Randomized, controlled trial of a best-practice individualized behavioral program for treatment of childhood overweight: Scottish childhood overweight treatment trial (SCOTT)
Randomized, controlled trial of a best-practice individualized behavioral program for treatment of childhood overweight: Scottish childhood overweight treatment trial (SCOTT)
复制标题
DOI：
10.1542/peds.2007-1786
复制
发表时间：
2008-03-01
期刊：
影响因子：
8
通讯作者：
Reilly, John J.
中科院分区：
文献类型：
--
作者：
Hughes, Adrienne R.;Stewart, Laura;Reilly, John J.
客观的。本研究的目的是确定相对于标准饮食护理，普遍适用的最佳实践个体化行为干预是否可以降低超重儿童的 BMI z 评分。该设计包括一项评估者盲法、随机对照试验，涉及 134 名超重儿童（59 名男孩，75 名女孩；相对于英国 1990 年 5-11 岁儿童参考数据，BMI >= 98%），这些儿童被随机分配到最佳实践行为计划（干预）或标准护理（对照）。该干预措施采用以家庭为中心的咨询和行为策略来改变饮食、身体活动和久坐行为。在基线以及 6 个月和 12 个月时记录 BMI z 评分、体重、客观测量的体力活动和久坐行为、脂肪分布、生活质量和身高 z 评分。 结果。相对于标准护理，干预对从基线到 6 个月和 12 个月的 BMI z 评分没有显着影响。从基线到 6 个月和 12 个月，两组的 BMI z 评分均显着下降。对于那些遵守治疗的人，从基线到 6 个月，与对照组相比，干预组的体重增加明显较小。组间存在显着差异，有利于对总体身体活动、久坐行为所花费的时间百分比和轻强度身体活动的变化进行干预。结论。与超重儿童的标准护理相比，普遍的、最佳实践的个体化行为干预对客观测量的体力活动和久坐行为有一定的益处，但对 BMI z 评分没有显着影响。所观察到的适度的益处可能需要长期和更强烈的干预，尽管这种治疗对于许多医疗保健系统来说可能并不现实。
OBJECTIVE. The objective of this study was to determine whether a generalizable best-practice individualized behavioral intervention reduced BMI z score relative to standard dietetic care among overweight children.METHODS. The design consisted of an assessor-blinded, randomized, controlled trial involving 134 overweight children (59 boys, 75 girls; BMI >= 98th centile relative to United Kingdom 1990 reference data for children aged 5-11 years) who were randomly assigned to a best-practice behavioral program (intervention) or standard care (control). The intervention used family-centered counseling and behavioral strategies to modify diet, physical activity, and sedentary behavior. BMI z score, weight, objectively measured physical activity and sedentary behavior, fat distribution, quality of life, and height z score were recorded at baseline and at 6 and 12 months.RESULTS. The intervention had no significant effect relative to standard care on BMI z score from baseline to 6 months and 12 months. BMI z score decreased significantly in both groups from baseline to 6 and 12 months. For those who complied with treatment, there was a significantly smaller weight increase in those in the intervention group compared with control subjects from baseline to 6 months. There were significant between-group differences in favor of the intervention for changes in total physical activity, percentage of time spent in sedentary behavior, and light-intensity physical activity.CONCLUSIONS. A generalizable, best-practice individualized behavioral intervention had modest benefits on objectively measured physical activity and sedentary behavior but no significant effect on BMI z score compared with standard care among overweight children. The modest magnitude of the benefits observed perhaps argues for a longer-term and more intense intervention, although such treatments may not be realistic for many health care systems.