Pediatric Weight Management (PWM) Treatment Format Options: Group vs. Individual Intervention
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PWM: Group vs. Individual Interventions
Either group or individual nutrition intervention may be used as part of a multi-component pediatric weight-management program. Limited research that compares individual vs. group format does not indicate differences in overall pediatric weight status. However, two studies suggest that some dietary outcome measures may be improved with an individual counseling format.
Risks/Harms of Implementing This Recommendation
Conditions of Application
Intervention format should be age and developmentally appropriate.
Potential Costs Associated with Application
- Both individual and group interventions may have different costs and resources associated with them
- If organizational and program costs are passed on to participants, this could limit program access. Additionally, parent commitment to program participation is required.
- The absence of health insurance coverage for weight management could limit program access.
Only four articles were identified that compared individual vs. group formats within the same pediatric obesity treatment program. This limited body of research did not find differences in weight status using group vs. individual counseling formats (Grade III).
However, the two studies that reported dietary intake outcomes separately from adiposity outcomes (De Mello ED, Luft VC et al, 2004; Nuutinen O, 1991) found that changes in dietary intake varied according to treatment format. Additionally, De Mello ED, Luft VC et al, 2004, reported significant changes in physical activity measures only in the group intervention format.
Goldfield GS, Epstein LH et al, 2001, found that a group intervention format (compared to a mixed treatment, group and individual treatment format) was associated with larger decreases in percentage overweight per dollar spent at 12 months. However, the authors point out that it is not clear whether this finding can be generalized to different subject populations.
Recommendation Strength Rationale
Research directly comparing treatment formats within a single program was very limited.
- Risks/Harms of Implementing This Recommendation
The recommendations were created from the evidence analysis on the following questions. To see detail of the evidence analysis, click the blue hyperlinks below (recommendations rated consensus will not have supporting evidence linked).
de Mello ED, Luft VC, Meyer F. Individual outpatient care versus group education programs. Which leads to greater change in dietary and physical activity habits for obese children? J Pediatr (Rio J). 2004 Nov-Dec;80(6):468-74.
Goldfield GS, Epstein LH, Kilanowski CK, Paluch RA, Kogut-Bossler B. Cost-effectiveness of group and mixed family-based treatment for childhood obesity. Int J Obes Relat Metab Disord. 2001 Dec;25(12):1843-9.
Nuutinen O, and Knip M. Long-term weight control in obese children: persistence of treatment outcome and metabolic changes. International Journal of Obesity 1992;16:279-287.
Nuutinen O. Long-term effects of dietary counseling on nutrient intake and weight loss in obese children. Eur J Clin Nutr. 1991 Jun;45(6):287-97.
References not graded in Academy of Nutrition and Dietetics Evidence Analysis Process