Enhancing Family-Based Behavioral Pediatric Obesity Treatment via Social Networks

描述(申请人提供)：以家庭为基础的儿童肥胖症治疗(FBT)的长期效果有限。肥胖环境威胁着家庭维持健康体重管理行为的能力，然而大多数干预只关注亲子二重(父母养育方式的改变)，而忽视了更大的社会关系背景。现有的干预措施教会了父母和孩子体重控制和短期坚持所需的行为技能，但最近的社会环境未能支持行为变化的维持，严重挑战了他们的长期成功。我们的初步数据表明，自然产生的社交网络可以也应该参与支持父母管理孩子体重状况的尝试。这项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。它的目标是(1)开发一种创新的干预措施，利用自然发生的关系来参与父母的社会支持网络，以加强对健康行为的维持和更好的体重管理(社交网络参与干预，简称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战略，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。试点试验将(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)估计对儿童BMI的影响程度。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。这项研究是第一批评估和加强围绕家庭的社会支持网络，作为改变社会环境以促进减肥行为的手段之一。

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.