Family-based obesity treatment, then and now: Twenty-five years of pediatric obesity treatment
Family-based obesity treatment, then and now: Twenty-five years of pediatric obesity treatment
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DOI：
10.1037/0278-6133.26.4.381
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发表时间：
2007-07-01
影响因子：
4.2
通讯作者：
Beecher, Meghan D.
中科院分区：
文献类型：
--
作者：
Epstein, Leonard H.;Paluch, Rocco A.;Beecher, Meghan D.
目的：以家庭为基础的儿童肥胖症治疗方法在25年前就已经发展起来。随着时间的推移，年轻人变得更加肥胖，环境变得更加肥胖，这可能会影响儿科体重控制的效果。采用混合效应回归模型，通过24个月的随访，比较20至25年前启动的项目与当前项目的疗效，并使用当代测量和分析策略重新分析先前研究的10年结果。主要结果测量：z-BMI和超重百分比。结果显示，随着时间的推移，z-BMI的变化显着降低，老年人与当代研究的z-BMI变化没有差异。年龄是z-BMI的预测因素，最长可达24个月，年龄较小的儿童显示出更大的变化。混合效应回归模型复制了以前基于家庭的干预措施的长期效应。性别是一个长期的z-BMI变化的预测因子，随着时间的推移，女孩比男孩受益更多。结论：以家庭为基础的行为方法治疗儿童肥胖的疗效复制超过25年的时间。随着时间的推移评估治疗效果的挑战进行了讨论。注意到研究不同的效果大小和加强以家庭为基础的行为治疗的治疗选择的想法。
Objective: Family-based treatments for pediatric obesity were developed over 25 years ago. Over that time, youth have become more obese and the environment more obesiogenic, which may influence efficacy of pediatric weight control. Mixed-effects regression models were used to compare the efficacy of programs initiated 20 to 25 years ago to current programs through 24-month follow-up, as well as to reanalyze 10-year outcomes of previous research using contemporary measures and analytic strategies.Main outcome measures: z-BMI and percent overweight.Results: Results showed significant reductions over time, with no differences in z-BMI change for older versus contemporary studies. Age was a predictor of z-BMI up to 24 months, with younger children showing larger change. Mixed-effects regression models replicated previous long-term effects of family-based interventions. Gender was a predictor of long-term z-BMI change, with girls benefiting more over time than did boys.Conclusion: The efficacy of the family-based behavioral approach to treating pediatric obesity replicates over a 25-year period. Challenges in evaluating treatment effects over time are discussed. Ideas for studying choice of treatments that vary in effect size and for strengthening family-based behavioral treatments are noted.