Promoting Healthy Families Through Enhanced Primary Care

通过加强初级保健促进家庭健康

• 批准号: 7140551
• 负责人: ARDIS L OLSON
• 金额: $ 17.57万
• 依托单位: DARTMOUTH COLLEGE
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-08-15 至 2008-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7140551
• 关键词: behavioral /social science research tag; clinical research; counseling; disease /disorder prevention /control; disease /disorder proneness /risk; family medicine; health behavior; human subject; human therapy evaluation; longitudinal human study; low socioeconomic status; middle childhood (6-11); obesity; patient oriented research; personal computers; rural area; rural health

DESCRIPTION (provided by applicant): Primary care has been an under-utilized resource for childhood obesity prevention. Promotion of healthy lifestyles in younger children when families still play a major role in controlling their environment and modeling behaviors is key. However, obesity prevention counseling during well child care is challenging due to difficulties in efficiently gathering data on child/family behaviors, lack of point of care clinician supports for effective counseling, and the need for family reinforcement of planned changes. We propose a feasibility study of an innovative family-focused intervention for primary care to meet these needs in rural, low-income...communities. Family readiness to change will guide the counseling and post-visit planned post visit reinforcement. This project brings together personal data assistant (PDA) technology, a community Practice Based Research Network (PBRN), and a research team experienced in office system change, to design and pilot test a primary care office system to address obesity risk, we will extend that work to obesity prevention in children through four specific aims. 1) Using hand held PDAs, we will develop an obesity risk screening and counseling system well child visits (WCV) for ages 4 -10. PDA summarized screening results will prompt the clinician to provide brief counseling messages tailored to each child's obesity risk behaviors and family readiness to change behavior. 2) We will evaluate the specific content and quality of clinician obesity counseling provided at the WCV through parent surveys before and after implementation of the PDA screening and counseling program. 3) To support action by families post visit, we will develop a post-visit intervention package of newsletters and materials also tailored to child/family obesity risk behaviors and parental readiness to change. 4) We will evaluate the impact of this post visit intervention program in a 6 month trial focused on children identified with BMI >85%. Families will be randomized to receive either a series of 4 mailed supports versus a single generic-content mailing. We will determine the respective impact of these two levels of post-visit support on stage of change, parental action on key obesity risk behaviors, child behaviors, and stabilization of BMI z scores after 6 months.

描述（由申请人提供）： 初级保健一直是儿童肥胖预防的一个未充分利用的资源。当家庭在控制儿童的环境和行为方面仍然发挥主要作用时，促进幼儿健康的生活方式是关键。然而，在良好的儿童保育期间，肥胖预防咨询是具有挑战性的，因为难以有效地收集儿童/家庭行为的数据，缺乏对有效咨询的护理点临床医生支持，以及需要家庭加强计划的改变。我们建议进行一项以家庭为中心的创新性初级保健干预措施的可行性研究，以满足农村低收入人群的需求。社区.家庭对改变的准备将指导咨询和访视后计划的访视后强化。本项目结合个人数据助理（PDA）技术、社区实践研究网络（PBRN）和一个在办公室系统变革方面经验丰富的研究团队，设计和试点测试一个初级保健办公室系统，以解决肥胖风险，我们将通过四个具体目标将这项工作扩展到儿童肥胖预防。 1)利用手持PDA，我们将开发一个肥胖风险筛查和咨询系统，以及4 - 10岁的儿童访问（WCV）。PDA总结的筛查结果将提示临床医生提供针对每个孩子的肥胖风险行为和家庭准备改变行为的简短咨询信息。 2)我们将通过实施PDA筛查和咨询计划前后的家长调查，评估WCV提供的临床肥胖咨询的具体内容和质量。 3)为了支持家庭在访问后采取的行动，我们将制定一个访问后干预包的通讯和材料，也适合儿童/家庭肥胖风险行为和父母准备改变。 4)我们将在一项为期6个月的试验中评估这项访视后干预计划的影响，该试验的重点是BMI > 85%的儿童。家庭将被随机接受一系列的4邮寄支持与一个单一的一般内容的邮件。我们将确定这两种水平的访视后支持对变化阶段、父母对关键肥胖风险行为的行为、儿童行为以及6个月后BMI z评分稳定性的各自影响。