Q&A: How to partner with parks and recreation to address pediatric obesity

BySara Kellner

BySarah C Armstrong, MD

Fact checked byCarol L. DiBerardino, MLA, ELS

Key takeaways:

Clinicians partnered with a local parks and recreation facility to offer fitness and nutrition classes to children with overweight and obesity.
Children who participated saw improvements in BMI vs. control.

Children with overweight and obesity experienced notable improvements in health outcomes after participating in a lifestyle treatment program through a pediatric obesity clinic and local parks and recreation facility.

“Lifestyle treatment for children with obesity helps improve their health in a number of important ways,” Sarah C. Armstrong, MD, professor of pediatrics at Duke University School of Medicine and director of the Duke Children’s Healthy Lifestyles Program in Durham, North Carolina, told Healio. “However, it has been very difficult for children to access.

“We partnered with parks and recreation because they are truly engrained into every aspect of a community’s health and wellbeing.”

Armstrong and colleagues designed a two-arm randomized controlled trial of 255 youths (47.8% boys; mean age, 10 years; standard deviation, 3 years) with overweight or obesity.

Armstrong’s Healthy Lifestyles clinic partnered with a local parks and recreation center, Bull City Fit, to offer participants access to fitness facilities 6 days a week. The researchers assigned 131 participants to the intervention arm, which included monthly visits with a clinician, weekly cooking and nutrition classes at Bull City Fit and a variety of structured and unstructured fitness opportunities.

They compared children in the intervention group to a control group of 124 participants who were on the waitlist for the program. Children in the control group received obesity counseling from their primary care physician during the study period.

The researchers evaluated the effects of the intervention by measuring participants’ BMI relative to the 95th percentile vs. the control group.

Overall, youths in the intervention group saw significant declines in their BMI relative to the 95th percentile compared with those in the control group (B = –3.32; 95% CI, –5.69 to –0.96).

The study took place from 2018 to 2021, and the researchers noted significant differences between children who participated before or during the COVID-19 pandemic.

Children who were not disrupted by the pandemic demonstrated improvements in BMI relative to the 95th percentile compared with the control group (B = –3.05; 95% CI, –5.08 to –1.01), whereas children who participated during pandemic closures did not experience a significant change vs. control.

Healio spoke with Armstrong about the outcomes of the study and how pediatricians can set up a partnership in their community.

Healio: What were the most notable differences you found between the intervention and control groups?

Armstrong: The intervention group showed several positive health outcomes that we did not see in the children who were in the control group, like BMI reduction, but maybe more importantly, the children in the intervention group developed greater self-confidence, were more willing to try new activities and new foods, were making friends with other participants. Their families also developed healthy habits. These things are sometimes tough to measure in a study, but anyone who knows kids knows these are some of the most important parts of a happy and healthy childhood.

Healio: Did you gather any qualitative data? What did participants and their families think about the intervention?

Armstrong: Not in this study, but in prior studies we used qualitative methods to develop and pilot test the intervention. Families loved that it was in a relaxed, non-clinical setting, that we did not weigh or measure children there — or even talk about weight at all. They loved being with other families, and just having fun. The kids said the thing they loved most is that the other children “look like me” — we found that made them more willing to be brave and participate actively.

Healio: What will future research look like in this area?

Armstrong: We need to understand how this can be adopted in a wide range of communities: urban and rural, large and small, and in many different parts of the country.

Healio: What can clinicians do if they want to set up a similar partnership in their community?

Armstrong: Go to fittogetherkids.org and request to become a partner!