Building a response criterion for pediatric multidisciplinary obesity intervention success based on combined benefits
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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.
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.
KeywordsPediatric obesity Intervention studies Treatment outcome Eating habits Exercise Lifestyle
Body mass index
Health-related quality of life
Moderately responsive to the intervention
Non-responsive to the intervention
Pediatric Quality of Life Inventory™
Multidisciplinary obesity treatment program
Slightly responsive to the intervention
Very responsive to the intervention
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.
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.
Araucaria Foundation (Agreement 179/10, protocol 19213).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
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 was obtained from all individual participants included in the study.
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