Childhood obesity treatment targeting specific behaviors

美国正处于肥胖流行病的中间，影响着幼儿。儿科初级保健环境是 一个理想的地方，以解决这个问题，因为大多数家庭有频繁的接触，他们的儿科医生和一个 在这种情况下，定期评估儿童的健康状况。治疗儿童身体的建议 一位专家在初级保健环境中制定了超过第85百分位数的质量指数（BMI）， 儿童委员会。需要制定符合委员会建议的方案， 包括：1）尽可能早地开始治疗; 2）以家庭为重点，父母是 治疗的主要改变剂; 3）使用行为矫正技术来改变饮食和活动 行为;和4）在饮食和活动中一次做出2或3个非常具体的改变。因此，这一目标 R21应用程序是开发，实施和评估6个月的儿童肥胖行为干预 符合委员会的建议，并可在初级保健环境中实施。第二 这个项目的目的是确定哪些饮食和活动行为应该作为干预的目标。 135名4 - 8岁BMI > 85 th百分位数的儿童，由 他们的儿科医生，将被随机分为三种情况之一：1）时事通讯条件; 2）行为 育儿计划，增加体力活动（60分钟/天），减少含糖饮料 消费（< 3份/周）（传统）;或3）减少电视的行为育儿计划 观看（< 2小时/天），并增加低脂牛奶的消费（2份/天）（替代品）。后续行动 将对体重、身高和标准化BMI（z-BMI）（主要因变量）进行评估， 在3、6、9和12个月时进行。儿科医生将提供后续信件给家庭，关于体重 和身高状况这项试点研究使我们能够确定可行性， 儿童肥胖干预的有效性，优化儿科医生的作用，并满足 委员会对初级保健环境中治疗的建议。此外，通过比较 针对传统或替代行为，将获得数据进行全面的功效分析， 试验这两种方法对长期减肥的影响。

The US is in the midst of an obesity epidemic, affecting young children. The pediatric primary care setting is an ideal place to address this problem since most families have frequent contact with their pediatrician and a child's health status is regularly assessed in this setting. Recommendations for treating children with a body mass index (BMI) over the 85th percentile in the primary care setting have been developed by an Expert Committee on childhood. Programs are needed that meet the recommendations from the Committee, which include: 1) beginning treatment as young as possible; 2) focusing on the family, with the parent being the primary change agent for treatment; 3) using behavior modification techniques to change eating and activity behaviors; and 4) making 2 or 3 very specific changes in diet and activity at one time. Thus, the aim of this R21 application is to develop, implement, and evaluate a 6-month behavioral childhood obesity intervention that meets the Committee's recommendations and can be implemented in a primary care setting. A second aim of this project is to determine which eating and activity behaviors should be targeted in the intervention. One hundred thirty-five children, aged 4 to 8 years with a BMI > 85th percentile, assessed and referred by their pediatricians, will be randomized to one of three conditions: 1) a newsletter condition; 2) a Behavioral Parenting Program that increases physical activity (60 min/day) and decreases sweetened drink consumption (< 3 servings/week) (Traditional); or 3) a Behavioral Parenting Program that reduces TV watching (< 2 hours/day) and increases low-fat milk consumption (2 servings/day) (Substitutes). Follow-up assessments on weight, height, and standardized BMI (z-BMI), the primary dependent variable, will be conducted at 3, 6, 9, and 12 months. Pediatricians will provide follow-up letters to families, regarding weight and height status, following the assessments. This pilot study allows us to determine the feasibility and efficacy of a pediatric obesity intervention that optimizes the role of the pediatrician and meets the Committee's recommendations for treatment in a primary care setting. Moreover, by comparing the effects of targeting the traditional or substitute behaviors, data will be obtained for a power analysis for a full-scale trial of the effects of these two approaches on long-term weight loss.