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， 确实存在有效的治疗方法。美国预防服务工作组最近的一项证据审查 结论是，以家庭为基础的、小组的、有26小时或更长时间干预接触的行为治疗 最有可能帮助减轻肥胖儿童和青少年的超重。 斯坦福儿童体重控制计划(SPWCP)是一项基于家庭的群体行为 治疗计划在现实世界的临床环境中产生出色的保留率和结果。我们 建议利用技术、设计、行为理论和生物医学业务创新 包装和推广斯坦福儿科体重控制计划的战略，以达到低体重- 美国各地的收入儿童。 为了实现这一目标，我们遵循一种融合了设计思维、行为 科学和商业发展战略。我们建议的解决方案包括以下组件： 1.用户友好、符合人类主体和HIPAA标准的基于网络和移动设备的软件，指导 供应商通过SPWCP实施的每一步。 2.通过突出介绍过去参与者的简短视频，提供《太平洋小岛屿发展中国家方案》的主要内容部分。 3.为患者提供网络和移动应用。 4.现场和在线供应商培训。 5.持续的技术援助/支持。 6.根据程序参数和结果对提供者进行认证。 我们将在获奖的头两年开发上述包装。开学第三年 奖项将包括由几名当地人员与一至两组参与者一起对所有组件进行Beta测试 代表为低收入家庭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，一直持续到#年年中。 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 为低收入家庭服务。我们将评估年龄和体重指数中值在六个月内的百分比变化 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- ARM干预试验在80名年龄体重指数≥为95百分位数的儿童意向治疗队列中进行 和性别在2000年疾病控制与预防中心生长参考指数或体重指数≥第85百分位数的年龄和性别中，至少有一个 父母肥胖(体重指数≥为30千克/平方米)和/或先前诊断为肥胖相关并存疾病。 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 由全国范围内的供应商广泛传播、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.