Clinic, Family & Community Collaboration to Treat Overweight and Obese Children

诊所、家庭

基本信息

批准号：
8136548
负责人：
THOMAS N. ROBINSON
金额：
$ 111.49万
依托单位：
STANFORD UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-09-01 至 2017-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8136548
关键词：
Academic achievement Advocacy Agreement Anthropology Behavior Behavioral Biological Blood Pressure Body mass index C-reactive protein California Caring Centers for Disease Control and Prevention (U.S.)Child Child Behavior Child health care Childhood Cholesterol Cities Clinic Clinical Clinical Management Clinical Psychology Clinical Research Collaborations Communities Control Groups Counseling DNA Data Decision Making Diabetes Mellitus Diastolic blood pressure Dietary intake Eating Economic Models Economics Endocrinology Energy Intake Enrollment Environment Epidemiology Exercise Exercise Physiology Failure Family Family Study Fasting Fatty acid glycerol esters Food Future Genetic Glucose Growth Health Priorities Health Professional Heart Rate High Density Lipoprotein Cholesterol High Density Lipoproteins Home environment Individual Insulin Intervention Knowledge LDL Cholesterol Lipoproteins Link Lipoproteins Low income Low-Density Lipoproteins Mediating Medical Modeling Morbidity - disease rate National Institute of Diabetes and Digestive and Kidney Diseases Neurosciences Obesity Outcome Measure Overweight Parents Participant Pediatric Hospitals Pediatric Research Pediatrics Phase Physical activity Physiological Physiology Pilot Projects Population Primary Health Care Process Provider Public Health Public Policy Qualifying Randomized Randomized Controlled Trials Recruitment Activity Redwood Research Research Design Research Infrastructure Resources Rest Schools Site Skinfold Thickness Social Development Social Psychology Sports Subgroup Translating Triceps Brachii Muscle Triglycerides Universities Weight Weight maintenance regimen Youth after-school program base boys clinical care clinical practice community based participatory research cost effectiveness depressive symptoms design economic cost eligible participant energy balance experience girls glucose metabolism improved innovation mortality novel nutrition obesity in children obesity prevention obesity risk obesity treatment patient population policy implication primary outcome programs psychologic research study secondary outcome sedentary social socioeconomics standard care success theories therapy design tv watching waist circumference

项目摘要

DESCRIPTION (provided by applicant): We propose an innovative, integrated, multi-component, multi-level, multi-setting (MMM) approach to treating overweight and obese children (BMI > 85th percentile). The experimental MMM intervention is based on successful past research and ongoing community based participatory research (CBPR), and is designed to overcome barriers to existing treatment models. It includes: a theory-based community center team sports program designed specifically for overweight & obese children; a home-based family intervention to reduce screen time and to alter the home food/eating environment; and a primary care provider behavioral counseling intervention linked to the community and home interventions. After two years of formative research and pilot studies, we will evaluate our intervention in a randomized controlled trial. 240 families with overweight and obese children will be recruited through primary care pediatric clinics serving low-income, ethnically-diverse patient populations in East Palo Alto and Redwood City, California. Eligible participants will be referred by their primary medical care providers to after school programs conducted by their local YMCAs and Boys and Girls Clubs. After completing baseline assessments and enrolling in the study, families will be randomized to standard clinical care and the standard community center programs, or to the experimental MMM intervention for 36 months. All participants will complete assessments at baseline, 12 months, 24 months and 36 months. The primary outcome measure is change in BMI over the entire course of the study. Secondary outcomes include changes to 12 and 24 months, and changes in waist circumference, triceps skinfold thickness, blood pressures, heart rate, fasting lipoprotein levels, glucose and Insulin, hsCRP, physical activity (accelerometery), screen time and other sedentary behaviors, dietary intake, weight concerns, and depressive symptoms. DNA will be collected to identify genetic moderators of intervention responsiveness. We will compare the MMM intervention and standard care control groups using random regression models to take full advantage of all longitudinal data. Primary Hypothesis: Compared to standard care controls, children randomized to our multi-component, multi-level, multi-setting (MMM) intervention will significantly reduce their body mass index. We will also examine potential baseline biological, psychological, social and environmental moderating and mediating variables, cost-effectiveness and public policy implications. RELEVANCE: Existing pediatric weight control programs are often insufficient. We propose a novel, integrated, multi-component, multi-level, multi-setting treatment model based on successful past research and designed to be more generalizable to real world communities and populations.

描述（由申请人提供）：我们提出了一种创新，综合，多组分，多级，多设定（MMM）方法来治疗超重和肥胖儿童（BMI> 85％）。实验性MMM干预基于过去的成功研究和持续的基于社区的参与研究（CBPR），旨在克服现有治疗模型的障碍。它包括：一个基于理论的社区中心团队体育计划，专门为超重和肥胖儿童设计；一项基于家庭的家庭干预措施，以减少屏幕时间并改变家庭食物/饮食环境；以及与社区和家庭干预有关的初级保健提供者的行为咨询干预措施。经过两年的形成性研究和试点研究，我们将在一项随机对照试验中评估干预措施。 240个拥有超重和肥胖儿童的家庭将通过初级保健儿科诊所招募，在东帕洛阿尔托和加利福尼亚州红伍德市提供低收入，多样化的患者人群。符合条件的参与者将由其主要医疗服务提供者介绍其当地YMCAS和男孩和女孩俱乐部进行的课后课程。在完成基线评估并参加了研究之后，家庭将被随机分配到标准的临床护理和标准社区中心计划，或者进行36个月的实验MMM干预。所有参与者将在基线，12个月，24个月零36个月的基线完成评估。主要结果指标是整个研究过程中BMI的变化。次要结果包括变化为12个月和24个月，以及腰围的变化，三头肌折叠厚度，血压，心率，空腹脂蛋白水平，葡萄糖和胰岛素，HSCRP，体育锻炼（加速度），筛查时间和其他久坐的行为和其他久坐的行为和其他久坐的摄入量，饮食摄入，体重，关注，抑郁症和抑郁症状。将收集DNA以识别干预反应的遗传主持人。我们将使用随机回归模型比较MMM干预和标准护理控制组，以充分利用所有纵向数据。主要假设：与标准护理对照组相比，儿童随机与我们的多组分，多级，多设定（MMM）干预将大大减少其体重指数。我们还将研究潜在的基线生物学，心理，社会和环境调节和调解变量，成本效益和公共政策的影响。相关性：现有的小儿体重控制计划通常不足。我们提出了一种基于过去的研究的新颖，综合，多组分，多层次，多设定的治疗模型，并旨在对现实世界的社区和人口更具概括性。