Pediatric obesity treatment in rural settings: Association between psychosocial functioning and health outcomes

Abstract

Objective. Evaluate associations between psychological functioning, weight, and diet in rural children participating in family-based pediatric obesity interventions. Methods. One hundred and forty-eight children participated in two trials of rural pediatric obesity interventions. Measures of internalizing, externalizing, and total behavior problems; BMIz; red food intake; and fruit and vegetable intake were taken at baseline and post-intervention. Pre- to post-intervention changes in health outcomes were assessed using paired-samples t-tests. Continuous and categorical associations between behavior problems and weight/diet were assessed using correlations, hierarchical linear regression models, and independent-samples t-tests. Results. Across all participants, red foods and behavior problems significantly improved from pre- to post-intervention. Externalizing problems were positively associated with red foods, and clinical levels of externalizing and internalizing problems were associated with higher baseline red foods and BMIz (compared to subclinical problems). Conclusion. Findings support associations between psychological functioning and weight/diet in rural children participating in a family-based pediatric obesity intervention. Identifying children with high baseline levels of psychological problems may help predict which children are the most or least likely to succeed in a pediatric obesity interventions as well as inform future development of interventions that are more effective in children with psychological problems.