Pediatric refugees in Rhode Island: increases in BMI percentile, overweight, and obesity following resettlement.

OBJECTIVE: To evaluate BMI change among pediatric refugees resettling in Providence, RI. METHODS: Retrospective chart review of pediatric refugees from the initial evaluation to year 3 post-resettlement at Hasbro Children's Hospital. Primary outcome of interest was within person change in BMI percentile at each time point. RESULTS: From 2007-2012, 181 children visited the clinic. Initial prevalence of overweight and obesity was 14.1% and 3.2% versus 22.8% and 12.6% at year 3. From visit 1 and years 1-3, there was a positive mean within person change in BMI percentile of 12.9% (95% CI 6.3-19.6%s), 16.6% (95% CI 11.2-21.9%), and 14.4% (95% CI 9.1-19.7%). CONCLUSIONS: The prevalence of overweight and obesity increased from 17.3% at initial intake to 35.4% at 3 years post-resettlement to surpass that of American children (31.7-31.8% for 2007-2012). Refugee children have additional risk factors for obesity; multidisciplinary interventions must be designed to address nutrition at each visit.

Training and fidelity monitoring of alcohol treatment interventions integrated into routine tuberculosis care in Tomsk, Russia: the IMPACT Effectiveness Trial.

IMPACT (Integrated Management of Physician-Delivered Alcohol Care for Tuberculosis patients) is a randomized, controlled effectiveness trial based in Tomsk, Russia, that assesses the effect of oral naltrexone and brief behavioral counseling on tuberculosis outcomes and alcohol use in 200 patients. Tuberculosis physicians without addiction experience delivered interventions as part of routine care over a 6-month period, focusing on alcohol intake reduction to support successful tuberculosis treatment. We describe design, training, and fidelity monitoring using a Russian and American team of physicians, bilingual coders, and supervisors. Culturally appropriate adaptations, limitations, and implications for future trials are discussed. The clinical trial identification number is NCT00675961. Funding came from the National Institutes of Health and National Institute on Drug Abuse.