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Open Access Study protocol

A shared-care model of obesity treatment for 3–10 year old children: Protocol for the HopSCOTCH randomised controlled trial

Melissa Wake1237*, Kate Lycett23, Matthew A Sabin123, Jane Gunn4, Kay Gibbons1, Cathy Hutton4, Zoe McCallum13, Elissa York2, Michael Stringer5 and Gary Wittert6

Author Affiliations

1 Royal Children’s Hospital, Parkville, VIC, Australia

2 Murdoch Childrens Research Institute, Parkville, Australia

3 Department of Paediatrics, University of Melbourne, Parkville, Australia

4 Department of General Practice, University of Melbourne, Parkville, Australia

5 Knowsys, Mt Waverley, Australia

6 Discipline of Medicine, University of Adelaide, Adelaide, Australia

7 Centre for Community Child Health, Royal Children’s Hospital, Flemington Road, Parkville, VIC, 3052, Australia

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BMC Pediatrics 2012, 12:39  doi:10.1186/1471-2431-12-39

Published: 28 March 2012

Abstract

Background

Despite record rates of childhood obesity, effective evidence-based treatments remain elusive. While prolonged tertiary specialist clinical input has some individual impact, these services are only available to very few children. Effective treatments that are easily accessible for all overweight and obese children in the community are urgently required. General practitioners are logical care providers for obese children but high-quality trials indicate that, even with substantial training and support, general practitioner care alone will not suffice to improve body mass index (BMI) trajectories. HopSCOTCH (the Shared Care Obesity Trial in Children) will determine whether a shared-care model, in which paediatric obesity specialists co-manage obesity with general practitioners, can improve adiposity in obese children.

Design

Randomised controlled trial nested within a cross-sectional BMI survey conducted across 22 general practices in Melbourne, Australia.

Participants

Children aged 3–10 years identified as obese by Centers for Disease Control criteria at their family practice, and randomised to either a shared-care intervention or usual care.

Intervention

A single multidisciplinary obesity clinic appointment at Melbourne’s Royal Children’s Hospital, followed by regular appointments with the child’s general practitioner over a 12 month period. To support both specialist and general practice consultations, web-based shared-care software was developed to record assessment, set goals and actions, provide information to caregivers, facilitate communication between the two professional groups, and jointly track progress.

Outcomes

Primary - change in BMI z-score. Secondary - change in percentage fat and waist circumference; health status, body satisfaction and global self-worth.

Discussion

This will be the first efficacy trial of a general-practitioner based, shared-care model of childhood obesity management. If effective, it could greatly improve access to care for obese children.

Trial Registration

Australian New Zealand Clinical Trials Registry ACTRN12608000055303