MA Childhood Obesity Research

描述(由申请人提供)：项目摘要拟议的运动中的群众：社区-临床伙伴关系以减少儿童肥胖将使用肥胖慢性护理模式来实施和评估一项全面、系统的干预措施，以减少服务不足的儿童中的儿童肥胖症。马萨诸塞州公共卫生部(MDPH)与哈佛医学院人口医学系、哈佛公共卫生学院和国家儿童保健质量倡议合作，寻求通过全州范围的群众运动健康倡议在社区建立良好的社区经验和相关的临床肥胖症预防工作，在菲奇堡和新贝德福德两个城市开发干预措施，可在全州复制。这项研究提出了多部门、多层次的综合办法。它纳入了以循证为基础的干预措施，包括初级卫生保健(儿童高五)、儿童护理(我在移动，我在学习；午睡SACC)和学校/课后计划(食物和乐趣、吃得好、保持移动和地球健康)，以及政策变化和社区范围的社会营销活动，以防止或减少以低收入为主的2-12岁儿童的肥胖。我们将使用事前时间序列和准实验设计相结合的方法，检验我们对个人水平的生活方式行为、体重指数(BMI)变化、对医疗服务的满意度和生活质量的干预效果。具体目标是：(1)在干预与比较社区中，检查以儿科初级保健、早期教育和儿童保育计划、小学和中学、课后计划和社区范围的社会营销活动为基础的多层次、多部门的儿童干预措施在多大程度上改善肥胖行为。(2)在干预与对照社区中，实现较小的年龄相关的BMI增加。(3)在干预社区的保健中心，在以下方面有所增加：对所有2-12岁儿童进行体重指数筛查和咨询；多学科临床小组和社区卫生工作者协调护理具有特定年龄和性别的体重指数e第85百分位数的儿童；父母对服务的满意度和与儿童肥胖有关的生活质量。(4)收集干预活动费用的数据，为成本效益分析做准备。(5)为MDPH制定详细的实施和传播指南，以支持该州其他社区的收养。

DESCRIPTION (provided by applicant): Project abstract The proposed Mass in Motion: Community-Clinical Partnerships to Reduce Childhood Obesity will use the Obesity Chronic Care Model to implement and evaluate a comprehensive, systematic intervention to reduce childhood obesity among underserved children. The Massachusetts Department of Public Health (MDPH), in partnership with the Department of Population Medicine at Harvard Medical School, the Harvard School of Public Health, and the National Initiative for Children's Healthcare Quality, seeks to build on promising community-level experience and related clinical obesity prevention work in communities through the statewide Mass in Motion wellness initiative to develop an intervention in two cities, Fitchburg and New Bedford, that could be replicated throughout the state. The study proposes an integrated multi-sector and multi-level approach. It incorporates evidence-based interventions in primary health care (High Five for Kids), child care (I Am Moving, I am Learning; NAP SACC) and schools/after-school programs (Food & Fun, Eat Well and Keep Moving, and Planet Health), as well as policy change and a community-wide social marketing campaign to prevent or reduce obesity among predominantly low-income 2-12-year- old children. Using a combination of pre- post time series and quasi-experimental designs, we will examine the effectiveness of our intervention on individual-level lifestyle behaviors, change in body mass index (BMI), satisfaction with health care services, and quality of life. The Specific Aims are: (1) In intervention v. comparison communities, examine the extent to which a multi-level, multi-sector intervention for children, based in pediatric primary care, early educatin and child care programs, elementary and middle schools, after school programs, and a community-wide social marketing campaign results in improvements in obesogenic behaviors. (2) In intervention v. comparison communities, achieve smaller age associated increases in BMI. (3) In health centers in the intervention communities, demonstrate increases in: BMI screening and counseling on the 5 targeted obesity-related behaviors for all children ages 2-12 years; Coordinated care by a multi-disciplinary clinical team and community health workers for children with an age- and sex-specific BMI e 85th percentile; Parental satisfaction with services and child obesity-related quality of life. (4) Collect data on the costs of the intervention activiies in preparation for cost-effectiveness analyses. (5) Develop a detailed implementation and dissemination guide for MDPH to use to support adoption in other communities across the state.