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，行为治疗与26小时或更长时间的干预接触， 最有可能帮助减少肥胖儿童和青少年的超重。 斯坦福大学儿童体重控制计划（SPWCP）是一个以家庭为基础的团体行为 治疗方案在真实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 战略包装和传播斯坦福大学儿科体重控制计划，以达到低， 美国各地的收入儿童。 为了实现这一目标，我们采用了一种方法，将设计思维、行为 科学和企业发展战略。我们建议的解决方案包括以下组件： 1.用户友好的人体受试者和符合HIPAA的基于Web和移动的软件， 供应商通过SPWCP实施的每一步。 2.通过突出过去参与者的简短视频提供SPWCP的关键内容。 3.面向患者的Web和移动的应用程序。 4.现场和在线提供商培训。 5.持续的技术援助/支持。 6.根据过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。第三年 该奖项将包括由几个当地的一至两组参与者对所有组件进行beta测试 代表不同背景的伙伴提供者和组织为低收入家庭服务。 试点实施研究将在第三年年底开始，并持续到年中。 第五年。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6个月内年龄和BMI中位数的百分比变化， 性别（主要结局指标）使用广义线性混合效应回归技术，在一个- 在80例BMI ≥年龄第95百分位数的儿童的意向治疗队列中进行的一项臂干预性试验 根据2000年CDC生长参考值，BMI ≥年龄和性别的第85百分位数， 父母肥胖（BMI ≥ 30 kg/m2）和/或既往诊断为肥胖相关合并症。 结果和额外的测试将为广泛的传播和可持续性战略提供信息， 由全国范围内广泛的供应商进行传播、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.