IT-Supported Early Treatment of Childhood Overweight

IT 支持的儿童超重早期治疗

• 批准号: 6987997
• 负责人: WILLIAM G ADAMS
• 金额: $ 24.15万
• 依托单位: BOSTON MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-08 至 2007-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6987997
• 关键词: behavior therapy; behavioral /social science research tag; body physical activity; clinical research; computer assisted patient care; diet; health behavior; human subject; human therapy evaluation; middle childhood (6-11); obesity; parent offspring interaction; self help; telemedicine

DESCRIPTION (provided by applicant): The prevention and treatment of pediatric obesity is a national priority. Minority children and those living in poverty are at additional risk for obesity. There is a pressing need for low-cost, effective interventions for the large numbers of overweight children. A reliable way to do this would have wide applicability and usefulness. The goal of this exploratory/developmental (R21) study is to develop and evaluate an integrated information system, Healthy Eating and Activity Today (HEAT), for promoting self-care in overweight children. HEAT is comprised of two components: 1) Telephone Linked Care-HEAT (TLC-HEAT), a self-care intervention delivered at home through totally automated telephone conversations; and 2) Primary Care-HEAT (PC-HEAT), a primary care intervention linked with TLCHEAT and delivered through an electronic health record (EHR). The HEAT system will guide children in the early stages of overweight (i.e., children with Body Mass Index (BMI) 0-3 BMI points above the 95th percentile for age and gender) toward healthy weight management and assist the child's parent(s) and primary care provider (PCP) to support the child's efforts. For this project we will: 1) develop TLC-HEAT for use by children in the earliest stage of overweight and their parents; 2) integrate TLC-HEAT with an electronic health record to provide child- and parent reported behavior summaries combined with evidence-based decision support to PCPs at the point-of care (PC-HEAT); and 3) conduct a pilot study of the combined HEAT system to explore the appropriateness of conducting a larger, randomized clinical trial in the future. We hypothesize that TLC use will 1) reduce the child's caloric and fat intake (% calories from total fat and saturated fat); 2) reduce the number of hours per week of recreational screen-time (TV, video, computer); 3) and lead to a reduced rate of BMI increase. We will also evaluate whether HEAT will be acceptable to children, parents, and their PCPs and feasible in pediatric practices using an EHR. The ultimate purpose of the development of HEAT is to create a program that is easy to disseminate widely in pediatric practice. If the aims of this study are met, the findings from this project will provide data to modify and improve the system, generate hypotheses, and determine the possibility of proposing a randomized clinical trial of the system with sufficient power to evaluate its effectiveness.

说明(申请人提供)：预防和治疗儿童肥胖症是国家的优先事项。少数族裔儿童和生活贫困的儿童患肥胖症的风险更大。迫切需要对大量超重儿童进行低成本、有效的干预。一种可靠的方法将具有广泛的适用性和实用性。这项探索性/发展性(R21)研究的目标是开发和评估一个集成的信息系统，即今天的健康饮食和活动(HEAT)，以促进超重儿童的自我照顾。HEAT由两个部分组成：1)电话连接护理热疗(TLC-HEAT)，这是一种通过全自动电话交谈在家中提供的自我护理干预；以及2)初级护理热疗(PC-HEAT)，这是一种与TLCHEAT相连并通过电子健康记录(EHR)提供的初级护理干预措施。热系统将引导超重早期的儿童(即身体质量指数(BMI)0-3的儿童，年龄和性别超过第95个百分位数)走向健康的体重管理，并帮助儿童的父母(S)和初级保健提供者(PCP)支持儿童的努力。 对于这个项目，我们将：1)开发TLC-HEAT，供超重儿童及其父母在早期使用；2)将TLC-HEAT与电子健康记录集成，提供儿童和父母报告的行为摘要，并在护理点为PCP提供循证决策支持(PC-HEAT)；以及3)对组合HEAT系统进行试点研究，以探索未来进行更大规模随机临床试验的适宜性。 我们假设，使用TLC将1)减少儿童的卡路里和脂肪摄入量(总脂肪和饱和脂肪占卡路里的百分比)；2)减少每周娱乐屏幕时间(电视、视频、电脑)的小时数；3)并导致BMI增加的速度降低。我们还将评估高温是否可以被儿童、父母和他们的初级保健医生接受，并在儿科实践中使用EHR是否可行。 开发HEAT的最终目的是创建一个易于在儿科实践中广泛传播的程序。如果这项研究的目标达到，这个项目的发现将提供数据来修改和改进该系统，产生假设，并确定提出该系统的随机临床试验的可能性，该系统具有足够的能力来评估其有效性。