Systems Approach to Obesity Prevention in Underserved Children in Texas

德克萨斯州服务不足的儿童预防肥胖的系统方法

• 批准号: 8255266
• 负责人: DEANNA MARIE HOELSCHER
• 金额: $ 174.62万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-30 至 2015-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8255266
• 关键词: Systems; Approach; Obesity; Prevention; Underserved

DESCRIPTION (provided by applicant): Project Summary/Abstract Despite intensive national efforts to address childhood obesity, the epidemic persists. Recognizing the challenges, the National Institutes of Health (NIH) and the Institute of Medicine (IOM) have called for a systems-oriented approach to address childhood obesity. We hypothesize that among low-income, ethnically diverse overweight and obese children, aged 2-12 years, a systems approach to child obesity incorporating secondary prevention programs embedded within primary prevention will reduce body mass index (BMI) z-scores compared to primary prevention alone. Intervention strategies will be adapted from the portfolio of evidence-based programs developed by study investigators. An assets-based assessment will be conducted with research and community partners in disadvantaged neighborhood catchment areas in Austin and Houston; data will inform integration of intervention strategies and provide a structure for program sustainability. Our specific study aims are: Aim 1: To implement and evaluate a primary prevention obesity program in low-income, ethnically diverse catchment areas in Austin and Houston. Baseline and 2-year follow-up data on the prevalence of child overweight, risk factors, and the availability of healthcare services and community programs will be collected in 2 demonstration (n=1614) and 2 control catchment areas (n=1614). Parent, child and community data will provide matched comparison data to assess the efficacy of the primary prevention intervention. Aim 2: To implement and evaluate the efficacy of a systems approach to child obesity on reducing obesity by embedding a 12-month family-based secondary prevention program within the community primary prevention program. The secondary prevention weight management program will be conducted with overweight/obese children and their families in the primary prevention catchment areas. Families of overweight/obese children (total n=576), aged 2-12 years, will be randomly assigned to either the 12-month secondary prevention program (experimental) or prevention program alone (control), stratified by age (2-5, 6-8, and 9-12 y). Outcomes include child BMI z-score, quality of life measures, and program use indicators. Aim 3: To quantify the incremental cost-effectiveness of the 12-month family-based secondary prevention program relative to primary prevention alone for child obesity. Activity Based Costing methods will be used to quantify the incremental cost of delivering the secondary prevention program relative to primary prevention. Public Health Relevance: If this research trial is proven efficacious and cost-effective, the demonstration project could be disseminated widely to address obesity among underserved, at risk children. Program sustainability will be ensured through active involvement of community partners within healthcare, childcare, schools and community sectors.

描述（由申请人提供）：项目摘要/摘要尽管密集的国家努力解决儿童肥胖症，流行病仍然存在。认识到这些挑战，美国国立卫生研究院（NIH）和医学研究所（IOM）呼吁采取系统导向的方法来解决儿童肥胖问题。我们假设，在低收入，不同种族的超重和肥胖儿童，年龄2-12岁，一个系统的方法，儿童肥胖症纳入二级预防计划嵌入一级预防将降低体重指数（BMI）的z分数相比，一级预防单独。干预策略将根据研究者制定的循证方案组合进行调整。将与奥斯汀和休斯顿弱势社区集水区的研究和社区合作伙伴进行基于资产的评估;数据将为干预战略的整合提供信息，并为方案的可持续性提供结构。我们的具体研究目标是：目标1：在奥斯汀和休斯顿的低收入、种族多样化的集水区实施和评估一级预防肥胖计划。将在2个示范区（n=1614）和2个对照集水区（n = 1614）收集儿童超重患病率、风险因素以及医疗服务和社区项目可用性的基线和2年随访数据。父母、儿童和社区数据将提供匹配的比较数据，以评估一级预防干预措施的有效性。目标二：通过在社区一级预防计划中嵌入12个月的以家庭为基础的二级预防计划，实施并评估儿童肥胖系统方法对减少肥胖的有效性。二级预防体重管理计划将在一级预防集水区对超重/肥胖儿童及其家庭进行。年龄在2-12岁的超重/肥胖儿童家庭（总数n=576）将被随机分配到12个月的二级预防计划（实验）或单独的预防计划（对照），按年龄分层（2-5岁，6-8岁和9-12岁）。结果包括儿童BMI z评分，生活质量指标和计划使用指标。目标三：量化12个月的以家庭为基础的二级预防计划相对于单纯的儿童肥胖一级预防的增量成本效益。将使用基于活动的成本计算方法来量化相对于一级预防实施二级预防计划的增量成本。公共卫生相关性：如果这项研究试验被证明是有效的和具有成本效益的，示范项目可以广泛传播，以解决服务不足的高危儿童的肥胖问题。将通过社区伙伴积极参与保健、儿童保育、学校和社区部门的工作，确保方案的可持续性。