Fully Subsidized Multiprofessional Health Services and Persistence in Pediatric Obesity Treatment

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Abstract
OBJECTIVES: We compared persistence in a lifestyle modification program and reductions in body mass index z-score (BMIz) among children with overweight or obesity attending a pediatric obesity management clinic based on their access to a family grant program (FGP) that fully subsidized multiprofessional health services for families with social vulnerabilities. METHODS: This is a retrospective, longitudinal analysis of medical records of children followed from April 8, 2021 (FGP implementation) to March 31, 2023. Children in youth centers, in foster families, with refugee status, or whose parents had a low income per Canada’s Revenue Agency were eligible for the FGP, which fully subsidized multiprofessional health services. The number of appointments, follow-up duration, and changes in BMIz over the study period were compared based on access to the FGP. RESULTS: Among the 198 included children, 62 received the FGP, and 136 were not eligible to it. Children with the FGP had longer follow-ups [10.3 (95% CI, 8.66–12.0) vs 6.55 (95% CI, 5.33–7.77) months; P = .0008] and a similar number of monthly appointments [0.81 (95% CI, 0.67–0.96) vs 0.90 (95% CI, 0.80–1.00); P = .69] compared with those without it. Over follow-up, children who received the FGP achieved similar BMIz reductions compared with those who were ineligible for it. CONCLUSIONS: Fully subsidizing multiprofessional health services for children with social vulnerabilities was associated with persistence in a lifestyle program and BMIz reductions comparable with those observed in children without such vulnerabilities. These findings suggest that free access to care may help overcome systemic barriers to managing childhood obesity.

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