. Antonini contributed to data collection, drafted the initial manuscript, critically reviewed the manuscript, and approved the final manuscript as submitted.

Corresponding author

Correspondence to Josiane Aparecida Alves Bianchini.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Communicated by Mario Bianchetti

This article has a part 2, which is a different manuscript that complements this one and is available as ESM file. The manuscript part 2 is a long-term intervention that aimed to analyze if the responders in short-term present a greater magnitude of change in the parameters included in the criterion as well as in cardiometabolic risk factors and different domains of HRQoL.

Electronic supplementary material

ESM 1

(DOC 159 kb)

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Nardo Junior, N., Bianchini, J.A.A., da Silva, D.F. et al. Building a response criterion for pediatric multidisciplinary obesity intervention success based on combined benefits. Eur J Pediatr 177, 1–12 (2018). https://doi.org/10.1007/s00431-018-3115-0

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  • DOI: https://doi.org/10.1007/s00431-018-3115-0

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