P2B277: Development of a Pilot Mindfulness Program for Pediatric Patients and Caregivers in a Multidisciplinary Weight Management Clinic

Background: The multidisciplinary UCLA Fit for Healthy Weight Program (Fit Clinic) serves pediatric patients with obesity in Los Angeles by providing comprehensive management services centered around nutrition, physical, and mental health. With California’s statewide initiative around adverse childhood experiences (ACE) and associated health conditions, we sought to align and improve our services for children with obesity as an ACE-associated health condition with a focus on mindfulness. After reviewing the literature on mindfulness-based interventions for obesity-related behaviors, we determined there was no readily available curriculum for children that could be integrated easily into the Fit Clinic. We, therefore, developed the UCLA Fit Mind Program (Fit Mind) integrating evidence-based mindfulness practices related to family systems and eating behaviors. The goal was to increase awareness and manage feelings related to food through skill building activities. We aimed to evaluate the feasibility of program implementation and changes in mindfulness measures.

Methods: For Fit Mind, we developed four patient-centered modules: (1) Introduction to Mindfulness, (2) Mindful Eating, (3) Mindful Thinking and Goal Setting, and (4) Chilling the Cravings. We invited Fit patients and their caregivers to participate in a 4-week, 30-minute virtual session covering each of the four modules. After each session, the Clinical Social Worker refined the sessions based on his reflection of participants’ engagement and level of understanding. Surveys were filled out at baseline, one week, and 3-6 months. We administered the Mindful Eating Questionnaire (MEQ) and the Cognitive and Affective Mindfulness Scale (CAMS-R) to caregivers, and the MEQ adapted for Children (MEQ-C) and the Child and Adolescent Mindfulness Measure (CAMM) to children. Higher scores reflect more mindful eating and mindfulness qualities.

Results: The Fit Mind started in January 2023. Eleven families enrolled with six completing the pre-surveys and five completing the post-surveys. Caregivers reported average MEQ 2.66/4 (pre) and 2.93/4 (post), and CAMS 28.67/48 (pre) and 31.6/48 (post). Child participants reported average MEQ-C 2.34/4 (pre) and 2.65/4 (post), and CAMM 22.83/40 (pre) and 20.6/40 (post). Participants reported more positive communication about food choices and health and wellness within their families; improved decisions regarding food choices (e.g., more home cooked meals, more vegetables consumed); development of mindful eating practices; utilization of mindful relaxation strategies; more family engagement and motivation with Fit Clinic goals.

Conclusion: The pilot UCLA Fit Mind Program reveals the potential benefits, patient learner satisfaction, changes in pre/post mindfulness measures and feasibility of delivering a 4-week session of a thirty-minute virtual curriculum to children and their caregivers. We noted increase in mindfulness measures among children and adult participants, except for the CAAM that saw a smaller post average score. We continue to refine the curriculum and test its adaptability to primary care practices with or without behavioral health professionals.