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.

治疗儿童和青少年肥胖症的方案往往是无效的，因为（持续）利用不足。根据申请人的主要假设，（持续）利用这些服务在很大程度上取决于受影响儿童父母变化的阶段。识别和特定的调制的个别阶段的变化的策略，承诺提高利用率，从而更好的临床结果。对变化阶段进行及时有效和标准化的诊断的先决条件是一份简短的调查表。从受影响儿童的父母的角度来看，目前还没有这样一项文书。因此，它是在这里提出的项目的目的，以适应现有的工具-罗得岛大学变化评估-短（URICA-S）-从自我的角度（“我自己的影响”）到父母的角度（“我的孩子是受影响的”），并验证该工具随后。所有16个项目的调整将通过合格专家的迭代德尔菲过程进行。新工具的验证将通过验证性因素分析进行，并在320名超重或肥胖儿童或青少年父母的队列中进行质量维度客观性，可靠性（内部一致性），结构和标准效度。有了这一新的工具，就有可能检验申请人的主要假设，即变化的阶段在很大程度上决定了保健服务的利用情况，针对父母的特定阶段的干预措施将改善受影响儿童的（持续）利用情况和结果。本课题是第一个将Andersen的卫生服务利用行为模型与Prochaska的跨理论模型的变化阶段相结合的研究。这种概念改进的经验评估将在申请人的后续研究中进行。

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.