BM12: Brief Motivational Interviewing to Reduce Child BMI

BM12：减少儿童体重指数的简短动机访谈

• 批准号: 7372612
• 负责人: Ken A. Resnicow
• 金额: $ 66.85万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-04-01 至 2013-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7372612
• 关键词: Academy; Accident and Emergency department; Address; Age; American; American Dietetic Association; Behavior; Behavior Therapy; Behavioral; Body mass index; Caring; Centers for Disease Control and Prevention (U.S.); Child; Childhood; Collaborations; Consumption; Continuing Education; Counseling; Data Reporting; Diet; Dietitian; Educational Intervention; Educational Materials; Educational workshop; Effectiveness of Interventions; Enrollment; Evidence based intervention; Health; Intake; Intervention; Life Style; Mediation; Metric; Modeling; Numbers; Obesity; Outcome; Outpatients; Overweight; Parents; Patient Self-Report; Patients; Pediatric Research; Pediatrics; Persons; Physical activity; Pilot Projects; Policies; Primary Health Care; Process; Public Health; Questionnaires; Randomized; Relative (related person); Reporting; SERPINI2 gene; Schedule; Screening procedure; Series; Supervision; System; Target Populations; Telephone; Television; Testing; Training; Videotape; Visit; Weight; Work; Youth; base; cohort; cost; cost effectiveness; day; design; drinking; efficacy trial; feeding; follow-up; fruits and vegetables; heme oxygenase-1; indexing; instrument; motivational enhancement therapy; nutrition; obesity treatment; pediatrician; programs; response; sugar; tool; tv watching

DESCRIPTION (provided by applicant): Working with the PROS (Pediatric Research in Office Settings) Network of the American Academy of Pediatrics (AAP), the American Dietetic Association (ADA), and the Centers for Disease Control (CDC), we will conduct an efficacy trial among 30 PROS practices to test two interventions that address many of the key barriers to obesity counseling in pediatric primary care. The target population will be 600 youth ages 2-8 with a BMI >= 85th and =< 97th percentile. We will employ a cluster-randomized design with PROS practice as the unit of randomization with three experimental groups. Group 1 (Usual Care-UC) will include determination of BMI percentile at baseline, 1 year, and 2 year follow up. UC practitioners will provide parents with a series of educational tip sheets as well as an educational video tape. UC pediatricians (PEDS) will also receive a = day study orientation session that will include a brief CME-type workshop addressing obesity treatment. Group 2 (PED only) will include the same assessments, enrollment criterion and educational materials as UC. In addition, Group 2 PEDs will receive 2.0 days of in-person training in Motivational Interviewing (MI) plus 2 telephone based counseling supervision sessions, and an interactive DVD MI booster training system to be developed during year 1. PEDs in Group 2 will schedule 3 proactive counseling sessions with a parent of the index child in Year 1 and 1 additional visits in year 2. Group 2 PEDS will be reimbursed $50 per visit. Group 3 (PED+RD) will include the same training and intervention components as Group 2, but will add counseling from a trained dietitian (RD). RDs will deliver 6 MI-based counseling sessions over 2 years, frontloaded with 4 contacts in year 1 and 2 in year 2. The RD sessions will be delivered both in-person and by telephone. RDs will receive 2.0 days of in-person MI training jointly with PEDS, plus 2 telephone-based supervision sessions. RDs will be compensated $50 per in-person visit and $35 for telephone sessions. The project is significantly informed by a recently completed pilot study conducted with AAP PROS, along with the team that will conduct the proposed study. The primary outcome for the trial will be child's BMI percentile at 2 year followup. Secondary outcomes include physical activity by accelerometry, diet and activity via 24hr recall and self report questionnaire, and parental feeding practices. Process, mediation, and cost effectiveness analyses will also be conducted. Pediatric obesity remains a major public health problem. There is a paucity of evidenced- based intervention models to assist primary care practitioners to treat their overweight pediatric patients. The results of this study could impact training, policy, and reimbursement of obesity care in pediatric practice.

描述（由申请人提供）：我们将与美国儿科学会 (AAP)、美国饮食协会 (ADA) 和疾病控制中心 (CDC) 的 PROS（办公室环境中的儿科研究）网络合作，对 30 个 PROS 实践进行有效性试验，以测试两种干预措施，以解决儿科初级保健中肥胖咨询的许多关键障碍。目标人群为 600 名 2-8 岁且 BMI >= 85% 且 =< 97% 的青少年。我们将采用以 PROS 实践为随机化单位的整群随机化设计，分为三个实验组。第 1 组（常规护理-UC）将包括确定基线、1 年和 2 年随访时的 BMI 百分位。 UC 从业人员将为家长提供一系列教育提示表以及教育录像带。加州大学儿科医生 (PEDS) 还将接受一天的研究指导会议，其中包括一个简短的 CME 型研讨会，讨论肥胖治疗问题。第 2 组（仅限 PED）将包括与 UC 相同的评估、入学标准和教育材料。此外，第 2 组 PED 将接受 2.0 天的动机访谈 (MI) 现场培训，加上 2 次基于电话的咨询监督课程，以及将在第 1 年开发的交互式 DVD MI 加强培训系统。第 2 组 PED 将在第 1 年与指标儿童的家长安排 3 次主动咨询课程，并在第 2 年安排 1 次额外访问。第 2 组 PEDS 每次访问将获得 50 美元的报销。第 3 组 (PED+RD) 将包括与第 2 组相同的培训和干预内容，但将增加经过培训的营养师 (RD) 的咨询。 RD 将在 2 年内提供 6 场基于 MI 的咨询课程，其中第一年有 4 名联系人，第二年有 2 名联系人。RD 课程将通过面对面和电话方式进行。 RD 将与 PEDS 联合接受 2.0 天的面对面 MI 培训，以及 2 次电话监督课程。 RD 每次亲自拜访将获得 50 美元的补偿，电话会议将获得 35 美元的补偿。最近完成的一项试点研究为该项目提供了重要信息，该研究与 AAP PROS 以及将进行拟议研究的团队一起进行。试验的主要结果是 2 年随访时儿童的 BMI 百分位。次要结果包括通过加速度测量进行的身体活动、通过 24 小时回忆和自我报告调查问卷进行的饮食和活动以及父母的喂养方式。还将进行流程、调解和成本效益分析。儿童肥胖仍然是一个主要的公共卫生问题。缺乏循证干预模型来帮助初级保健医生治疗超重儿科患者。这项研究的结果可能会影响儿科实践中肥胖护理的培训、政策和报销。