***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : This study examined the role of demographic characteristics , psychological factors , and family functioning on attendance in a r and omized controlled trial of a family-based pediatric obesity program . Method : Participants included 155 children between the ages of 4 and 7 years ( M age = 5.77 , 57.4 % female , 73.6 % black , M body mass index = 25.5 ) and their primary caregivers who were r and omized to the treatment group . Three groups of participants were created based on their patterns of attendance during the program : ( 1 ) noncompleters , ( 2 ) partial completers , and ( 3 ) completers . Results : Results indicated no differences among the attendance groups in child gender , child body mass index , or child psychological functioning . Significant group differences were found with respect to race/ethnicity , parent marital status , and family income , such that noncompleters were more likely to be racial/ethnic minorities , to living in single parent households , and to have lower incomes than partial completers and completers . After controlling for the effects of these sociodemographic risk factors , noncompleters , and partial completers reported more family dysfunction characterized by high levels of disengagement than completers . Conclusion : Adapting existing weight management programs to include a focus on family engagement in the early stages of treatment may help to improve participation in family-based obesity interventions targeting high risk , socioeconomically disadvantaged youth OBJECTIVE To assess height growth over 10 years in children treated for obesity . DESIGN Longitudinal , prospect i ve follow-up of a series of r and omized , controlled weight control trials . SETTING Specialized pediatric weight control clinic . PARTICIPANTS One hundred fifty-eight 6- to 12-year-old obese children who were followed up for 10 years after treatment . INTERVENTIONS Family-based behavioral weight control . MEASUREMENTS /MAIN RESULTS At entry the height percentiles of the obese children were significantly higher ( 71.6 percentile ) than same-sex parent ( 52.0 percentile ) or midparent ( 51.5 percentile ) height ( an estimate of parental contribution to height ) . After an average growth of 22.7 cm , children were 2.2 cm taller than their same-sex parent and decreased to an average height percentile of 57.8 . Multiple regression analysis showed that child sex , age , baseline height and percent overweight , midparent height , and height change of the child from baseline to 5 years accounted for 94 % of the variance in growth . Child percent overweight change made no contribution to predicting height change . Comparison between children obese and nonobese at 10 years showed no differences in growth . CONCLUSIONS Moderate energy restriction with dietary guidance by overweight children did not negatively influence long-term growth Background Recruitment to trials evaluating the effectiveness of childhood obesity management interventions is challenging . We report our experience of recruitment to the Families for Health study , a r and omised controlled trial evaluating the effectiveness of a  family-based community programme for children aged 6–11 years , versus usual care . We evaluated the effectiveness of active recruitment ( contacting eligible families directly ) versus passive recruitment ( informing the community through flyers , public events , media ) . Methods Initial approaches included passive recruitment via the media ( newspapers and radio ) and two active recruitment methods : National Child Measurement Programme ( letters to families with overweight children ) and referrals from health-care professionals . With slow initial recruitment , further strategies were employed , including active ( e.g. targeted letters from general practice s ) and passive ( e.g. flyers , posters and public events ) methods . At first enquiry from a potential participant , families were asked where they heard about the study . Further quantitative ( question naire ) and qualitative data ( one-to-one interviews with parents/carers ) , were collected from recruited families at baseline and 3-month follow-up and included questions about recruitment . Results In total , 194 families enquired about Families for Health , and 115 ( 59.3 % ) were recruited and r and omised . Active recruitment yielded 85 enquiries , with 43 families recruited ( 50.6 % ) ; passive recruitment yielded 99 enquiries with 72 families recruited ( 72.7 % ) . Information seen at schools or GP surgeries accounted for over a quarter of enquiries ( 28.4 % ) and over a third ( 37.4 % ) of final recruitment . Eight out of ten families who enquired this way were recruited . Media-led enquiries were low ( 5 % ) , but all were recruited . Children of families recruited actively  were more likely to be Asian or mixed race . Despite extensive recruitment methods , the trial did not recruit as planned , and was awarded a no-cost extension to complete the 12-month follow-up . Conclusions The higher number of participants recruited through passive methods may be due to the large number of potential participants these methods reached and because participants may see the information more than once . Recruiting to a child obesity treatment study is complex and it is advisable to use multiple recruitment strategies , some aim ing at blanket coverage and some targeted at families with children who are overweight . Trial registration Current Controlled Trials IS RCT N45032201 ( Date : 18 August 2011 INTRODUCTION The present study describes a r and omised controlled trial ( RCT ) based on a novel , generalisable intervention for childhood obesity , comparing the intervention with a no-treatment control group . METHOD The Malaysian Childhood Obesity Treatment Trial ( MASCOT ) was a single-blind RCT of a dietetic treatment for childhood obesity in children of primary school age ( 7 to 11 years old ) in Kuala Lumpur , Malaysia . The MASCOT comprising eight sessions , of an 8-hour family-centred group treatment programme is described , based on behavioural change techniques . The study sample was characterised by BMI z-score , health related quality of life reported by participants and their parents ( PedsQL question naire ) , objective ly measured habitual physical activity and sedentary behaviour ( Actigraph accelerometry ) RESULTS The MASCOT sample of 107 children was characterised by a low quality of life , mean total score on PedsQL 67.7 ( 4.5 ) as reported by the children , and 66.0 ( 16.4 ) as reported by their parents . The children spent , on average , 89 % of their waking day on sedentary activity , and 1 % of the day in moderate-vigorous intensity physical activity , equivalent to only around 8 minutes/day . CONCLUSION Obese children in the MASCOT study had an impaired quality of life , high levels of sedentary behaviour and very low levels of physical activity OBJECTIVE The objective was to compare targeting increased eating of healthy foods vs. reducing intake of high energy-dense foods within the context of a family-based behavioral weight control program . METHODS AND PROCEDURES Forty-one 8 - 12 year-old children > 85th BMI percentile were r and omly assigned to a 24-month family-based behavioral treatment that targeted increasing fruits and vegetables and low-fat dairy vs. reducing intake of high energy-dense foods . RESULTS Children in the increase healthy food group showed greater reduction in z BMI compared to children in the reduce high energy-dense food group at 12- ( -0.30 z BMI units vs. -0.15 z BMI units , P = 0.01 ) and 24- ( -0.36 z BMI units vs -0.13 z BMI units , P = 0.04 ) month follow-up . Parents in the increase healthy food group showed greater reductions in concern about child weight ( P = 0.007 ) , and these changes were associated with child z BMI change ( P = 0.008 ) . Children in the reduce high energy-dense group showed larger sustained reductions in high energy-dense foods ( P < 0.05 ) . Baseline levels of high energy-dense foods ( P < 0.05 ) , parent food restraint ( P = 0.01 ) , parent concern over parent weight ( P = 0.01 ) and parent acceptance of the child ( P < 0.05 ) moderated child z BMI change , with greater sustained reductions in z BMI for children in the increase healthy food group for each measure . Parent z BMI change followed the same pattern as child changes , and parent and child z BMI changes were correlated ( P < 0.001 ) . DISCUSSION Focusing on healthy food choices within an energy restricted diet may be useful in family-based weight control programs Background Child obesity internationally has been identified as one of the major threats to future population health . Indigenous people and those from lower socio-economic background s are over-represented in obesity statistics . There is a need for evidence of effect of interventions for child obesity with long-term follow-up . Whether engaging with those that are more motivated to make lifestyle changes is a useful strategy has not been fully explored . We hypothesise that in obese/overweight children , assessed as psychologically “ ready for change ” , delivery of a 12-month multi-disciplinary intervention programme results in a significant reduction in body mass index st and ard deviation score . Methods / Design Whanau Pakari is an unblinded r and omised controlled clinical trial comparing a 12 month intervention programme with st and ard practice , with 6 monthly assessment s for 2 years , conducted in Taranaki , New Zeal and ( a region where 15.8 % of the population are indigenous ) . It specifically targets indigenous people and those in more deprived households . Obese/overweight children and adolescents aged 5–16 years are eligible . Exclusion criteria are medical/psychological conditions leading to inability to undertake physical activity/participate in group sessions ; those not “ ready ” to make lifestyle changes ; and those without a committed family member . Assessment s of health parameters , dietary history , physical activity and overall health-related quality of life/psychological functioning are completed in the participant ’s home .  Fasting blood tests are obtained at baseline , 12 and 24 months . The primary outcome is body mass index st and ard deviation score . Secondary outcomes include quality of life , dietary behaviour and physical activity , cardiovascular and metabolic profile ( blood pressure , resting heart rate , waist circumference ) , glycaemic control ( fasting glucose and glycated Haemoglobin ) , fasting insulin , and lipids . A general linear mixed model will be used to assess change from baseline using the 6 , 12 , 18 and 24 month measures , adjusting for age , gender , socioeconomic status and ethnicity , and whether at the contemplative or preparation/action stages of readiness for change . Discussion This trial will inform the development of management programmes for obese children and adolescents that are appropriate for indigenous population s. It will investigate whether those at the preparation/action stage of “ readiness ” to make lifestyle changes are more successful in making changes than those who are contemplative . Trial registration Australian New Zeal and Clinical Trials Registry (ANZCTR):12611000862943 . ( Date registered 15/08/2011 ) The objective of the present study was to evaluate the effectiveness of a one-year multi-component immersive day-camp weight-loss intervention for children with overweight and obesity . The study design was a parallel-group r and omized controlled trial . One hundred fifteen 11 - 13-year-old children with overweight and obesity were r and omized into either : A six-week day-camp intervention arm focusing on increased physical activity , and healthy diet followed by a subsequent one-year family-based intervention , or a st and ard intervention arm consisting of one weekly exercise session for six weeks .  Body mass index ( BMI ) was the primary outcome . BMI z-score , clustered cardiovascular risk z-score , and body composition were secondary outcomes . All outcomes were measured at baseline , six week- , and 52 week follow-up . After six weeks , children from the day-camp intervention arm had improved their BMI ( -2.2 kg/m2 ( 95 % CI -2.6 to -1.7 , P<0.001 ) ) and all secondary outcomes when compared to the children from the st and ard intervention arm . After 52 weeks , the day-camp intervention arm had a lower BMI ( -1.2 kg/m2 ( 95 % CI -1.8 to -0.5 , P = 0.001 ) ) , and BMI z-score ( -0.20 ( 95 % CI -0.35 to -0.05 , P = 0.008 ) ) , and clustered cardiovascular risk z-score ( -0.23 ( 95 % CI -0.37 to -0.08 , P = 0.002 ) ) compared to the st and ard intervention arm . No group differences were detected in body composition after 52 weeks . This study shows that the day-camp intervention arm is effective in reducing BMI and improving the metabolic health of  children with overweight and obesity . However , the effects seem to be diminishing over time OBJECTIVE To evaluate the feasibility , acceptability , and efficacy of an after-school team sports program for reducing weight gain in low-income overweight children . DESIGN Six-month , 2-arm , parallel-group , pilot r and omized controlled trial . SETTING Low-income , racial/ethnic minority community . PARTICIPANTS Twenty-one children in grade s 4 and 5 with a body mass index at or above the 85th percentile . INTERVENTIONS The treatment intervention consisted of an after-school soccer program . The " active placebo " control intervention consisted of an after-school health education program . MAIN OUTCOME MEASURES Implementation , acceptability , body mass index , physical activity measured using accelerometers , reported television and 
    Output:
    
No subgroup effects were shown for any of the subgroups on any of the outcomes .
Multi-component behaviour-changing interventions that incorporate diet , physical activity and behaviour change may be beneficial in achieving small , short-term reductions in BMI , BMI z score and weight in children aged 6 to 11 years .
The evidence suggests a very low occurrence of adverse events .