Comprehensive Approach to Family Weight Management

家庭体重管理的综合方法

• 批准号: 7841927
• 负责人: JUDITH WYLIE-ROSETT
• 金额: $ 69.89万
• 依托单位: ALBERT EINSTEIN COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-05-01 至 2013-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7841927
• 关键词: 12 year old; Address; Adoption; Adult; Affect; Age; American; Behavior; Behavioral Model; Biological Markers; Body mass index; Child; Childhood; Clinic; Collaborations; Community Health; Computerized Medical Record; Consult; Counseling; Data; Dietary intake; Effectiveness; Enrollment; Environment; Evaluation; Evaluation Studies; Family; Family member; Food; Goals; Health; Healthy People 2010; High Prevalence; Hispanics; Hospitals; Individual; Intervention; Life Style; Maintenance; Managed Care; Measures; Medicaid; Medical; Medical Staff; Metabolic; Modeling; Motivation; New York City; Newsletter; Obesity; Overweight; Parents; Participant; Physical activity; Poverty; Prevalence; Prevention strategy; Primary Health Care; Process Measure; Professional Education; Quality Control; Randomized; Randomized Controlled Clinical Trials; Readiness; Role; Schools; Services; Social Marketing; Students; Surveys; Target Populations; Techniques; Testing; Training Support; Weight; Weight maintenance regimen; Youth; arm; base; cost; cost effectiveness; follow-up; improved; intervention effect; obesity prevention; post intervention; programs; sedentary; sex; skills; social; staff intervention; theories

DESCRIPTION (provided by applicant): Project Summary: The purpose of this study is to address the Healthy People 2010 obesity prevention objective. This study will test the effects of a comprehensive family weight management program on the BMI z-score of 7-12 year-old children with a BMI > 85th percentile who receive primary care in a large municipal Bronx hospital. The intervention framework will draw on social marketing theory and the transtheoretical model of behavioral change to incorporate successful obesity prevention strategies. A two-arm randomized controlled clinical trial (RCT), which will enroll (n =506) 7-12 year old children with a = 85th BMI percentile, will compare the Experimental Intensive Intervention to a Standard (Control) Intervention. The Standard Intervention will receive: 1) an initial consult, which includes an overview of lifestyle goals, 2) quarterly follow-up, 3) and a monthly newsletter. The Intensive Intervention will add: 1)12 core group modules for parents (to address roles and skills) and for children (to enhance motivation and skills and to provide physical activity), 3) Tailored support using a }toolbox} approach from community health workers as extensions of the Family Weight Management professional education staff, and 4) monthly after-core follow-up groups. The study will determine if children randomized to the Experimental Intensive Intervention will have greater improvement in BMI change (z-scores) than those randomized to the Control Standard Intervention. The study will also evaluate the effects on the Experimental Intervention on lifestyle variables and assess intervention costs. The RE-AIM evaluation will address: Reach: How many of the eligible children/ families were referred and how many of those referred actually enrolled? We will use BMI data in the computerized medical records to evaluate the proportion and the appropriateness of the referrals. Efficacy/Effectiveness: How did the Experimental intervention affect BMI (changes in z-score), and key biomarkers when followed as planned? Adoption: How acceptable were the intervention(s) to the primary care medical team and the children/families in the pediatric clinics etc? (from process measures and post intervention surveys) Implementation: How many of the intervention activities were provided as planned? Quality control measures will be used to evaluate the integrity of the intervention(s). Maintenance: How much of the intervention effect is sustainable? Individual effects will be evaluated based on the 24 month follow data. Institutional effects evaluation will include the potential to maintain services using third-party coverage. Project Narrative The purpose of this study is to address the Healthy People 2010 obesity prevention objective and to test a comprehensive family weight management program in 7-12 year- old Bronx children who are overweight. The study will randomize 506 children to the Experimental (Intensive) Intervention or to a Standard (Control) Intervention. The Standard Intervention will receive: 1) an initial consult, which includes an overview of lifestyle goals, 2) quarterly follow-up, 3) and a monthly newsletter. The Intensive Intervention will add: 1)12 core group modules for parents (to address roles and skills) and for children (to enhance motivation and skills and to provide physical activity), 3) tailored support using a "toolbox" approach from community health workers as extensions of the Family Weight Management professional education staff, and 4) Monthly after-core follow-up groups.

描述（由申请人提供）： 项目摘要：本研究的目的是实现“健康人 2010”肥胖预防目标。本研究将测试综合家庭体重管理计划对在布朗克斯一家大型市立医院接受初级保健的 BMI > 85% 的 7-12 岁儿童的 BMI z 分数的影响。干预框架将借鉴社会营销理论和行为改变的跨理论模型，以纳入成功的肥胖预防策略。一项双组随机对照临床试验 (RCT) 将招募 (n = 506) BMI 百分位数 = 85 的 7-12 岁儿童，将实验强化干预与标准（对照）干预进行比较。标准干预将收到：1) 初步咨询，其中包括生活方式目标概述，2) 每季度跟进，3) 和每月通讯。强化干预将增加：1）针对父母（解决角色和技能）和针对儿童（增强动机和技能并提供身体活动）的 12 个核心小组模块，3）使用社区卫生工作者的“工具箱”方法提供定制支持，作为家庭体重管理专业教育人员的延伸，以及 4）每月核心后续小组。该研究将确定随机接受实验强化干预的儿童是否比随机接受对照标准干预的儿童在体重指数变化（z 分数）方面有更大的改善。该研究还将评估实验干预对生活方式变量的影响并评估干预成本。 RE-AIM 评估将解决： 覆盖范围：有多少符合资格的儿童/家庭被推荐，其中有多少被推荐实际入学？我们将使用电脑病历中的体重指数数据来评估转诊的比例和适当性。功效/效果：按计划进行时，实验干预措施如何影响 BMI（z 分数的变化）和关键生物标志物？收养：初级保健医疗团队和儿科诊所等儿童/家庭对干预措施的接受程度如何？ （来自过程测量和干预后调查） 实施：有多少干预活动按计划进行？将使用质量控制措施来评估干预措施的完整性。维持：干预效果有多少是可持续的？个人效果将根据 24 个月的跟踪数据进行评估。机构影响评估将包括使用第三方覆盖维持服务的潜力。 项目叙述 本研究的目的是实现 Healthy People 2010 肥胖预防目标，并测试针对 7-12 岁布朗克斯超重儿童的综合家庭体重管理计划。该研究将 506 名儿童随机分为实验（强化）干预组或标准（对照）干预组。标准干预将收到：1) 初步咨询，其中包括生活方式目标概述，2) 每季度跟进，3) 和每月通讯。强化干预将增加：1) 12 个针对父母（解决角色和技能）和儿童（增强动机和技能并提供身体活动）的核心小组模块，3）使用社区卫生工作者的“工具箱”方法提供定制支持，作为家庭体重管理专业教育人员的延伸，以及 4）每月核心后续小组。