Peer-reviewed article
Neighborhood-Level Variation in the Effectiveness of Intensive Health Behavior and Lifestyle Treatment for Pediatric Obesity.
Wang G, Samuels S, Maciejewski KR, Hu P, Savoye M et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined how neighborhood characteristics affect the success of Bright Bodies, an intensive treatment program for obese children. Children from neighborhoods with better resources and healthier environments showed greater weight loss than those from disadvantaged neighborhoods, though all groups improved. The findings suggest that access to supportive neighborhood environments significantly influences treatment outcomes for pediatric obesity.
Key points
- All neighborhood groups showed BMI reductions, but High Child Opportunity Index neighborhoods saw the greatest monthly reduction (-1.86% BMI percentile) versus Moderate COI neighborhoods (-1.17%)
- High COI-Healthy Environment neighborhoods achieved -2.32% monthly reduction versus Low COI-HE neighborhoods at -1.53%
- 80.8% of participants lived in Low COI neighborhoods and 66.5% in Low COI-HE neighborhoods, indicating the program served predominantly disadvantaged populations
- The study included 391 youth aged 11.7 years on average, 60.1% female, with BMI at or above 85th percentile at baseline
Limitations
The study is observational and does not establish causation about neighborhood factors; it cannot identify which specific neighborhood characteristics or environmental features drive the differential outcomes, only that variation exists.
Abstract
Objective This study assessed variation in BMI change by neighborhood characteristics of participants in Bright Bodies, a family-based intensive health behavior and lifestyle treatment for pediatric obesity. Methods For first-time participants (2008-2018) with initial BMI ≥ 85th percentile, we geocoded addresses and assigned Child Opportunity Index (COI) and COI-Healthy Environment (COI-HE) scores (Low/Moderate/High). Using multivariable mixed effect linear regression, we assessed monthly change in BMI percent of the 95th percentile (%BMIp95) and extended BMI z score by COI and COI-HE. Results Of 391 youth (mean ± SD age 11.7 ± 2.8 years, 60.1% female), 80.8% resided in Low COI and 66.5% in Low COI-HE neighborhoods. Monthly %BMIp95 change differed by COI (p = 0.039 for interaction) and COI-HE (p = 0.004). Mean %BMIp95 decreased in all subgroups; greatest reductions were in High COI (-1.86 [95% CI: -2.40, -1.33]) and High COI-HE groups (-2.32 [-2.78, -1.85]) and lowest in Moderate COI (-1.17 [-1.59, -0.75]) and Low COI-HE groups (-1.53 [-1.75, -1.32]). Change in extended BMI z score differed significantly between COI-HE subgroups only (p < 0.001). Conclusions Bright Bodies participation was associated with BMI reduction among all COI/COI-HE subgroups, but the highest COI/COI-HE groups had the greatest reductions. Modifications to intensive health behavior and lifestyle treatments should address inequities in access to built environments that facilitate healthy, active living.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Bright Bodies family-based intensive health behavior and lifestyle treatment program
- Population
- 391 youth (mean age 11.7 years, 60.1% female) with BMI ≥85th percentile, first-time participants 2008-2018
Key finding
Monthly %BMIp95 change differed significantly by COI (p=0.039) and COI-HE (p=0.004)
G et al. · Europe PMC · 17 Sept 2026