Web-based Family Intervention for Pediatric Obesity

描述(申请人提供)：最近的研究表明，儿童超重和肥胖的发生率非常高(约25%-30%)，而且发病率正在上升，特别是在少数民族非裔美国人和西班牙裔儿童中。儿童时期的肥胖与青春期和成年期肥胖持续的高风险有关。这对公共卫生具有重大意义，因为肥胖会增加患2型糖尿病和心血管疾病的风险。经经验验证的干预措施可用于治疗儿童肥胖症。然而，儿童肥胖治疗的主要困难之一是获得有效的治疗方案；大多数超重儿童没有接受正式的基于家庭的行为体重控制干预。因此，应对儿童肥胖流行的一个关键问题是如何为超重儿童人群提供有效的治疗。我们认为，儿科医生对这一重大公共卫生问题的更多关注为提供更多有效干预提供了机会。我们建议开发一个创新的网络计划，以支持儿科减肥，基于那些在肥胖儿童临床研究中被证明有效的原则。我们设想了一个系统，在这个系统中，儿科医生将超重儿童识别为常规初级保健的一部分，然后让家庭访问一个网站，该网站旨在提高他们对肥胖问题及其相关健康风险的认识，并通过发展健康的饮食和体育活动习惯来增强他们改变生活方式以减少超重的动力。随着时间的推移，儿童和家长将访问该网站，该系统将生成关于使用情况的报告，以及健康行为和体重变化的报告，并以电子方式发送给推荐的儿科医生。在第一阶段，我们将在一个网站上开发一个针对父母及其超重儿童的互动原型。原型将使用现有有效的基于家庭的行为干预的几个概念和技能，以及超重儿童、他们的父母和儿科医生的重点小组的意见来开发。我们将通过评估超重儿童及其父母的健康行为，以及他们和转诊的儿科医生在使用通过互联网网站提供的互动程序前后的态度、知识、使用意图、感知障碍和消费者满意度来评估原型的整体可用性。

DESCRIPTION (provided by applicant): Recent studies indicate that the prevalence of overweight and obesity in children is very high (about 25-30 percent), and the incidence is increasing, especially among minority African- American and Hispanic children. Obesity in childhood is associated with a high risk of continued obesity into adolescence and adulthood. This is of great public health significance because obesity increases risk for the development of type 2 diabetes and cardiovascular disease. Empirically validated interventions are available for the treatment of pediatric obesity. However, one of the major difficulties with treatment of pediatric obesity is access to effective treatment programs; the majority of overweight children do not receive formal family-based behavioral weight control intervention. Therefore, a key issue in dealing with the epidemic of pediatric obesity is how to provide effective treatment to the population of overweight children. We believe that pediatricians' increased attention to this significant public health problem affords an opportunity for providing greater access to effective intervention. We propose to develop an innovative web program to support pediatric weight loss, based on those principles shown to be effective in clinical studies of obese children. We envision a system in which pediatricians identify overweight children as part of routine primary care, and then refer families to a web site designed to increase their awareness of the problem of obesity and its associated health risks, as well as increase their motivation to engage in lifestyle change to reduce overweight through the development of healthful dietary and physical activity habits. The web site will be accessed by children and parents over time and the system will generate reports on usage, as well as health behaviors and weight changes to be sent electronically to the referring pediatricians. During Phase I, we will develop an interactive prototype on a web site aimed at parents and their overweight children. The prototype will be developed using several of the concepts and skills from existing effective family-based behavioral interventions, as well as input from focus groups of overweight children, their parents, and pediatricians. We will evaluate the overall usability of the prototype by assessing health behaviors of overweight children and their parents, as well as their and the referring pediatricians' attitudes, knowledge, intent to use, perceived barriers, and consumer satisfaction both pre and post use of the interactive program presented via the internet web site.