Fully Subsidized Multiprofessional Health Services and Persistence in Pediatric Obesity Treatment
Bibliographic record
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.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".