Sensible Treatment of Obesity in Rural Youth- STORY

描述(由申请人提供)： 儿童肥胖症的流行是一个主要的公共卫生问题。儿童肥胖与2型糖尿病、胰岛素抵抗、糖耐量异常和其他负面健康后果有关。儿童肥胖症的成功治疗与显著的健康益处有关。包括儿童和父母在内的基于行为的家庭干预已经成功地在儿童中产生了减肥效果。然而，这些干预措施的普遍性是有限的，而且几乎没有随机试验检验社区和农村环境中针对儿童和家庭的减肥干预措施。最近的研究表明，在儿童肥胖症的行为治疗中，只针对父母可能会导致类似的结果，而且可能比包括儿童和父母在内的干预措施更具成本效益。然而，这两种治疗方法尚未在随机对照试验(RCT)中进行比较。这项可行性研究需要一项三臂随机对照试验，以测试两组干预措施的有效性，这些干预措施旨在促进医疗服务不足的农村环境中超重儿童及其父母的体重管理。参与者将被随机分配到基于行为的家庭干预(BFI)、基于父母的行为干预(BPI)或等待名单控制(WLC)。这两个治疗计划都将采取行为生活方式来改变饮食和体力活动模式。在BPI中，只有家长将参加小组会议，而在BFI中，孩子和家长都将参加小组会议。这两种干预措施将包括为期4个月的12次会议，在基线、治疗后和6个月的随访(第10个月)时进行评估。据假设，(A)在10个月时，BFI和BPI的儿童在体重状况方面的改善将比WLC中的儿童更大；(B)在10个月时，BPI中的儿童在体重状况方面的改善将比BFI中的儿童更大；以及(C)BPI中的儿童将比BFI中的儿童表现出更大的成本效益。研究结果将为规划R18随机对照试验提供关键信息。

DESCRIPTION (provided by applicant): The epidemic of childhood obesity is a major public health concern. Childhood obesity has been linked to type 2 diabetes, insulin resistance, abnormal glucose tolerance, and other negative health outcomes. Successful treatment of childhood obesity is associated with significant health benefits. Behavioral family-based interventions including both children and parents have been successful in producing weight loss in children. However, the generalizability of these interventions is limited, and there are virtually no randomized trials examining weight loss interventions for children and families in community-based, rural settings. Recent research suggests that exclusively targeting parents in the behavioral treatment of childhood obesity may lead to similar outcomes, and may be more cost-effective than interventions including both children and parents. These two treatment approaches, however, have yet to be compared in a randomized controlled trial (RCT). This feasibility study entails a three arm RCT to test the effectiveness of two group interventions designed to promote weight management in overweight children and their parents in medically underserved, rural settings. Participants will be randomly assigned to a Behavioral Family-Based Intervention (BFI), Behavioral Parent-Based Intervention (BPI), or a Wait List Control (WLC). Both treatment programs will take a behavioral lifestyle approach to modify dietary and physical activity patterns. In the BPI, only parents will attend group meetings, while in the BFI both children and parents will attend group sessions. Both interventions will include 12 sessions over 4-months, with assessment at baseline, post-treatment, and 6-month follow-up (month 10). It is hypothesized that, (a) children in the BFI and BPI will exhibit greater improvements in weight status than children in the WLC at month 10, (b) children in the BPI will exhibit greater improvements in weight status than those in the BFI at month 10, and (c) the BPI will demonstrate greater cost-effectiveness than the BFI. Findings will provide critical information for planning the R18 RCT.