{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T05:39:51Z","timestamp":1783575591443,"version":"3.55.0"},"reference-count":39,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,11,22]],"date-time":"2020-11-22T00:00:00Z","timestamp":1606003200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["ascpt.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Translational Sci"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:p>Non\u2010alcoholic fatty liver disease (NAFLD) is an increasing problem in pediatrics with limited treatment options. We prospectively assessed outcomes in patients managed in a hepatology clinic (HC) alone vs. those managed in combination with a multidisciplinary weight management program (MWMP). We describe each group\u2019s readiness to change at the time of NAFLD diagnosis. Patients diagnosed with NAFLD were given a modified Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) at enrollment (T1) to assess readiness to change. They were then followed at 3\u20139\u00a0months (T2) and at 10\u201315\u00a0months (T3). Linear mixed models were used to evaluate changes in body mass index (BMI), BMI <jats:italic>z<\/jats:italic>\u2010score, and transaminases over time and between the two groups. There were no significant treatment group main effects or treatment\u00a0\u00d7\u00a0time interactions for our primary end points for HC alone (<jats:italic>n<\/jats:italic>\u00a0=\u00a075) or with MWMP (<jats:italic>n<\/jats:italic>\u00a0=\u00a018). There was a significant main effect for time for BMI <jats:italic>z<\/jats:italic>\u2010score, with BMI <jats:italic>z<\/jats:italic>\u2010scores declining on average by 0.0568 (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.004) from visit to visit. Low SOCRATES subscales scores in HC alone (<jats:italic>n<\/jats:italic>\u00a0=\u00a033) or with MWMP (<jats:italic>n<\/jats:italic>\u00a0=\u00a04) suggested a patient population with low recognition of disease and likelihood of taking steps for change. Patients with obesity and NAFLD had low scores on all three SOCRATES subscales. Despite this, both groups had improvement in BMI z\u2010score without significant difference between the two treatment groups in other primary end points. Further study is needed to identify the most effective patient selection and treatment strategies for pediatric patients with NAFLD, including pharmacotherapy and surgery.<\/jats:p>","DOI":"10.1111\/cts.12913","type":"journal-article","created":{"date-parts":[[2020,11,3]],"date-time":"2020-11-03T19:14:38Z","timestamp":1604430878000},"page":"582-588","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Readiness to Change and Prospective Effects of Weight Management Programs in Pediatric Nonalcoholic Fatty Liver Disease"],"prefix":"10.1111","volume":"14","author":[{"given":"Voytek","family":"Slowik","sequence":"first","affiliation":[{"name":"Division of Pediatric Gastroenterology Children\u2019s Mercy Kansas City University of Missouri \u2010 Kansas City School of Medicine Kansas City Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Wasserkrug","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology Children\u2019s Mercy Kansas City University of Missouri \u2010 Kansas City School of Medicine Kansas City Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan T.","family":"Fischer","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology Children\u2019s Mercy Kansas City University of Missouri \u2010 Kansas City School of Medicine Kansas City Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Connelly","sequence":"additional","affiliation":[{"name":"Division of Developmental and Behavioral Health Children\u2019s Mercy Kansas City University of Missouri \u2010 Kansas City School of Medicine Kansas City Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda D.","family":"Deacy","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology Children\u2019s Mercy Kansas City University of Missouri \u2010 Kansas City School of Medicine Kansas City Missouri USA"},{"name":"Division of Developmental and Behavioral Health Children\u2019s Mercy Kansas City University of Missouri \u2010 Kansas City School of Medicine Kansas City Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Hampl","sequence":"additional","affiliation":[{"name":"Division of General Academic Pediatrics and Center for Children\u2019s Healthy Lifestyles &amp; Nutrition Children\u2019s Mercy Kansas City University of Missouri \u2010 Kansas City School of Medicine Kansas City Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James F.","family":"Daniel","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology Children\u2019s Mercy Kansas City University of Missouri \u2010 Kansas City School of Medicine Kansas City Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,11,22]]},"reference":[{"key":"e_1_2_9_1_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017-3459"},{"key":"e_1_2_9_2_1","first-page":"1","article-title":"Prevalence of obesity among adults and youth: United States, 2015\u20132016","volume":"288","author":"Hales C.M.","year":"2017","journal-title":"NCHS Data Brief"},{"key":"e_1_2_9_3_1","article-title":"Multi\u2010etiological perspective on child obesity prevention","author":"Baranowski T.","journal-title":"Curr. 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