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Efficacy of individual counseling versus group program in promoting healthier lifestyle behaviours among children (seven to 11 years old) who are overweight Koh, Jiak Chin

Abstract

The prevalence of childhood obesity has increased dramatically in Canada in recent decades. Despite this, treatment services are often limited, and when available, traditional weight control approaches have been criticized for unrealistic goals, possible adverse effects, and ultimately lack of long-term success. It is hypothesized that a group program focused on promoting healthier lifestyle behaviours for overweight children and their families in a fun, friendly and supportive. environment aimed at improving eating behaviour, physical activity, self-efficacy, and self-esteem would be more effective than individual counseling sessions despite a similar message. Forty-six children aged seven to 11 years with body mass index > 85th percentile were randomized with gender stratification to either a group program involving eight weekly two-hour sessions or a single one hour individual counseling session with a half-hour follow-up session two months later. Both groups were followed up 12 months after the initial session. Drop-out was high with only five and seven children respectively finishing the study, limiting its power. At 12 months, there were no differences between groups in change in body mass index (BMI) or triceps skinfold (TSF), although TSF (p=0.012) but not BMI fell in both groups. Questionnaire-measured physical activity level, self-efficacy and self-esteem did not differ between groups. This study concludes that, at least in the short term, a widely-focused group program for the management of childhood obesity is no better than individual nutritional counseling sessions with a similar message. Longer term studies are needed to investigate the effectiveness of a healthful lifestyle approach in children, irrespective of the mode of delivery.

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