Health behaviour outcomes of a family based intervention for paediatric obesity in primary care: A randomized type II hybrid effectiveness-implementation trial.
Health behaviour outcomes of a family based intervention for paediatric obesity in primary care: A randomized type II hybrid effectiveness-implementation trial.
复制标题
初级保健中儿童肥胖家庭干预的健康行为结果：一项随机 II 型混合有效性实施试验。
作者：
Smith,JustinD;Berkel,Cady;Carroll,AllisonJ;Fu,Emily;Grimm,KevinJ;Mauricio,AnneM;Rudo-Stern,Jenna;Winslow,Emily;Dishion,ThomasJ;Jordan,Neil;Atkins,DavidC;Narayanan,ShrikanthS;Gallo,Carlos;Bruening,MegM;Wilson,Charlton;
背景儿童肥胖是一个多方面的公共卫生问题。以家庭为基础的行为干预是预防儿童和青少年超重增加的推荐方法，但很少有人在“真实世界”条件下进行测试。目的评估与儿科初级保健相配合的基于家庭的干预对儿童和家庭健康结果的有效性。方法在儿科初级保健中确定了240个家庭的样本，这些家庭的种族和民族多样性(非白人占86%)，主要是低收入儿童(女性占49%)，年龄在6-12 (男性=19.5 年)。参与者被随机分为家庭体检4健康(FCU4Health)计划(N=6141)或常规护理加信息计划(N=699)。FCU4Health是一种以评估为导向的个性化干预措施，旨在通过提高育儿技能来预防超重增加，已在诊所、家庭和社区提供了6个月的服务。在基线、3个月、6个月和12个 月时，使用生物电阻抗量表评估儿童体重指数和体脂，并获得照顾者报告的健康行为(例如，饮食、体力活动和家庭健康例行公事)。通径分析显示，12个 月时儿童健康行为存在显著的群体差异，6个月时家庭健康程序的改善起到了中介作用。结论FCU4健康与儿科初级保健相配合，显著影响与儿童肥胖的发生和维持相关的儿童和家庭健康行为。BMI没有显著差异。
BackgroundPaediatric obesity is a multifaceted public health problem. Family based behavioural interventions are the recommended approach for the prevention of excess weight gain in children and adolescents, yet few have been tested under “real‐world” conditions.ObjectivesTo evaluate the effectiveness of a family based intervention, delivered in coordination with paediatric primary care, on child and family health outcomes.MethodsA sample of 240 families with racially and ethnically diverse (86% non‐White) and predominantly low‐income children (49% female) ages 6 to 12 years (M = 9.5 years) with body mass index (BMI) ≥85th percentile for age and gender were identified in paediatric primary care. Participants were randomized to either the Family Check‐Up 4 Health (FCU4Health) program (N = 141) or usual care plus information (N = 99). FCU4Health, an assessment‐driven individually tailored intervention designed to preempt excess weight gain by improving parenting skills was delivered for 6 months in clinic, at home and in the community. Child BMI and body fat were assessed using a bioelectrical impedance scale and caregiver‐reported health behaviours (eg, diet, physical activity and family health routines) were obtained at baseline, 3, 6 and 12 months.ResultsChange in child BMI and percent body fat did not differ by group assignment. Path analysis indicated significant group differences in child health behaviours at 12 months, mediated by improved family health routines at 6 months.ConclusionThe FCU4Health, delivered in coordination with paediatric primary care, significantly impacted child and family health behaviours that are associated with the development and maintenance of paediatric obesity. BMI did not significantly differ.