National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
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- Adverse Events (5)
- Asthma (1)
- Behavioral Health (1)
- Children/Adolescents (2)
- Comparative Effectiveness (3)
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- (-) Obesity (24)
- Obesity: Weight Management (13)
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- (-) Outcomes (24)
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- Patient-Centered Outcomes Research (7)
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- Provider: Physician (1)
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- Surgery (11)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 24 of 24 Research Studies DisplayedChhabra KR, Ghaferi AA, Yang J
Relationship between health care spending and clinical outcomes in bariatric surgery: implications for Medicare bundled payments.
This study’s objective was to evaluate sources of 90-day episode spending variation in Medicare patients undergoing bariatric surgery and whether spending variation was related to quality of care. A retrospective analysis of fee-for-service Medicare claims data from 761 acute care hospitals providing inpatient bariatric surgery was conducted between January 1, 2011 and September 30, 2016. Of 64,537 bariatric patients, 46% went sleeve gastrectomy, 22% revisited the emergency department (ED) within 90 days, and 12.5% were readmitted. Average 90-day payments were $14,124, ranging from $12,220 to $16,887. The largest components of spending variation were readmissions (44% of variation), post-acute care (19%), and index professional fees (15%). The lowest spending hospitals had the lowest complication, ED visit, post-acute utilization, and readmission rates.
AHRQ-funded; HS024403; HS023597.
Citation: Chhabra KR, Ghaferi AA, Yang J .
Relationship between health care spending and clinical outcomes in bariatric surgery: implications for Medicare bundled payments.
Ann Surg 2022 Feb;275(2):356-62. doi: 10.1097/sla.0000000000003979..
Keywords: Healthcare Costs, Surgery, Obesity, Outcomes
Bramante CT, Buse J, Tamaritz L
Outpatient metformin use is associated with reduced severity of COVID-19 disease in adults with overweight or obesity.
This study investigated whether outpatient metformin use is associated with reduced severity of COVID-19 in adults with overweight or obesity. Metformin can decrease interleukin-6 and tumor-necrosis factor- α, which appears to contribute to COVID-19 mortality. The authors conducted a retrospective cohort analysis of electronic health record (EHR) data that was pooled across multiple EHR systems from 12 hospitals and 60 primary care clinics in the Midwest between March and December 2020. Inclusion criteria included data for BMI > 25 kg/m(2); age range 30-85 years; and a positive SARS-CoV-2 polymerase chain reaction test. Metformin was associated with a decrease in mortality from COVID-19 and a nonsignificant decrease in hospital admission in the overall cohort.
AHRQ-funded; HS026379.
Citation: Bramante CT, Buse J, Tamaritz L .
Outpatient metformin use is associated with reduced severity of COVID-19 disease in adults with overweight or obesity.
J Med Virol 2021 Jul;93(7):4273-79. doi: 10.1002/jmv.26873..
Keywords: COVID-19, Infectious Diseases, Obesity, Medication, Treatments, Outcomes
Rosas LG, Lv N, Xiao L
Effect of a culturally adapted behavioral intervention for Latino adults on weight loss over 2 years: a randomized clinical trial.
Identifying effective weight loss interventions for Latino adults at risk of diabetes is of critical public health importance. The purpose of this study was to determine whether a culturally adapted behavioral intervention for Latino adults was more effective than usual care for weight loss over 24 months. The investigators concluded that among Latino adults with high diabetes risk, a culturally adapted behavioral lifestyle intervention was effective for weight loss over 12 months but not 24 months.
AHRQ-funded; HS022702.
Citation: Rosas LG, Lv N, Xiao L .
Effect of a culturally adapted behavioral intervention for Latino adults on weight loss over 2 years: a randomized clinical trial.
JAMA Netw Open 2020 Dec;3(12):e2027744. doi: 10.1001/jamanetworkopen.2020.27744..
Keywords: Racial and Ethnic Minorities, Obesity: Weight Management, Obesity, Cultural Competence, Diabetes, Primary Care, Outcomes, Patient-Centered Outcomes Research, Comparative Effectiveness, Evidence-Based Practice
Yaramala SR, McElroy SL, Geske J
The impact of binge eating behavior on lithium- and quetiapine-associated changes in body weight, body mass index, and waist circumference during 6 months of treatment: Findings from the bipolar CHOICE study.
Lithium and quetiapine can cause weight gain, but their comparative longer term anthropometric effects are unknown, as are the potential moderating effects of baseline binge-eating (BE) behavior. In this research, the investigators assessed 6 month changes in body weight, body mass index (BMI) and waist circumference in 482 adults with DSM-IV bipolar disorders who participated in a comparative effectiveness study of lithium and quetiapine with evidence-based adjunctive treatment (Bipolar CHOICE).
AHRQ-funded; HS019371.
Citation: Yaramala SR, McElroy SL, Geske J .
The impact of binge eating behavior on lithium- and quetiapine-associated changes in body weight, body mass index, and waist circumference during 6 months of treatment: Findings from the bipolar CHOICE study.
months of treatment: Findings from the bipolar CHOICE study.
J Affect Disord 2020 Apr 1;266:772-81. doi: 10.1016/j.jad.2018.09.025.
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J Affect Disord 2020 Apr 1;266:772-81. doi: 10.1016/j.jad.2018.09.025.
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Keywords: Behavioral Health, Medication, Obesity, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Yuce TK, Khorfan R, Soper NJ
Post-operative complications and readmissions associated with smoking following bariatric surgery.
The link between smoking and poor postoperative outcomes is well established. Despite this, current smokers are still offered bariatric surgery. In this study, the investigators describe the risk of postoperative 30-day complications and readmission following laparoscopic sleeve gastrectomy and laparoscopic Roux-En-Y gastric bypass in smokers. The investigators concluded that smokers undergoing bariatric surgery experienced significantly worse 30-day outcomes when compared with non-smokers.
AHRQ-funded; HS000078.
Citation: Yuce TK, Khorfan R, Soper NJ .
Post-operative complications and readmissions associated with smoking following bariatric surgery.
J Gastrointest Surg 2020 Mar;24(3):525-30. doi: 10.1007/s11605-019-04488-3..
Keywords: Surgery, Tobacco Use, Adverse Events, Hospital Readmissions, Obesity: Weight Management, Obesity, Risk, Outcomes
Kanters AE, Shubeck SP, Varban OA
Incidence and efficacy of stent placement in leak management after bariatric surgery: an MBSAQIP analysis.
The goal of this study was to evaluate the rates of use and efficacy of stent placement for postoperative leak following bariatric surgery. Using data from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program, findings showed that the use of stents can be effective; however, such use does not prevent reoperation and is associated with an increased likelihood of readmission. Recommendations included consideration of both technique and resource utilization when choosing a management pathway for leaks.
AHRQ-funded; HS000053; HS023597.
Citation: Kanters AE, Shubeck SP, Varban OA .
Incidence and efficacy of stent placement in leak management after bariatric surgery: an MBSAQIP analysis.
Ann Surg 2020 Jan;271(1):134-39. doi: 10.1097/sla.0000000000003023..
Keywords: Surgery, Obesity: Weight Management, Obesity, Adverse Events, Patient Safety, Outcomes
Turer CB, Barlow SE, Sarwer DB
Association of clinician behaviors and weight change in school-aged children.
This study used clinical practice data to determine whether recommended weight management clinician behaviors were associated with weight status improvement in children aged 6-12 years who are overweight or obese. Electronic health record data (2009-2014) from 52 clinics were used. Weight status was examined from 1 visit to the next as dichotomous improvement (versus worsening or no change) and change in percentage overweight (over sex/age-specific BMI95).
AHRQ-funded; HS022418.
Citation: Turer CB, Barlow SE, Sarwer DB .
Association of clinician behaviors and weight change in school-aged children.
Am J Prev Med 2019 Sep;57(3):384-93. doi: 10.1016/j.amepre.2019.04.029..
Keywords: Children/Adolescents, Obesity, Obesity: Weight Management, Outcomes, Patient-Centered Outcomes Research
Sheetz KH, Woodside KJ, Shahinian VB
Trends in bariatric surgery procedures among patients with ESKD in the United States.
This study examined trends in bariatric surgery among patients with end-stage kidney disease (ESKD) in the United States. There was an almost ninefold increase in surgery between 2006 and 2016 for ESKD patients and also for sleeve gastrectomy surgery. ESKD patients showed similar complication rates compared with non-ESKD patients, but there were more readmissions.
AHRQ-funded; HS023597; HS000053.
Citation: Sheetz KH, Woodside KJ, Shahinian VB .
Trends in bariatric surgery procedures among patients with ESKD in the United States.
Clin J Am Soc Nephrol 2019 Aug 7;14(8):1193-99. doi: 10.2215/cjn.01480219..
Keywords: Obesity, Surgery, Kidney Disease and Health, Obesity: Weight Management, Hospital Readmissions, Adverse Events, Outcomes
Smith ME, Lee JS, Bonham A
Effect of new persistent opioid use on physiologic and psychologic outcomes following bariatric surgery.
In this study, the investigators sought to determine the relationship between new persistent opioid use and 1-year postoperative outcomes for patients undergoing bariatric surgery. The investigators concluded that new persistent opioid use is common following bariatric surgery and associated with significantly worse physiologic and psychologic outcomes. More effective screening and postoperative surveillance tools are needed to identify these patients, who likely require more aggressive counseling and treatment to maximize the benefits of bariatric surgery.
AHRQ-funded; HS024403.
Citation: Smith ME, Lee JS, Bonham A .
Effect of new persistent opioid use on physiologic and psychologic outcomes following bariatric surgery.
Surg Endosc 2019 Aug;33(8):2649-56. doi: 10.1007/s00464-018-6542-0..
Keywords: Opioids, Surgery, Medication, Obesity: Weight Management, Obesity, Obesity: Weight Management, Pain, Outcomes
Grant MC, Gibbons M M, Ko CY
Evidence review conducted for the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery: focus on anesthesiology for bariatric surgery.
The authors conducted an evidence review to select anesthetic interventions that positively influence outcomes and facilitate recovery after bariatric surgery. They summarize the best available evidence to recommend the anesthetic components of care for enhanced recovery after bariatric surgery. The concluded that there is evidence in the literature, and from society guidelines, to support AHRQ’s Safety Program for Improving Surgical Care and Recovery goals for bariatric surgery.
AHRQ-funded; 233201500020I.
Citation: Grant MC, Gibbons M M, Ko CY .
Evidence review conducted for the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery: focus on anesthesiology for bariatric surgery.
Anesth Analg 2019 Jul;129(1):51-60. doi: 10.1213/ane.0000000000003696..
Keywords: Evidence-Based Practice, Medication, Obesity, Outcomes, Patient-Centered Outcomes Research, Patient Safety, Quality Improvement, Surgery
Derose KP, Williams MV, Florez KR
Eat, pray, move: a pilot cluster randomized controlled trial of a multilevel church-based intervention to address obesity among African Americans and Latinos.
The purpose of this study was to implement a multilevel, church-based intervention with diverse disparity populations using community-based participatory research and evaluate feasibility, acceptability, and preliminary effectiveness in improving obesity-related outcomes. The investigators concluded that the intervention resulted in small improvements in obesity outcomes. They assert that a longer time line is needed to fully implement and assess effects of community and congregation environmental strategies and to allow for potential larger impacts of the intervention.
AHRQ-funded; HS000046.
Citation: Derose KP, Williams MV, Florez KR .
Eat, pray, move: a pilot cluster randomized controlled trial of a multilevel church-based intervention to address obesity among African Americans and Latinos.
Am J Health Promot 2019 May;33(4):586-96. doi: 10.1177/0890117118813333..
Keywords: Lifestyle Changes, Nutrition, Obesity, Outcomes, Racial and Ethnic Minorities
Pellegrini CA, Chang RW, Dunlop DD
Comparison of a Patient-Centered Weight Loss Program starting before versus after knee replacement: a pilot study.
This article reports the results of a randomized pilot study that assessed changes in weight during a Patient Centered Weight Loss Program (PACE) initiated either before or after knee replacement. The feasibility of recruiting and retaining participants over 26 weeks was also examined. Recruitment outreach was extended to patients scheduled for knee replacement. Sixteen participants were randomly assigned to a 14-session weight loss program that started either at least 6 weeks before surgery or at 12 weeks following surgery. The authors conclude that behavioral intervention is challenging but feasible in a knee replacement population. Preliminary evidence suggests that initiating a program 12 weeks after surgery produces greater weight losses at 26 weeks when compared to a program that begins before knee replacement.
AHRQ-funded; HS023011.
Citation: Pellegrini CA, Chang RW, Dunlop DD .
Comparison of a Patient-Centered Weight Loss Program starting before versus after knee replacement: a pilot study.
Obes Res Clin Pract 2018 Sep - Oct;12(5):472-78. doi: 10.1016/j.orcp.2018.06.009..
Keywords: Orthopedics, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Obesity: Weight Management, Surgery, Obesity, Outcomes
Stevens H, Carlin AM, Ross R
Effect of surgeon age on bariatric surgery outcomes.
This study examined the effect of surgeon age on complication rates for bariatric surgery. A retrospective study was done with 71 surgeons in Michigan who participated in a statewide collaborative improvement program. Older surgeons performed more Roux-en Y Gastric Bypass (40%) and less sleeve gastrectomy (38.8%) than younger surgeons. There was not found to be any statistically significant differences in patient outcome between the two age groups.
AHRQ-funded; HS024403.
Citation: Stevens H, Carlin AM, Ross R .
Effect of surgeon age on bariatric surgery outcomes.
Ann Surg 2018 May;267(5):905-09. doi: 10.1097/sla.0000000000002297..
Keywords: Adverse Events, Obesity, Outcomes, Patient Safety, Provider, Provider: Physician, Provider Performance
Kochkodan J, Telem DA, Ghaferi AA
Physiologic and psychological gender differences in bariatric surgery.
This paper aims to describe differences in bariatric surgery outcomes by gender and to understand the physiologic and psychological differences that may explain this gender gap. It concludes that, despite significantly lower weight loss and increased complication rates, males tend to have markedly higher satisfaction and psychological well-being scores than females.
AHRQ-funded; HS023621; HS024403.
Citation: Kochkodan J, Telem DA, Ghaferi AA .
Physiologic and psychological gender differences in bariatric surgery.
Surg Endosc 2018 Mar;32(3):1382-88. doi: 10.1007/s00464-017-5819-z.
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Keywords: Obesity, Outcomes, Sex Factors, Surgery, Obesity: Weight Management
Varban OA, Cassidy RB, Bonham A
Factors associated with achieving a body mass index of less than 30 after bariatric surgery.
This study identified predictors for achieving a BMI of less than 30 after bariatric surgery. Patients who had a sleeve gastrectomy, gastric bypass, or duodenal switch were more likely to achieve a BMI of less than 30 compared with those who underwent adjustable gastric banding. Only 8.5 percent of patients with a BMI greater than 50 achieved a BMI of less than 30 after bariatric surgery.
AHRQ-funded; HS023621.
Citation: Varban OA, Cassidy RB, Bonham A .
Factors associated with achieving a body mass index of less than 30 after bariatric surgery.
JAMA Surg 2017 Nov;152(11):1058-64. doi: 10.1001/jamasurg.2017.2348.
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Keywords: Health Status, Obesity, Outcomes, Obesity: Weight Management
Fallah-Fini S, Adam A, Cheskin LJ
The additional costs and health effects of a patient having overweight or obesity: a computational model.
This paper estimates specific additional disease outcomes and costs that could be prevented by helping a patient go from an obesity or overweight category to a normal weight category at different ages.
AHRQ-funded; HS023317.
Citation: Fallah-Fini S, Adam A, Cheskin LJ .
The additional costs and health effects of a patient having overweight or obesity: a computational model.
Obesity 2017 Oct;25(10):1809-15. doi: 10.1002/oby.21965.
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Keywords: Healthcare Costs, Obesity, Outcomes
Ibrahim AM, Ghaferi AA, Thumma JR
Variation in outcomes at bariatric surgery centers of excellence.
This review describes the variation in surgical outcomes across bariatric centers of excellence and the geographic availability of high-quality centers. Even among accredited bariatric surgery centers, wide variation exists in rates of postoperative serious complications across geographic location and operative volumes.
AHRQ-funded; HS02362; HS024403.
Citation: Ibrahim AM, Ghaferi AA, Thumma JR .
Variation in outcomes at bariatric surgery centers of excellence.
JAMA Surg 2017 Jul;152(7):629-36. doi: 10.1001/jamasurg.2017.0542.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Obesity, Surgery, Outcomes, Adverse Events
Chang SH, Liu X, Carlsson NP
Reexamining the association of body mass index with overall survival outcomes after liver transplantation.
The purpose of this study is to identify the range of body mass index (BMI) at liver transplantation (LT) associated with the lowest risks of posttransplant mortality by Model of End Stage Liver Disease (MELD) category. It concluded that obesity in LT patients is not necessarily associated with higher posttransplantation mortality and highlighted the importance of the interaction between BMI and MELD category to determine their survival likelihood.
AHRQ-funded; HS022330.
Citation: Chang SH, Liu X, Carlsson NP .
Reexamining the association of body mass index with overall survival outcomes after liver transplantation.
Transplant Direct 2017 Jun 12;3(7):e172. doi: 10.1097/txd.0000000000000681.
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Keywords: Obesity, Transplantation, Mortality, Patient-Centered Outcomes Research, Outcomes
Varban OA, Greenberg CC, Schram J
Surgical skill in bariatric surgery: Does skill in one procedure predict outcomes for another?
Whether skill for one bariatric procedure can predict outcomes for another related procedure is unknown. This study found that video ratings of surgical skill with laparoscopic gastric bypass do not predict outcomes of laparoscopic sleeve gastrectomy. Evaluation of surgical skill with one procedure may not apply to other related procedures and may require independent assessment of surgical technical proficiency.
AHRQ-funded; R01 HS023597.
Citation: Varban OA, Greenberg CC, Schram J .
Surgical skill in bariatric surgery: Does skill in one procedure predict outcomes for another?
Surgery 2016 Nov;160(5):1172-81. doi: 10.1016/j.surg.2016.04.033.
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Keywords: Surgery, Obesity: Weight Management, Obesity, Outcomes, Provider Performance
Ehrlich SF, Sternfeld B, Krefman AE
Moderate and vigorous intensity exercise during pregnancy and gestational weight gain in women with gestational diabetes.
The researchers estimated the associations of exercise intensity during pregnancy with the rate of gestational weight gain (GWG) from gestational diabetes (GDM) diagnosis to delivery. Upon stratification by prepregnancy overweight/obesity, they found that significant associations were only observed for BMI greater than or equal to 25.0. There were no associations observed for moderate intensity exercise.
AHRQ-funded; HS019367.
Citation: Ehrlich SF, Sternfeld B, Krefman AE .
Moderate and vigorous intensity exercise during pregnancy and gestational weight gain in women with gestational diabetes.
Matern Child Health J 2016 Jun;20(6):1247-57. doi: 10.1007/s10995-016-1926-z.
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Keywords: Diabetes, Lifestyle Changes, Obesity, Obesity: Weight Management, Outcomes, Patient-Centered Outcomes Research, Pregnancy, Women
Scally CP, Varban OA, Carlin AM
Video ratings of surgical skill and late outcomes of bariatric surgery.
The authors sought to study the association between surgical skill and long-term outcomes of bariatric surgery. They found that surgical skill did not affect postoperative weight loss or resolution of medical comorbidities at 1 year after laparoscopic gastric bypass. They suggested that long-term outcomes after bariatric surgery may be less dependent on a surgeon's operative skill and instead be driven by other factors.
AHRQ-funded; HS023597.
Citation: Scally CP, Varban OA, Carlin AM .
Video ratings of surgical skill and late outcomes of bariatric surgery.
JAMA Surg 2016 Jun 15;151(6):e160428. doi: 10.1001/jamasurg.2016.0428.
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Keywords: Surgery, Obesity: Weight Management, Obesity, Quality of Care, Outcomes
Yawn BP, Rank MA, Bertram SL
Obesity, low levels of physical activity and smoking present opportunities for primary care asthma interventions: an analysis of baseline data from the asthma tools study.
The researchers calculated cross-sectional frequencies of activity levels, smoking, secondhand smoke exposure and the presence of obesity, as well as rates of out-of-control asthma and asthma exacerbations. They found that tobacco smoke exposure, obesity, low activity levels, poverty, inadequately controlled asthma and high asthma-related health-care utilization were common. Across all age groups, obesity was associated with poorer asthma outcomes.
AHRQ-funded; HS018431.
Citation: Yawn BP, Rank MA, Bertram SL .
Obesity, low levels of physical activity and smoking present opportunities for primary care asthma interventions: an analysis of baseline data from the asthma tools study.
NPJ Prim Care Respir Med 2015 Oct 1;25:15058. doi: 10.1038/npjpcrm.2015.58..
Keywords: Asthma, Obesity, Tobacco Use, Primary Care, Outcomes
McVay MA, Jeffreys AS, King HA
The relationship between pretreatment dietary composition and weight loss during a randomised trial of different diet approaches.
Identifying pretreatment dietary habits that are associated with weight-loss intervention outcomes could help guide individuals’ selection of weight-loss approach among competing options. This study concluded that selection of a weight-loss approach on the basis of pretreatment macronutrient intake is unlikely to improve weight outcomes at the end of a 1-year treatment.
AHRQ-funded; HS000079.
Citation: McVay MA, Jeffreys AS, King HA .
The relationship between pretreatment dietary composition and weight loss during a randomised trial of different diet approaches.
J Hum Nutr Diet 2015 Feb;28 Suppl 2:16-23. doi: 10.1111/jhn.12188..
Keywords: Nutrition, Obesity: Weight Management, Obesity, Outcomes, Comparative Effectiveness
Cai L, Wu Y, Cheskin LI
Effect of childhood obesity prevention programmes on blood lipids: a systematic review and meta-analysis.
This study, the first systematic, quantitative study of childhood obesity prevention programs on blood lipids in high-income countries found that most interventions (70 percent) showed similar significant or no effects on adiposity- and lipid outcomes; 15 percent of interventions improved both adiposity- and lipids outcomes; 55 percent had no significant effects on either. These programs had a significant desirable effect on LDL-C and HDL-C.
AHRQ-funded; 290200710061I
Citation: Cai L, Wu Y, Cheskin LI .
Effect of childhood obesity prevention programmes on blood lipids: a systematic review and meta-analysis.
Obes Rev. 2014 Dec;15(12):933-44. doi: 10.1111/obr.12227..
Keywords: Children/Adolescents, Obesity, Prevention, Outcomes, Social Determinants of Health