Packaging and Spreading the Stanford Pediatric Weight Control Program - A Family-Based, Group, Behavioral Weight Control Program for Children with Obesity and their Families

许多临床医生认为儿童肥胖是他们面临的最令人沮丧的问题之一。然而， 有效的治疗方法确实存在。美国预防服务工作组最近的证据审查 得出的结论是，基于家庭、团体、行为治疗并进行 26 小时或更长时间的干预接触 最有可能帮助减轻肥胖儿童和青少年的体重。 斯坦福儿童体重控制计划 (SPWCP) 是一项以家庭为基础的团体行为 治疗计划在现实世界的临床环境中产生出色的保留和结果。我们 建议利用技术、设计、行为理论和生物医学业务创新 包装和传播斯坦福儿童体重控制计划以达到低体重的策略 美国各地的收入儿童 为了实现这一目标，我们以一种将设计思维、行为思维相结合的方法为指导 科学和商业发展战略。我们提出的解决方案包括以下组件： 1. 用户友好、以人为本且符合 HIPAA 的基于网络和移动的指导软件 供应商参与 SPWCP 实施的每一步。 2. 通过突出过去参与者的简短视频来传递 SPWCP 的关键内容组成部分。 3. 面向患者的网络和移动应用程序。 4. 现场和在线提供商培训。 5. 持续的技术援助/支持。 6. 根据流程参数和结果对供应商进行认证。 我们将在获奖的前两年开发上述包装。第 3 年 奖励将包括由几位当地的一到两组参与者对所有组件进行 Beta 测试 代表为低收入家庭提供服务的不同环境的合作伙伴提供者和组织。 试点实施研究将于第三年年底开始，并持续到第三年中期。 第 5 年。我们将与至少 4 个代表不同类型提供商的不同社区合作伙伴合作 服务低收入家庭。我们将评估年龄和体重的 BMI 中位数的六个月变化百分比 性别（主要结果指标）使用广义线性混合效应回归技术，在一个单一的 在 80 名年龄 BMI ≥ 95% 的儿童组成的意向治疗队列中进行了手臂干预试验 2000 年 CDC 生长参考或性别 BMI ≥ 85%（年龄和性别）且至少有一项 父母患有肥胖症（BMI ≥ 30 kg/m2）和/或先前诊断出肥胖相关的共病。 结果和额外的测试将为广泛传播和可持续发展战略提供信息 由全国范围内的众多提供商传播、采用、实施和维护。

Many clinicians consider childhood obesity to be one of the most frustrating problems they face. Yet, efficacious treatments do exist. A recent evidence review for The US Preventive Services Task Force concluded that family-based, group, behavioral treatments with 26 or more hours of intervention contact were most likely to help reduce excess weight in children and adolescents with obesity. The Stanford Pediatric Weight Control Program (SPWCP) is a family-based group behavioral treatment program producing outstanding retention and outcomes in real world clinical settings. We propose to utilize technology, design, behavioral theory and biomedical business innovation strategies to package and spread the Stanford Pediatric Weight Control Program to reach low- income children throughout the U.S. To accomplish this aim, we are guided by an approach that merges design thinking, behavioral science, and business development strategy. Our proposed solution includes the following components: 1. User-friendly, human subjects and HIPAA compliant web-based and mobile software that guides providers through every step of SPWCP implementation. 2. The delivery of key content components of the SPWCP via brief videos highlighting past participants. 3. Web and mobile apps for patients. 4. Onsite and online provider training. 5. Ongoing technical assistance/support. 6. Certification of providers based on process parameters and outcomes. We will develop the packaging described above over the first two years of the award. Year 3 of the award will include beta testing of all components with one to two groups of participants by several local partner providers and organizations representing different settings serving low-income families. A pilot implementation study will commence at the end of Year 3 and continue through the middle of Year 5. We will partner with at least 4 different community partners representing different types of providers serving low income families. We will evaluate six-month changes in percent over median BMI for age and sex (the primary outcome measure) using generalized linear mixed effects regression techniques, in a one- arm interventional trial conducted in an intent-to-treat cohort of 80 children with BMI ≥ 95th percentile for age and sex on the 2000 CDC growth reference or with BMI ≥ 85th percentile for age and sex and at least one parent with obesity (BMI ≥ 30 kg/m2) and/or prior diagnosis of an obesity-related co-morbid condition. Results and additional testing will inform a dissemination and sustainability strategy for widespread dissemination, adoption, implementation and maintenance by a wide array for providers nationwide.