Implementing family-based behavioral treatment in the pediatric primary care setting: Design of the PLAN study.
Implementing family-based behavioral treatment in the pediatric primary care setting: Design of the PLAN study.
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DOI：
10.1016/j.cct.2021.106497
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发表时间：
2021-10
影响因子：
2.2
通讯作者：
Wilfley, Denise E.
中科院分区：
文献类型：
--
作者：
Epstein, Leonard H.;Schechtman, Kenneth B.;Kilanowski, Colleen;Ramel, Melissa;Moursi, Nasreen A.;Quattrin, Teresa;Cook, Steven R.;Eneli, Ihouma U.;Pratt, Charlotte;Geller, Nancy;Campo, Rebecca;Lew, Daphne;Wilfley, Denise E.
关键词：
基于家庭的行为治疗（FBT）是一种基于证据的儿童肥胖治疗方法。FBT主要在专业诊所实施，有训练有素的介入医生。本研究的目的是评估FBT在儿科初级保健机构实施的有效性，使用新培训的干预医师，他们可能会在儿科实践中实施FBT。目标是在四个地点（纽约州布法罗和罗切斯特市；俄亥俄州哥伦布市；密苏里州圣路易斯市）随机抽取528个有超重/肥胖儿童（BMI≥85个百分点）和超重/肥胖父母（BMI≥25）的家庭，进行FBT或常规护理，并在24个月的治疗期间每隔6个月进行评估。FBT采用掌握模式实施，该模式根据家庭进展情况提供治疗数量，并遵循美国预防服务工作队关于有效剂量和治疗持续时间的建议。该试验的主要结果是儿童相对体重的变化，其次是超重/肥胖的父母和兄弟姐妹。在偏好小的即时奖励而不是大的延迟奖励（延迟折扣）的倾向上，组间差异以及这与治疗结果的关系也被评估。讨论了在初级保健机构中将基于群体的干预措施转化为个性化治疗方面的挑战，以及由于COVID-19大流行而出现的研究实施方面的挑战。假设FBT干预将与儿童、父母和兄弟姐妹的相对体重比常规护理有更好的变化相关。本研究的结果可以为未来在初级保健机构中传播和实施FBT提供信息。
Family-based behavioral treatment (FBT) is an evidence-based treatment for pediatric obesity. FBT has primarily been implemented in specialty clinics, with highly trained interventionists. The goal of this study is to assess effectiveness of FBT implemented in pediatric primary care settings using newly trained interventionists who might implement FBT in pediatric practices. The goal is to randomize 528 families with a child with overweight/ obesity (≥85th BMI percentile) and parent with overweight/obesity (BMI ≥ 25) across four sites (Buffalo and Rochester, New York; Columbus, Ohio; St. Louis, Missouri) to FBT or usual care and obtain assessments at 6- month intervals over 24 months of treatment. FBT is implemented using a mastery model, which provides quantity of treatment tailored to family progress and following the United States Preventive Services Task Force recommendations for effective dose and duration of treatment. The primary outcome of the trial is change in relative weight for children, and secondarily, for parents and siblings who are overweight/obese. Between group differences in the tendency to prefer small immediate rewards over larger, delayed rewards (delay discounting) and how this is related to treatment outcome is also evaluated. Challenges in translation of group-based interventions to individualized treatments in primary care settings, and in study implementation that arose due to the COVID-19 pandemic are discussed. It is hypothesized that the FBT intervention will be associated with better changes in relative weight for children, parents, and siblings than usual care. The results of this study can inform future dissemination and implementation of FBT into primary care settings.
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影响因子：
2.2
作者：
Bickel WK;Mueller ET
通讯作者：
Mueller ET
DOI：
10.1080/15374416.2014.963854
发表时间：
2015-07-04
影响因子：
4.2
作者：
Altman, Myra;Wilfley, Denise E.
通讯作者：
Wilfley, Denise E.
DOI：
10.1038/oby.2001.103
发表时间：
2001-12-01
期刊：
OBESITY RESEARCH
影响因子：
--
作者：
Epstein, LH;Paluch, RA;Raynor, HA
通讯作者：
Raynor, HA
影响因子：
13.5
作者：
Bickel, Warren K.;Jarmolowicz, David P.;Mueller, E. Terry;Koffarnus, Mikhail N.;Gatchalian, Kirstin M.
通讯作者：
Gatchalian, Kirstin M.
DOI：
10.1249/01.mss.0000227639.83607.4d
发表时间：
2006-09-01
期刊：
MEDICINE AND SCIENCE IN SPORTS AND EXERCISE
影响因子：
--
作者：
Cerin, Ester;Saelens, Brian E.;Frank, Lawrence D.
通讯作者：
Frank, Lawrence D.