A family-based education program for obesity: a three-year study.
A family-based education program for obesity: a three-year study.
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DOI：
10.1186/1471-2431-7-33
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发表时间：
2007-10-22
期刊：
影响因子：
2.4
通讯作者：
Gilli G
中科院分区：
文献类型：
--
作者：
Tanas R;Marcolongo R;Pedretti S;Gilli G
肥胖症的流行在所有国家都在增加。然而，关注儿童肥胖的对照研究的数量仍然有限，并且随访时间较长。尽管行为疗法显示出一定的疗效，但它需要长期的团队合作，而这在公共卫生环境中并不总是可行的。此外，行为疗法并不总是被接受。我们描述了一个新的密集和可持续的家庭为基础的，治疗教育计划的儿童肥胖。对照临床研究：一个以家庭为基础的治疗教育方案，没有饮食处方，涉及超重和肥胖的儿童/青少年，没有明显的心理问题，及其家庭。该方案包括三个临床和治疗教育会议，由一名医生进行。此后，第一年每六个月举行一次会议，之后每年举行一次会议。研究人群：190名超重儿童，85名接受治疗性教育计划治疗（男45名，女40名，平均年龄10.43 ± 3岁），平均BMI%为154.72 ± 19.6%，105名匹配儿童接受传统饮食治疗。比较基线时和随访3年后儿童的体重指数（BMI）%和BMI标准差评分。统计检验：通过Kolmogorov-Smirnov、Bartlett检验或相应的非参数程序、X2检验或Fisher精确检验和简单线性回归控制分布的ANOVA-RM（重复测量）。经过2.7 ± 1.1年的随访，72.9%接受治疗教育计划的儿童的BMI%降低，而接受传统饮食治疗的儿童为42.8%。体重减轻在中度肥胖儿童和重度肥胖儿童中效果良好。此外，接受治疗性教育的儿童中出现阴性结果（BMI增加>10%）的比例低于接受饮食方法治疗的儿童（11.8% vs. 25.7%）;最后，定期打电话降低了治疗性教育组的辍学率。这些结果表明，治疗教育计划的有效性和可持续性，这是完全由一个儿科医生进行;此外，它会见了一个升高的参与者接受，这表明一个方便的治疗解决方案，为熟练的儿科医生和选定的肥胖儿童，当行为疗法是不可用的或团队合作是穷人。
The epidemic of obesity is increasing in all countries. However, the number of controlled studies focusing on childhood obesity, with a long follow-up is still limited. Even though Behavioral Therapy shows some efficacy, it requires a prolonged teamwork that is not always available in public health settings. In addition, Behavioral Therapy is not always accepted. We describe a new intensive and sustainable family-based, Therapeutic Education program for childhood obesity. Controlled clinical study: a family-based Therapeutic Education program without dietetic prescription involving overweight and obese children/adolescents, without evident psychological troubles, and their families. The program consisted of three clinical and therapeutic education sessions, carried out by a single physician. Further sessions were carried out every six months in the first year and then every year. Study population: 190 overweight children, 85 treated with a therapeutic education program (45 males and 40 females, mean age of 10.43 ± 3) with an average BMI% of 154.72 ± 19.6% and 105 matched children, treated with traditional dietary approach. Children's Body Mass Index (BMI) % and BMI Standard Deviation Score measured at baseline and after a three year-follow-up, were compared. Statistical tests: ANOVA-RM (repeated measures) controlled for distribution by Kolmogorov-Smirnov, Bartlett's test or correspondent non-parametric procedures, X2 tests or Fisher's exact test and simple linear regression. After a follow-up of 2.7 ± 1.1 years, 72.9% of the children who followed the Therapeutic Education Program obtained a BMI% reduction, compared to 42.8% of children who followed the traditional dietary treatment. Weight reduction was good in moderately obese children and in the severely obese. In addition, a smaller proportion of children treated with therapeutic education had negative results (BMI increase of >10%) compared to those treated with dietary approach (11.8% vs. 25.7%); finally, periodic phone calls reduced the drop-out rate in the therapeutic education group. These results indicate the efficacy and sustainability of the Therapeutic Education program, that was completely carried out by a single pediatrician; in addition, it met with an elevated participant acceptance, suggesting a convenient therapeutic solution for skilled pediatricians and selected obese children, when Behavioral Therapy is not available or teamwork is poor.