Baseline Targeted Moderation in a Trial of the Family Check-Up 4 Health: Potential Explanations for Finding Few Practical Effects.
Baseline Targeted Moderation in a Trial of the Family Check-Up 4 Health: Potential Explanations for Finding Few Practical Effects.
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家庭检查 4 健康试验中的基线目标调节：几乎没有发现实际效果的潜在解释。
DOI：
10.1007/s11121-021-01266-z
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Berkel,Cady
中科院分区：
文献类型：
--
作者：
Smith,JustinD;Carroll,AllisonJ;Fu,Emily;Berkel,Cady
并不是所有的参与者都能从完善的、以证据为基础的预防项目中平等受益。出于这个原因，预防科学领域开始采用个性化的干预措施。家庭检查是第一个针对家庭层面的预防项目，而不是更普遍的针对不同文化、性别和其他不可改变的参与者特征进行调整的项目。尽管有针对性，但压力和父母心理健康问题水平较低的家庭、基线行为问题较低的儿童以及生活在极度贫困社区的家庭从家庭检查中受益较少。本研究在家庭健康检查（FCU4Health）项目的一项试验中检验了基线目标调节（BTM），该项目是家庭健康检查的一种调整，用于初级保健服务，明确针对致肥行为。本研究纳入了来自不同种族的低收入家庭（N= 240），这些家庭的儿童年龄在5.5至12岁之间，在儿科初级保健中被确定为身体质量指数（BMI）升高，并随机分配到FCU4Health或常规护理组。在主要（儿童BMI、身体组成）和次要结果（家庭健康常规；儿童饮食行为、食物选择、情绪问题、问题行为、生活质量；照顾者BMI和身体组成）以及假设的中介（儿童自我调节、育儿技能）中，使用单变量调节和潜在类调节分析方法发现的BTM效应很少。样本的高风险性质和单独定制的FCU4Health可能减轻了发现BTM的影响。该试验已前瞻性注册（NCT03013309 ClinicalTrials.gov）。
Not all participants will benefit equally from even well-established, evidence-based prevention programs. For this reason, the field of prevention science is beginning to embrace individual tailoring of interventions. The Family Check-Up was among the first prevention programs to tailor at the family level as opposed to the more prevalent focus on adapting programs for different cultures, genders, and other immutable participant characteristics. Despite tailoring, families with lower levels of stress and parental mental health issues, children with lower baseline conduct problems, and families living in an extremely deprived neighborhood benefitted less from the Family Check-Up. This study examined baseline targeted moderation (BTM) within a trial of the Family Check-Up 4 Health (FCU4Health) program, an adaptation of the Family Check-Up for primary care delivery and explicit targeting of obesogenic behaviors. Ethnically diverse, low-income families (N= 240) with children ages 5.5 to 12 years identified in pediatric primary care with elevated body mass index (BMI) were enrolled and randomized to FCU4Health or usual care. Few BTM effects were found using single-variable-as-moderator and latent-class-as-moderator analytic approaches across the primary (child BMI, body composition) and secondary outcomes (family health routines; child eating behaviors, food choices, emotional problems, problem behaviors, quality of life; caregiver BMI and body composition), as well as hypothesized mediators (child self-regulation, parenting skills). The high-risk nature of the sample and the FCU4Health being individually tailored might have mitigated finding BTM effects. This trial was prospectively registered (NCT03013309 ClinicalTrials.gov).
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影响因子：
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作者：
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