Published March 26, 2014
New research reveals that nonmedical professionals without prior pediatric weight control experience can be trained to effectively deliver a childhood obesity treatment program and produce meaningful results.
The results of the study, which focused on JOIN for ME® – a community-based, pediatric obesity intervention program developed by UnitedHealth Group – will help efforts to scale the initiative nationally. The research was published in the peer-reviewed journal International Journal of Behavioral Nutrition and Physical Activity (Feb. 13, 2014).
Researchers evaluated the JOIN for ME facilitators who did not have a medical background to identify key characteristics needed to effectively deliver the program, including interpersonal skills and ability to manage group interactions. They also looked at how closely the facilitators adhered to the protocol. Researchers then evaluated the relationship between facilitator characteristics and adherence to protocol with the level of weight reduction among participants. They found that there was a correlation between protocol adherence and a decrease in weight among participants.
A study published in the October 2012 issue of Pediatrics showed JOIN For ME resulted in a clinically significant reduction in excess weight and improved health-related quality of life among overweight and obese children. This follow-up research on facilitators aimed to find ways to make the program’s success sustainable and broaden its reach.
“An important factor in making community-based treatment programs work is ensuring the group facilitator can both deliver the evidence-based content and engage with children and families who are enrolled,” said Deborah Sundal, senior vice president of UnitedHealth Group’s Center for Health Reform & Modernization and one of the report’s authors. “Our study found that it is important to invest in training nonmedical professionals to deliver the JOIN for ME content and consistently use group-facilitation skills. When both are used optimally, we see higher family engagement and better results, including a reduction of excess weight.”
JOIN for ME, which was piloted with the YMCA of the USA and the YMCA of Greater Providence, R.I., engaged overweight and obese kids ages six to 17, along with their parents, in a series of learning sessions. The goal was for the children to achieve healthier weight through balanced nutrition choices, increased activity and monitoring behaviors. The sessions were conducted by YMCA staff with no previous training in pediatric obesity.
After six months, participants in the JOIN for ME pilot achieved, on average, a 3.4 percent reduction in excess weight. The researchers also found that 10 percent fewer children were in the obese category after enrolling in the program, which means that, if scaled nationally, JOIN for ME has the potential to make tremendous health and economic impacts.
The study also revealed significant improvements in child health-related quality of life (measured by the 23-item Pediatric Quality of Life Inventory), as reported by both children and parents, and that the participants who attended a higher number of face-to-face group sessions experienced greater weight loss. Parents of participants in the study also experienced small, but statistically significant, reductions in weight.
The facilitator study is important because, to be effective, affordable and have the broadest impact, such interventions will require a large number of facilitators, many of whom may not be medical professionals.
“It is imperative that we find new ways to broaden the availability and impact of effective treatment for childhood obesity,” said Elissa Jelalian, Ph.D., associate professor of Psychiatry and Human Behavior, Alpert Medical School of Brown University and one of the study’s authors. “This includes making evidence-based programs more broadly available in primary care clinical settings, partnering with community organizations to deliver them, and training nonmedical professionals to engage children under a clinician’s supervision. By training facilitators who may not have previous experience in pediatric weight management, we can expand the program nationally to more families seeking care.”
Childhood obesity is an epidemic in the United States. While Federal health authorities reported in late February a 43 percent drop in the obesity rate among two- to five-year-old children over the past decade, there is still a great deal of work to be done, as obesity among youth puts them at grave risk for cancer, heart disease, diabetes and stroke.
About one-third of all American children ages six to 18 are obese or overweight, leading to increased health risks and higher health care costs, and a decrease in parents’ productivity at work, according to the Centers for Disease Control and Prevention (CDC). Obesity affects 17 percent of all children and adolescents in the United States – nearly triple the rate from just 30 years ago – according to the CDC.
JOIN for ME is a 16-week childhood obesity program that builds a network of family support for children who struggle with extra weight. In the JOIN for ME classes, a child and parent participate together in group classes at local Ys, Boys & Girls Clubs or other community locations. Sessions are led by a trained facilitator and cover topics such as reducing less healthy foods and drinks, getting and staying active, managing screen time, improving sleep habits, and understanding the link between moods and foods.
JOIN for ME focuses on helping children who struggle with extra weight, underscoring the importance of cultivating a healthier environment and healthier behaviors at home with the entire family. To read the article in the Journal of Behavioral Nutrition and Physical Activity, click here.
About UnitedHealth Group
UnitedHealth Group (NYSE: UNH) is a diversified health and well-being company dedicated to helping people live healthier lives and making health care work better. With headquarters in Minnetonka, Minn., UnitedHealth Group offers a broad spectrum of products and services through two distinct platforms: UnitedHealthcare, which provides health care coverage and benefits services; and Optum, which provides information and technology-enabled health services. Through its businesses, UnitedHealth Group serves more than 85 million people worldwide. For more information, visit UnitedHealth Group at www.unitedhealthgroup.com.