DISCUSSION
We found that a family-based community intervention for
childhood overweight or obesity, when implemented at scale
and under service conditions, was associated with improvements
in BMI and in psychosocial outcomes. The reduction in BMI under
service conditions was slightly but not statistically significantly less
than that observed in the RCT of the same intervention. Although
previous research has shown that family-based interventions for
child overweight are associated with changes in adiposity6 and
psychosocial28 outcomes when tested under trial conditions, to
our knowledge this is the first study to show that such
interventions implemented at scale and under service conditions
might also be associated with changes in these outcomes.
Our results also showed that all population subgroups
improved on average for all outcomes, but that improvements
varied by participant, family, programme and neighbourhood
factors. For example, BMI fell more in children with higher baseline
DISCUSSION
We found that a family-based community intervention for
childhood overweight or obesity, when implemented at scale
and under service conditions, was associated with improvements
in BMI and in psychosocial outcomes. The reduction in BMI under
service conditions was slightly but not statistically significantly less
than that observed in the RCT of the same intervention. Although
previous research has shown that family-based interventions for
child overweight are associated with changes in adiposity6 and
psychosocial28 outcomes when tested under trial conditions, to
our knowledge this is the first study to show that such
interventions implemented at scale and under service conditions
might also be associated with changes in these outcomes.
Our results also showed that all population subgroups
improved on average for all outcomes, but that improvements
varied by participant, family, programme and neighbourhood
factors. For example, BMI fell more in children with higher baseline
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