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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 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.
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.
| Original language | English |
|---|---|
| Pages (from-to) | 77-90 |
| Journal | Obesity Science Practice |
| Volume | 8 |
| Issue number | 1 |
| Early online date | 2021 Jul 28 |
| DOIs | |
| Publication status | Published - 2022 |
Subject classification (UKÄ)
- Pediatrics
- Health Care Service and Management, Health Policy and Services and Health Economy
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Dive into the research topics of 'A child‐centered health dialogue for the prevention of obesity in child health services in Sweden – A randomized controlled trial including an economic evaluation'. Together they form a unique fingerprint.Research output
- 1 Doctoral Thesis (compilation)
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A Child-Centred Health Dialogue for the prevention of obesity: Feasibility and evaluation of a structured model for the promotion of a healthy lifestyle in preschool children and their families in the Swedish Child Health Services
Derwig, M., 2021, Lund: Lund University, Faculty of Medicine. 121 p.Research output: Thesis › Doctoral Thesis (compilation)
Open AccessFile
Projects
- 2 Finished
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GSV: Child Centred Health Dialogue- a model to promote a healthy lifestyle in families and prevent overweight and obesity in preschool children.
Derwig, M. (Research student), Kristensson Hallström, I. (Supervisor), Tiberg, I. (Assistant supervisor) & Björk, J. (Assistant supervisor)
2016/04/01 → 2022/12/31
Project: Dissertation
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LUC3 - Lund University Child Centered Care
Kristensson Hallström, I. (PI), Magnusson, B. (Researcher), Lindgren, B. (Researcher), Hansson, K. (Researcher), Hegaard, H. K. (Researcher), Tiberg, I. (Researcher), Landgren, K. (Researcher), Shargie, M. B. (Researcher), Carlsson, A. (Researcher), Kvist, L. (Researcher), Ekelin, M. (Researcher), Derwig, M. (Researcher), Björk, J. (Researcher), Steen Carlsson, K. (Researcher), Skoog, M. (Researcher), Lefevre, Å. (Researcher), Hansson, H. (Researcher), Persson, E.-K. (Researcher), Pålsson, P. (Researcher), Jerene, D. (Researcher), Idvall, M. (Researcher), Bergström, S. (Researcher), Johnsson, B. A. (Researcher), Dykes, A.-K. (Researcher), Erlandsson, L.-K. (Researcher), Edwinson Månsson, M. (Researcher), Berggren, V. (Researcher), Schmiegelow, K. (Researcher), Selander, B. (Researcher), Castor, A. (Researcher), Nilsson, G. (Researcher), Nordmark, E. (Researcher), Sjöström-Strand, A. (Researcher), Gårdling, J. (Researcher), Måstrup, R. (Researcher), Lundqvist, P. (Researcher), Castor, C. (Researcher), Sivberg, B. (Researcher), Quaye, A. A. (Research student) & Persson, M. C. (Administrator)
The Swedish Childhood Cancer Fund, Diabetesfonden - Stiftelsen Svenska Diabetesförbundets Forskningsfond, Ekhagastiftelsen, County Administrative Board, Östergötlands län, Swedish Research Council, Region Skåne, Crafoord Foundation, Fanny Ekdahls Stiftelse, Swedish Council for Working Life and Social Research (Forte)
2013/01/01 → 2021/12/31
Project: Research
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