Family Inclusive Childhood Obesity Treatment designed for Low Income and Hispanic Families

专为低收入和西班牙裔家庭设计的家庭包容性儿童肥胖治疗

• 批准号: 10460619
• 负责人: MATTHEW A. HAEMER
• 金额: $ 64万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-16 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10460619
• 关键词: 16 year old; Academy; Address; Adoption; Adult; Advisory Committees; Affect; Behavior Therapy; Body mass index; Caregivers; Caring; Child; Clinic; Clinical; Counseling; Data; Development; Diabetes Mellitus; Dissemination and Implementation; Dose; Eating Behavior; Educational Curriculum; Effectiveness; Enrollment; Family; Foundations; Funding; Goals; Health; Health Educators; High-Income Populations; Hispanic; Hispanic Populations; Home; Insurance; Intervention; Lead; Linguistics; Low income; Maintenance; Measures; Medicaid; Mentored Patient-Oriented Research Career Development Award; Non obese; Not Hispanic or Latino; Obesity; Overweight; Parents; Pediatrics; Pilot Projects; Population; Population Intervention; Preparation; Prevention; Preventive service; Primary Health Care; Protocols documentation; Public Health; Quality of life; Randomized Controlled Trials; Reach Effectiveness Adoption Implementation and Maintenance; Recommendation; Recreation; Research; Research Personnel; Siblings; Testing; Training; Waiting Lists; Weight maintenance regimen; active control; age group; base; cardiometabolism; care providers; clinically significant; community clinic; community engaged research; community organizations; community partnership; compare effectiveness; cooking; cost; design; effective intervention; effectiveness implementation study; effectiveness implementation trial; effectiveness testing; evidence base; experience; fitness; food insecurity; food security; group intervention; health disparity; healthy weight; implementation evaluation; implementation fidelity; implementation outcomes; implementation process; implementation strategy; lower income families; mortality; novel; obesity in children; obesity prevention; obesity treatment; payment; prevent; programs; prospective; randomized controlled design; safety net; scale up; therapy design; treatment program; trend

Project Summary: This proposal addresses a significant public health problem – childhood obesity and related health disparities faced by Hispanic children from low-income families – for which interventions are lacking. This Randomized Controlled Trial (RCT) will test the effectiveness of a family-inclusive weight management program developed for low-income Hispanic populations. Interventions to prevent and treat childhood obesity have historically excluded Spanish speaking families. The intervention to be tested has been designed through in-depth collaborative research involving childhood-obesity clinician/researchers, safety-net clinics, community organizations, and the low-income and mostly Hispanic families they serve. The Healthy Living Program / La Vida Saludable (HeLP) has been designed to achieve reach, retention, and effectiveness for low-income and Hispanic families, including Spanish Speakers. HeLP incorporates the core components of evidence-based family-based-behavioral- therapy at a dose the US Preventive Services Task Force has recommended to be effective. The key novel design components of HeLP include: 1) Inclusion of the entire family. Previous interventions have focused on parent-child dyads. In HeLP, children with obesity and all siblings 2-16 years and adult caregivers receive targeted curricular components. Younger healthy weight siblings of children referred for obesity are targeted for obesity prevention, 2) Hands-on family training in meal-planning, shopping, and cooking is focused on reducing food insecurity while adapting traditional cuisine, 3) Delivery close to home through a partnership of primary care clinics and recreation centers, and 4) Delivery by trained, low-cost, culturally and linguistically concordant health educators. The goal of this research is to definitively assess using a randomized controlled design the effectiveness of the HeLP intervention for treatment and prevention of overweight and obesity vs a primary care counseling protocol active control condition—Recommended Treatment of Obesity in Primary Care (RTOP). The aims of this study are to: 1) compare the effectiveness of HeLP vs. RTOP at BMI reduction in three age groups of low- income Hispanic children with obesity: 2-6, 7-12, and 13-16 years (secondary measures include: cardiometabolic lab tests, fitness, quality of life, eating behaviors, and food security); 2) To compare the effectiveness of HeLP at obesity prevention by comparing the BMI trajectory of non-obese 2-11yr old children with BMI above median whose siblings are enrolled in HeLP vs. RTOP; 3) To study implementation of HeLP and RTOP within the RE-AIM framework, including: Reach, Adoption, Implementation (fidelity, replication costs, and cost per unit BMI change), and Maintenance. This proposal seeks to fill a major gap in understanding of how childhood obesity might be effectively treated in low-income and Hispanic families.

项目摘要：该提案解决了一个重大的公共卫生问题——儿童肥胖和 低收入家庭的西班牙裔儿童面临的相关健康差异——为此采取干预措施 缺乏。这项随机对照试验 (RCT) 将测试家庭体重的有效性 为低收入西班牙裔人口制定的管理计划。预防和治疗干预措施 儿童肥胖症历来将西班牙语家庭排除在外。 要测试的干预措施是通过深入的合作研究设计的，涉及 儿童肥胖症临床医生/研究人员、安全网诊所、社区组织以及低收入和低收入人群 他们服务的主要是西班牙裔家庭。健康生活计划 / La Vida Saludable (HeLP) 已 旨在实现低收入和西班牙裔家庭的覆盖面、保留率和有效性，包括 西班牙语使用者。 HeLP 融合了基于证据的家庭行为的核心组成部分 按照美国预防服务工作组建议的有效剂量进行治疗。关键小说 HeLP 的设计组成部分包括： 1) 包含整个系列。之前的干预措施主要集中在 亲子二人组。在 HeLP 中，肥胖儿童和所有 2-16 岁的兄弟姐妹以及成年护理人员接受 有针对性的课程组成部分。因肥胖而转介的儿童的年龄较小、体重健康的兄弟姐妹是目标 预防肥胖，2) 在膳食计划、购物和烹饪方面进行家庭实践培训，重点是减少肥胖 粮食不安全，同时适应传统美食，3）通过初级合作伙伴在家附近送货 护理诊所和娱乐中心，以及 4) 由训练有素、低成本、文化和语言一致的服务提供 健康教育者。 本研究的目标是使用随机对照设计明确评估以下方法的有效性： 用于治疗和预防超重和肥胖的 HeLP 干预与初级保健咨询 方案主动控制条件——初级保健中肥胖的推荐治疗（RTOP）。的目标 这项研究的目的是： 1) 比较 HeLP 与 RTOP 在三个低体重年龄组中降低 BMI 的效果 收入 西班牙裔肥胖儿童：2-6、7-12 和 13-16 岁（次要指标包括： 心脏代谢实验室测试、健康、生活质量、饮食行为和食品安全）； 2）比较 通过比较非肥胖 2-11 岁儿童的 BMI 轨迹，HeLP 在预防肥胖方面的有效性 BMI 高于中位数且其兄弟姐妹参加了 HeLP 与 RTOP； 3）研究HeLP的实施 RE-AIM 框架内的 RTOP，包括：触及、采用、实施（保真度、复制 成本，以及每单位 BMI 变化的成本），以及维护。该提案旨在填补一个重大空白 了解如何在低收入和西班牙裔家庭中有效治疗儿童肥胖症。