Efficacy of a Community- Versus Primary Care-Centered Program for Childhood Obesity: TX CORD RCT
Efficacy of a Community- Versus Primary Care-Centered Program for Childhood Obesity: TX CORD RCT
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DOI：
10.1002/oby.21929
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发表时间：
2017-09-01
期刊：
影响因子：
6.9
通讯作者：
Kelder, Steven H.
中科院分区：
文献类型：
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作者：
Butte, Nancy F.;Hoelscher, Deanna M.;Kelder, Steven H.
目的 这项随机对照试验旨在确定针对低收入儿童的为期 12 个月的以社区为中心的体重管理计划（针对 2-5 岁的 MEND2-5 或针对 6-12 岁的 MEND/CATCH6-12）与以初级保健为中心的计划（后续步骤）的比较效果。方法 549 名西班牙裔和黑人儿童（BMI 85%），按年龄组（2-5 岁、6-8 岁和 5 岁）进行分层。 9-12 岁），被随机分配到 MEND2-5（27 个接触小时）/MEND/CATCH6-12（121.5 个接触小时）或后续步骤（8 个接触小时）。主要结果（第 95 个百分位数的 BMI 值 [%BMIp95]）和次要结果在基线、3 个月（强化阶段）和 12 个月（过渡阶段）进行测量。结果对于 6-8 岁年龄组，MEND/CATCH6-12 在 %BMIp95 方面比强化阶段的后续步骤有更大的改善。效应大小 (95% CI) 为 -1.94 (-3.88, -0.01) 个百分点 (P=0.05)。对于 9-12 岁年龄组，%BMIp95 的效应大小为 -1.38 (-2.87, 0.16) 个百分点 (P=0.07)。 MEND2-5 对 %BMIp95 没有差异影响。强化阶段和过渡阶段的平均出勤率为 52% 和 22%。干预依从性与强化阶段期间 %BMIp95 的变化呈负相关 (P
ObjectiveThis randomized controlled trial was conducted to determine comparative efficacy of a 12-month community-centered weight management program (MEND2-5 for ages 2-5 or MEND/CATCH6-12 for ages 6-12) against a primary care-centered program (Next Steps) in low-income children.MethodsFive hundred forty-nine Hispanic and black children (BMI85th percentile), stratified by age groups (2-5, 6-8, and 9-12 years), were randomly assigned to MEND2-5 (27 contact hours)/MEND/CATCH6-12 (121.5 contact hours) or Next Steps (8 contact hours). Primary (BMI value at the 95th percentile [%BMIp95]) and secondary outcomes were measured at baseline, 3 months (Intensive Phase), and 12 months (Transition Phase).ResultsFor age group 6-8, MEND/CATCH6-12 resulted in greater improvement in %BMIp95 than Next Steps during the Intensive Phase. Effect size (95% CI) was -1.94 (-3.88, -0.01) percentage points (P=0.05). For age group 9-12, effect size was -1.38 (-2.87, 0.16) percentage points for %BMIp95 (P=0.07). MEND2-5 did not differentially affect %BMIp95. Attendance averaged 52% and 22% during the Intensive and Transition Phases. Intervention compliance was inversely correlated to change in %BMIp95 during the Intensive Phase (P