Stages of Change as Determinants of Health Service Use: Adaptation and Validation of the German Short Version of the University of Rhode Island Change Assessment (URICA-S) for the Perspective of Parents of Children with Obesity.

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Programs for the treatment of obesity in children and adolescents are often ineffective because of inadequate (continuing) utilization. Following the main hypothesis of the applicant, the (continuing) utilization of such services is significantly determined by the stages of change of parents of the affected children. The identification and the specific modulation of the individual stage of change are strategies which promise improved utilization and hence better clinical outcomes. The prerequisite for the time-efficient and standardized diagnosis of the stages of change is a short-form questionnaire. Such an instrument does not exist so far for the perspective of parents of affected children. Hence, it is the aim of the project presented here, to adapt an existing instrument - the University of Rhode Island Change Assessment - Short (URICA-S) - from the Self-Perspective ('I am myself affected') to the Parent-Perspective ('my child is affected') and to validate the instrument subsequently. The adaptation of all 16 items will be performed through an iterative Delphi-Process of eligible experts. The validation of the new instrument will be conducted by confirmatory factor analysis and with regards to the quality dimensions objectiveness, reliability (internal consistency), construct- and criteria-validity within a cohort of 320 parents of overweight or obese children or adolescents. Given this new instrument, it will be possible to test the main hypothesis of the applicant that the stages of change significantly determine the utilization of health services and that stage-specific interventions targeting parents will improve (continuing) utilization and outcome of affected children. The project applied for here is the first study to extent the Behavioral Model of Health Service Utilization by Andersen (BM) with the Stages of Change of the Transtheoretical Model (TM) by Prochaska. The empirical assessment of this conceptual amelioration will follow within successor studies of the applicant.