Impact of Psychosocial Risk on Outcomes among Families Seeking Treatment for Obesity.
Impact of Psychosocial Risk on Outcomes among Families Seeking Treatment for Obesity.
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DOI：
10.1016/j.jpeds.2018.02.071
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发表时间：
2018-07
期刊：
影响因子：
--
通讯作者：
Kazak AE
中科院分区：
文献类型：
--
作者：
Phan TT;Chen FF;Pinto AT;Cox C;Robbins J;Kazak AE
为了验证这一假设，即心理社会风险升高的儿童在体重管理治疗中会增加损耗和更差的体重结果。这是一项前瞻性队列研究，100名新患者，年龄4-12岁，体重管理诊所。父母完成了心理社会评估工具（PAT）。进行逻辑回归分析，以计算门诊流失的几率，以及基于心理社会风险类别，调整儿童人口统计学和基线体重类别，6个月内BMI z评分的无意义变化（BMI z评分下降小于0.1单位）。大多数患者为男性（59%）、黑人（36%）或白色人（43%），并患有重度肥胖症（55%）。59%的家庭被归类为中度或高度心理社会风险。超过6个月，53%的家庭失访，67%的家庭BMI z评分没有临床意义的降低。与低心理社会风险家庭的儿童相比，中或高心理社会风险家庭的儿童失访的可能性高3.1倍（95% CI 1.3-7.2），BMI z评分无临床意义变化的可能性高2.9倍（95% CI 1.1-7.9）。心理社会风险增加的儿童有更高的损耗和更差的体重结果，支持需要心理社会筛查作为儿科体重管理治疗的标准组成部分。
To test the hypothesis that children with elevated psychosocial risk would have increased attrition and worse weight outcomes in weight management treatment. This was a prospective cohort study of 100 new patients, ages 4-12, to a weight management clinic. Parents completed the Psychosocial Assessment Tool (PAT). Logistic regression analyses were conducted to calculate the odds of attrition from the clinic and a non-meaningful change in BMI z-score (decrease in BMI z-score less than 0.1 units) over six months based on psychosocial risk category, adjusting for child demographics and baseline weight category. The majority of patients were male (59%), Black (36%) or White (43%), and had severe obesity (55%). 59% of families were categorized as having moderate or high psychosocial risk. Over 6 months 53% of families were lost to follow-up and 67% did not have a clinically meaningful decrease in BMI z-score. Children in families with moderate or high psychosocial risk were 3.1 times more likely to be lost to follow-up (95% CI 1.3-7.2) and 2.9 times more likely to have a non-clinically meaningful change in BMI z-score (95% CI 1.1-7.9) compared with children of families with low psychosocial risk. Children presenting with increased psychosocial risk have higher attrition and poorer weight outcomes, supporting the need for psychosocial screening as a standard component of pediatric weight management treatment.
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