Pilot Implementation of an Adapted Online Clinic‐Community Model for Childhood Obesity

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Abstract
Background: Intensive health‐behaviour lifestyle treatment is recommended for paediatric obesity, but evidence for young children and synchronous online delivery remains limited. Objectives: To evaluate the feasibility, acceptability, and preliminary effectiveness of an adapted online clinic‐community model for children aged 4 to < 8 years with overweight or obesity. Methods: In this two‐arm randomized controlled trial, children were randomized to an online family‐based intervention or usual care. The primary outcome was treatment dose at 6 months, defined as intervention contact hours. Secondary outcomes included BMI z‐score, percentage of the 95th BMI percentile, health‐related quality of life, eating behaviours, and perceived movement skills at 3 and 6 months. Results: Forty children were enrolled; mean age was 6.6 ± 1.0 years and 58% were male. At 6 months, 70% of intervention participants achieved at least 26 treatment hours. Although the between‐group differences were not statistically significant, the intervention group demonstrated numerically greater reductions in BMI z‐score (−0.2 ± 0.3 vs. −0.1 ± 0.1; p = 0.091) and percentage of the 95th BMI percentile (−3.5 ± 6.4 vs. −0.2 ± 4.0; p = 0.075). Physical quality of life improved at 3 and 6 months, object control skills at 3 months, and perceived locomotor skills at 6 months. Conclusions: The adapted online model was feasible and acceptable, with preliminary improvements in physical quality of life, movement skills, and BMI metrics. Larger adequately powered trials are needed to confirm effectiveness and longer‐term outcomes.

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