Enhancing Family-Based Behavioral Pediatric Obesity Treatment via Social Networks

描述（由申请人提供）：以家庭为基础的儿童肥胖治疗（FBT）的长期有效性有限。致胖环境威胁到家庭维持健康体重管理行为的能力，但大多数干预措施只关注父母-子女二元关系（养育子女的变化），忽视了更大的社会关系背景。现有的干预措施教导父母和儿童体重管理和短期坚持所需的行为技能，但最近的社会环境未能支持维持行为改变严重挑战他们的长期成功。我们的初步数据表明，自然发生的社交网络可以而且应该参与支持父母试图管理孩子的体重状况。这个R21探索性试验解决了父母的社会网络在行为改变过程中的作用。其目的是（1）开发一种创新的干预措施，利用自然发生的关系来吸引父母的社会支持网络，以加强健康行为的维持和更好的体重管理（社交网络参与干预，或SNE）;以及（2）在单臂试验中试行这种干预措施。这种干预的新元素包括使用社会计量数据来创建SNE策略，以及教授父母核心技能，以促进与家人和朋友的支持性互动。先导试验将（a）评估干预的可接受性和可行性，（B）评估其对干预目标（解决问题的技能、社会支持和社会网络特征）的影响，以及（c）估计儿童BMI的效应大小。我们的多学科研究团队在儿童肥胖治疗、行为改变和社交网络方面拥有专业知识。这项研究是第一个评估和加强家庭周围的社会支持网络，作为改变社会环境的一种手段，以促进维持减肥行为。 公共卫生相关性：这个探索性的试点项目解决了儿童肥胖治疗导致持续健康行为改变的失败，并利用父母自然产生的社交网络为体重管理创造一个更支持的社会环境。我们将开发一种社会网络参与（SNE）干预，将其整合到儿童超重的标准治疗计划中。我们会进行新能源的试验，评估其可行性，并逐步进行全面评估。

DESCRIPTION (provided by applicant): Long-term effectiveness of family-based pediatric obesity treatment (FBT) is limited. The obesogenic environment threatens the family's ability to maintain healthy weight management behaviors, yet most interventions focus only on the parent-child dyad (changes in parenting) ignoring the larger social-relational context. Existing interventions teach parents and children behavioral skills needed for weight management and short-term adherence, but a failure of the proximal social environment to support maintenance of behavior change severely challenges their long-term success. Our preliminary data suggest that naturally-occurring social networks can and should be engaged in support of parents' attempts to manage their children's weight status. This R21 exploratory pilot address the role of parents' social network on the behavior change process. Its aims are (1) to develop an innovative intervention that capitalizes on naturally-occurring relationships to engage the parents' social support networks to enhance maintenance of healthy behaviors and better weight management (Social Network Engagement intervention, or SNE); and (2) to pilot this intervention in a single- arm trial. Novel elements of this intervention include the use of sociometric data to create a SNE strategy as well as teaching parents core skills to promote supportive interaction with their family and friends. The pilot trial will (a) assess the acceptability and feasibility of intervention, (b) evaluate its impact on intervention targets (problem-solving skill, social support and social network characteristics) and (c) estimate effect size with respect to child BMI. Our multi-disciplinary research team has expertise in pediatric obesity treatment, behavior change, and social networks. This study is among the first to assess and enhance social support networks surrounding the family as a means of changing the social environment to promote maintenance of obesity reduction behaviors. PUBLIC HEALTH RELEVANCE: This exploratory pilot project addresses the failure of pediatric obesity treatment to lead to sustained health behavior change and capitalizes on parents' naturally occurring social networks to create a more supportive social environment for weight management. We will develop a Social Network Engagement (SNE) Intervention that will be integrated into a standard treatment program for childhood overweight. We will conduct a pilot trial of SNE to assess its feasibility and take steps toward and full-scale evaluation.